培训课件--嗜铬细胞瘤.pptVIP

Pheo Management Prior to 1951, reported mortality for excision of pheochromoyctoma 24 - 50 % HTN crisis, arrhythmia, MI, stroke Hypotensive shock Currently, mortality: 0 - 2.7 % Preoperative preperation, ?-blockade? New anesthetic techniques? Anesthetic agents Intraoperative monitoring: arterial line, EKG monitor, CVP line, Swan-Ganz Experienced Coordinated team: Endocrinologist, Anesthesiologist and Surgeon 1.内科治疗：适用于控制症状、术前准备、手术不能耐受、恶性嗜铬细胞瘤术后复发 　　(1)Regitin为?1和?2受体阻滞剂 初始剂量为10mg, bid 5～7天后增加至30～40mg, 分次口服 副作用：体位性低血压、鼻黏膜充血、β-受体活性相对增强 治 疗 (2)哌唑嗪(prazosin): ?1-受体阻滞剂 可避免低血压