腹腔镜与开放性肾上腺嗜铬细胞瘤切除术对呼吸与循环功能影响的比较

目的：观察比较腹腔镜手术与开放性手术切除肾上腺功能性嗜铬细胞瘤患者围手术期呼吸，循环功能变化的差异，为开展经腹腔和后腹腔腹腔镜手术治疗肾上腺嗜铬细胞瘤提供依据。方法：选择经腹腔及经后腹腔腹腔镜手术（A组）与开放性手术（B组）治疗的肾上腺嗜铬细胞瘤患者与各6例，分别于手术开始，充气后（B组为术中探要），分离肿瘤，肿瘤切除及术毕各10min时检测两组患者心率（HR），平均动脉压（MAP），中心静脉压（CVP），气道压（Paw)，每分通气量（V E），并抽血检测血气指标。结果：两组间PacO2差异有显著性意义（P＜0．05），在PH，PaO2,Paw,VE,HR,MASR,CVP指标上虽有一定差异，但差异无显著性意义（P＞0．05），结论：只要正确选择手术适应证经腹腔和后腹腔腹腔镜手术治疗肾上腺功能性嗜铬细胞瘤是可行的。

Comparative study on the effects of respiratory and circulatory functional changes between laparoscopic and open resection for functioning pheochromocytoma of adrenal

Purpose:Effects of respiratory and circulatory functional changes between laparascopic and open surgery were compared in order to provide scientific basis for laparoscopic resection of pheochromocytoma. Method:From Feb. 1996 to Dec. 1999. 12 cases were divided into two groups .intraperitoneal and retroperitoneal approch(Group A.6 cases) and open approch(Group B,6 cases )undergoing resection of pheochromocytoma, we established 5 patients to observe the respiratory and circulatory functional changes; 10 minutes of each in the beginning of operation, immediatedly after insufflation(exploration in group B), just the time for tumour separation,post tumour resection and the operation termination. Result: PaCO2 in blood gas reveals signifficant difference( P <0. 05),But there are no obvious difference of PH,PaO2,Paw, VE and HR,MAP,CVP( P >0. 05) between 2 groups . Conclusion; Laparoscopic technique for removal of pheochromocytoma are feasible under careful selection of patient.