多沙唑嗪联合替米沙坦预处理维持嗜铬细胞瘤切除术中循环稳定的效果

Efficiency of pretreatment with doxazosin combined with telmisartan in maintaining intraoperative circulation stability during pheochromocytoma resection

目的观察多沙唑嗪联合替米沙坦预处理维持嗜铬细胞瘤切除术中循环稳定的效果。方法行腹腔镜肾上腺嗜铬细胞瘤切除术患者88例分为两组。术前2周,D组(47例)单用多沙唑嗪预处理,DT组(41例)联合应用多沙唑嗪和替米沙坦预处理。比较两组围手术期BP和HR变化、血管活性药使用及术后心血管并发症发生情况。结果与D组相比,DT组术中SBP>160 mmHg持续时间的比例少(P<0.05),HR>100次/分发生率低(P<0.05),拔管后SBP低(P<0.05),SBP变化幅度小(P<0.05),使用血管活性药比例少(P<0.01),血流动力学不稳定评分低(P<0.05)。两组术后心血管并发症发生率无统计学差异(P>0.05)。结论肾上腺嗜铬细胞瘤切除术前2周使用多沙唑嗪联合替米沙坦预处理较单独使用多沙唑嗪预处理能更有效地维持围手术期循环稳定。

Objective To observe the efficiency of pretreatment with doxazosin combined with telmisartan in maintaining intraoperative circulation stability during pheochromocytoma resection.Methods Eighty-eight patients undergoing laparoscopic adrenal pheochromocytoma resection were divided into two groups.Two weeks before operation,a pretreatment with doxazosin alone was given in group D(47 cases)and doxazosin combined with telmisartan was given in group DT(41 cases).The perioperative changes of BP and HR,the use of vasoactive drugs and the occurrence of postoperative cardiovascular complications were compared between the two groups.ResultsCompared with group D,group DT had less proportion of SBP>160 mmHg duration(P<0.05),lower incidence of HR>100 beats per minute(P<0.05),lower SBP after extubation(P<0.05),less variation of SBP(P<0.05),less use of vasoactive drugs(P<0.01),and lower hemodynamic instability score(P<0.05).There was no significant difference in the incidence of postoperative cardiovascular complications between the two groups(P>0.05).Conclusion Compared with doxazosin alone as a pretreatment drug 2 weeks before surgery,combined use of doxazosin and telmisartan is more effective in maintaining intraoperative circulation stability during pheochromocytoma resection.