| 嗜铬细胞瘤的术前准备 |
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| 引用本文： | 张荣明,沈周俊,何威,祝宇,孙福康,周文龙,吴瑜璇,谢欣,戴军.嗜铬细胞瘤的术前准备[J].上海医学,2009,32(2). |
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| 作者姓名： | 张荣明 沈周俊 何威 祝宇 孙福康 周文龙 吴瑜璇 谢欣 戴军 |
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| 作者单位： | 上海交通大学医学院附属瑞金医院泌尿外科,200025 |
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| 摘 要： | 目的 提高嗜铬细胞瘤围术期治疗水平,降低病死率.方法 2003年11月-2008年11月收治92例嗜铬细胞瘤患者,应用嗜铬细胞瘤围术期管理方案,即在术前应用选择性al受体阻滞剂甲磺酸多沙唑嗪控释片(商品名可多华),最大剂量为12 mg/d,最小剂量为4 mg/d,同时在术中补充血容量.使术前准备时间明显缩短,中位时间为11 d,且术中血压稳定.结果 所有患者的血压稳定,收缩压≤140 mmHg(1 mmHg=0.133 kPa)及舒张压≤90 mmHg,无阵发性血压升高、心悸和多汗等现象,心率为80～90次/min,外周循环改善,肿瘤直径为2.5～13.0 cm,中位直径为4.5 cm,肿瘤大小与功能和用药时间长短无明显关系.85%的患者在麻醉诱导和术中挤压肿瘤时血压仍发生波动,但易控制,术后血压平稳.结论 嗜铬细胞瘤术前充分的准备是保证麻醉、术中及术后血压平稳控制、减少心血管并发症及降低病死率的关键.
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| 关 键 词： | 嗜铬细胞瘤 术前准备 治疗 |
Perioperative management for pheochromocytoma |
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| ZHANG Rongming,SHEN Zhoujun,HE Wei,ZHU Yu,SUN Fukang,ZHOU Wenlong,WU Yuxuan,XIE Xin,DAI Jun.Perioperative management for pheochromocytoma[J].Shanghai Medical Journal,2009,32(2). |
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| Authors: | ZHANG Rongming SHEN Zhoujun HE Wei ZHU Yu SUN Fukang ZHOU Wenlong WU Yuxuan XIE Xin DAI Jun |
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| Institution: | ZHANG Rongming,SHEN Zhoujun,HE Wei,ZHU Yu,SUN Fukang,ZHOU Wenlong,WU Yuxuan,XIE Xin,DAI Jun. Department of Urology,Ruijin Hospital,Shanghai Jiaotong University School of Medicine,Shanghai 200025,China |
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| Abstract: | Objective To improve the perioperative management for pheochromocytoma and lower the mortality rate. Methods A total of 92 patients with pheochromocytoma were admitted from November 2003 to November 2008 and were managed according to the peri-operative regimen for pheochromocytoma. All the patients were administered with Dosazoxin GITs preoperatively (maximum dose was 12 mg/d and minimum dose was 4 mg/d). The blood volume was expanded during the operation. The pre-operation preparation period was obviously ... |
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| Keywords: | Pheochromocytoma Preoperative management Therapy |
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