儿茶酚胺替代法在嗜铬细胞瘤围手术期应用(附15例报告)

目的探讨儿茶酚胺替代法在嗜铬细胞瘤围手术期的应用。方法15例嗜铬细胞瘤患者，术前未行扩容准备，而于手术中及手术后应用儿茶酚胺替代法治疗。结果本组15例，术中平均输液2950mL，输血或浓缩红细胞约400mL。术后禁食期间输液2500—3500mL，进食后输液500—1500mL。术后9例血压恢复正常，5例继续服用降压药血压可维持正常，1例服药后血压仍有波动。结论对于术前来不及行扩容准备的高危嗜铬细胞瘤患者，于围手术期应用儿茶酚胺替代法，一方面可抓住抢救时间，赢得手术治疗的机会。另一方面，可以避免术前、术中及术后因大量输液而造成的心、肺及血管系统的并发症，而提高手术的成功率和安全性。

Management of catecholamine substitution therapy in perioperation of pheochromocytoma (report of 15 cases)

Objective To probe into the application of catecholamine substitution therapy in perioperation of pheochromocytoma. Methods 15 cases of pheochromocytoma were reviewed. All cases received a catecholamine substitution therapy in operation and post-operation, without preoperative hydration. Results In all the 15 cases, an average of 2 950 mL fluid was given during surgery, and 400 mL blood was transfused. 2 500-3 200 mL fluid was given intravenously after surgery daily with no diet, and 500 - 1 500 mL fluid was given after diet. The blood pressure of 9 cases returned normal postoperatively, that of 5 cases was controlled to normal level under hypotensor treatment, and that of 1 case remained unstable with hypotensor. Conclusion The management of catecholamine substitution therapy in perioperation to replace preoperative hydration can save time for some critical cases, and allow them more opportunities of surgery. It also reduces the cardiopulmonary complications due to the great amount of transfusion perioperatively. In this way, we can improve the success and safety of operation and relieve the economic burden on patients.