嗜铬细胞瘤/副神节瘤的围手术期处理

Perioperative management for pheochromocytoma/paraganglioma

嗜铬细胞瘤/副神节瘤是由神经嵴起源的嗜铬细胞产生的肿瘤,具有分泌儿茶酚胺的功能,而儿茶酚胺作用于血管、心脏,常常引起血液循环系统及代谢的改变。嗜铬细胞瘤手术前后血液中儿茶酚胺浓度的变化会引起相应血液动力学的改变,若没有充分的术前准备和术后监护,心血管意外事件的发生几率很高。因此,了解嗜铬细胞瘤/副神节瘤的病理学特点,术前进行良好的药物准备,术中轻柔的手术操作及与麻醉师的良好配合,术后ICU的严密监护,是嗜铬细胞瘤围手术期处理的关键,也是嗜铬细胞瘤/副神节瘤成功治疗的基本保障。

Pheochromocytoma/paraganglioma is a tumor originated from the neural crest,which can secrete catecholamine,while catecholamine can affect the metabolism and blood circulatory system.The changes of catecholamine concentration in blood before and after surgery will affect hemodynamics.Without adequate preoperative preparation and postoperative care,the incidence of cardiovascular events is high.Therefore,good understanding of the pathophysiologcal characteristics of pheochromocytoma/paraganglioma,careful preparation of drugs before operation,gentle surgical operation and good cooperation between surgeons and anesthetists during operation,and intensive care in ICU after operation are the key components of perioperative management and the basis for successful treatment.