特拉唑嗪和酚苄明在嗜铬组织肿瘤术前准备中的作用比较

Comparison of terazosin and phenoxybenzamine in preoperative preparation for pheochromocytoma/paraganglioma

目的比较盐酸特拉唑嗪和酚苄明在嗜铬细胞瘤/副神经节瘤术前准备中的疗效。方法回顾性分析唐山市人民医院泌尿外科2010年3月-2019年2月收治的73例嗜铬细胞瘤/副神经节瘤行腹腔镜下嗜铬细胞瘤/副神经节瘤切除术患者的临床资料。其中34例患者术前应用酚苄明进行术前准备,39例患者术前应用盐酸特拉唑嗪进行术前准备。比较两组患者在围手术期对循环的影响和不良反应的发生率。结果73例患者均成功在腹腔镜下完成手术,术后病理证实为嗜铬细胞瘤或副神经节瘤。酚苄明组术前降压有效率88.24%,特拉唑嗪组84.62%,差异无统计学意义。术中血压不稳定发生率酚苄明组为11.76%,特拉唑嗪组12.82%,术中心率不稳定(≥100次/min)发生率酚苄明组为5.88%,特拉唑嗪组为5.13%,差异均无统计学意义。头晕、口干、低血压等副作用发生率在酚苄明组为38.24%,特拉唑嗪组为12.82%,差异有统计学意义(P<0.05)。结论盐酸特拉唑嗪和酚苄明在嗜铬细胞瘤/副神经节瘤的围手术期准备中均具有良好的稳定血压和扩容效果,但盐酸特拉唑嗪不良反应发生率低,是嗜铬细胞瘤/副神经节瘤术前准备的理想药物。

Objective To compare the efficacy of terazosin and phenoxybenzamine in the preparation of pheochromocyto⁃ma/paraganglioma surgery.Methods Clinical data of 73 pheochromocytoma/paraganglioma patients who underwent laparo⁃scopic resection at our hospital during Mar.2010 and Feb.2019 were retrospectively analyzed,including 34 who used phenoxy⁃benzamine and 39 who used terazosin for preoperative preparation.The effects on the circulation and incidence of adverse reac⁃tions were compared.Results All operations were successful,and postoperative pathology confirmed pheochromocytoma/paraganglioma.There were no significant differences in the effective rate of preoperative blood pressure reduction(88.24%vs.84.62%),incidence of unstable blood pressure(11.76%vs.12.82%),incidence of unstable heart rate(≥100 times/min)(5.88%vs.5.13%)between the phenoxybenzamine group and terazosin group,but there was difference in the incidence of side effects such as dizziness,dry mouth,and hypotension(38.24%vs.12.82%,P<0.05).Conclusion Both terazosin and phenoxybenzamine have good effect on stabilizing blood pressure and expanding capacity.However,terazosin has fewer side ef⁃fects.Therefore,it is safer and better for pheochromocytoma/paraganglioma preoperative preparation.