高危嗜铬细胞瘤围手术期处理(附35例报告)

The management of the pheochromocytoma of high risk

目的 总结高危嗜铬细胞瘤的诊断和治疗经验。 方法 回顾性分析 3 5例高危嗜铬细胞瘤患者临床手术治疗资料 ,总结围手术期的处理方法。 结果 2 7例肿瘤位于肾上腺 ,8例位于肾上腺外。切除肿瘤 3 3个 ,平均直径 10cm ,平均重量 3 5 0g ;2例因切除困难 ,仅作活检。 4例为复发性嗜铬细胞瘤 ,3例证实为恶性嗜铬细胞瘤。 结论 高危嗜铬细胞瘤术前必须有充分的药物准备和明确的定位诊断 ,术中应严密监测和处理血压波动 。

Objective To probe into the diagnosis and treatment of pheochromocytoma of high risk. Methods The clinical data of 35 cases of pheochromocytoma of high risk underwent surgical extirpation from 1990 to 2000 were reviewed. Results The tumors were intraadrenal in 27 and extraadrenal in 8.The average diameter of the growth which could be successfully resected was 10 cm and the weight 350 g.Biopsy was undertaken in 2 because of the difficulty in extirpation of the tumor.Recurrence occurred in 4 and there were 3 cases being comfirmed to be malignant. Conclusions Adequate preoperative preparation and definite location of the tumor are the most important before surgery.Fluctuation of blood pressure have to be monitored during surgery and to be treated carefully and promptly.Hypoglycemia have to be awared of after the surgery.