嗜铬细胞瘤术前的高血压控制与术中高容量血液稀释.pdfVIP

l临床泌尿外科杂志 2006 年 8 月 1在 21 卷第 8 期 ? 571 ? 嗜锦细胞瘤术前的高血压控制与 术中高容量血液稀释 祝宇1 五卫庆2 沈永情3 夹瑜璇1 张将中宇 l 芮文斌1 周文龙l 孙福康1 刘定益l 邵 i在 1 沈周俊1 毕宇芳2 苏额为2 美蕾2 宁光2 [摘要〕 目的:提高嗜错细胞瘤 (pheo) 圈子术期的治疗水平。方法 :52 例嗜锚细胞瘤患者术前采用选探性 αl 受体阻滞剂多沙噬嚓控释片(可多华)控制血压(剂量， 4 mg/d-16 mg/d) ;30 例患者术中采用联合高密量血液 稀稀(AHH)和术中自体血回输纠正血容盘。结果:可多华对阵发性商血压患者的疗效满意; AHH 联合术中自 体胞1剧输使 23 例患者避免了异体输血。结论:可多华可减少药物不良反应，对阵发性高血压患者的疗效满意， {且 对持续性高血压患者，尚需联合用药，才能较好控制 I自1压 ;AHH 联合术中自体血回输可减少医疗成本和异体血 回输，以及由此而产生的并发症。 [关键词] 嗜锵细胞瘤 ;al 受体阻滞剂;血液稀释;自体血阴输 〔中阁分类号] 民737 [文献标识码] A [文章能编号] 1001-1420(2006)08-0571-03 The preoperative control of high blood pressure and acute hypervolemic hemodilution in operation of pheochromocytoma ZHUYu 1 WANG Weiqing 2 SHEN Yongqian 3 WU Yu.zuan 1 ZHANG Congyu l RUI Wenbin l ZHOU Wenlong 1 SUN Fukaηgl LIU Dingyi 1 SHAO Yuan 1 SHEN Zhoujun 1 BI Yufang 2 SU Tingwei 2 ] IANG Lei 2 NING Guang 2 ( Department of U rology , 2 Department of Endocrinology , 3 Department of Anesthesiology , Ruijin Hospital ,Shanghai ]iaoTong University School of Medicine ,Shanghai , 200025 ,China) Abstract Objective , 10 elevate the level of the treatment of pheochromocytoma perioperatively. Methods , 52 pheochromacytoma patients were administrated orally selective阳 inhibitor (controlled release tablets) Doxazosin (Cardura , 4-16 mg/d). 30 patients appli巳d acute hypervolemic hemodilution (AHH) and Intraoperative autolo- gous blood transfusion to compen日ate blood volume. Results , Cardura was efficaciou日 to episodic hypertension. 23 patients avoided allo-transfusion by AHH and Intraoperative autologous blood transfusion. Conclusions , Cardura was efficacious to episodic hypertension with little adverse effects. For persistent hypertension. we should take several anti-hypertensive drugs to control blood pressure. AHH and Intraoperative autologous blood transfusion could reduce the medical costs and avoid the allo-transfusion with more complications. Key words Pheochromocytoma; Selectiveα1 receptor blocker ; Acute hypervol