嗜铬细胞瘤手术治疗的体会

手术治疗嗜铬细胞瘤20例,其中肾上腺内17例,肾上腺外3例,均作肿瘤切除,无1例死亡。作者认为:(1)联合应用酚苄明和哌唑嗪,可缩短术前准备时间,并部分克服单用酚苄明心率快的缺点;(2)连续硬膜外麻醉效果好,高危重症病例辅以气管内插管备用有利术中抢救;(3)对大型肿瘤采用改良的胸膜外十一肋进路优点较多;(4)术中除操作轻柔、避免挤压外,每一步操作都应在直视下进行,避免盲目性。

Surgical Treatment of Pheochromocytoma

Twenty cases of pheochromocytomas had been successfully operated in this group, including 17 cases of intra--adrenal and 3 cases of extra--adrenal tumors. All the patients underwent tumor resec- tion, none of whom died. It is considered that, (1) The combination of phenoxybenzamine and prazosine preoperatively can shorten the time for preparation before surgery, and in some degree, overcome the disadvantages of increasing heart rate by single use of phenoxybenzamine; (2) in most eases, continuous epidural block may be used safely, but in critically ill patients, endotracheal anesthesia should be adopted, (3) a modified extrapleural approach through 11th rib has much advantages for larger tumors, and (4) operative procedures must be gende, avoid crushing the tumors, and performed under direct vi- sion.