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[嗜铬细胞瘤手术后的低血糖症]

[Hypoglycaemia after surgery on phaeochromocytoma].

作者信息

Alilou M, Gaamouche K, El Moussaoui R, Harandou M, El Hijri A, Kanjaa N, Azzouzi A, Benerradi H, Slaoui A

机构信息

Service de réanimation chirurgicale, bloc opératoire central, CHU Ibn-Sina, Rabat, Maroc.

出版信息

Ann Fr Anesth Reanim. 2003 May;22(5):481-3. doi: 10.1016/s0750-7658(03)00099-6.

Abstract

Few cases of postoperative hypoglycaemia complicating the removal of a phaeochromocytoma have been reported in the literature. We reported one case of hypoglycaemia secondary to the removal of right phaeochromocytoma in a 30-year-old patient. Seven hours after the excision of the tumour, the patient developed a severe hypoglycaemia at 1.67 mmol x l(-1) revealed by seizures completely resolving in 24 h. The hypoglycaemia in this context resulted probably from the massive secretion of insulin by the beta cells of Langerhans islands due to the suppression of alpha-adrenergic inhibition. The prevention of this complication requires the repeated measurement of the capillary glycaemia in the postoperative period. An important supply of carbohydrate may be necessary to maintain a normoglycaemia.

摘要

文献中报道的因嗜铬细胞瘤切除术后并发低血糖的病例很少。我们报告了一例30岁患者因右侧嗜铬细胞瘤切除继发低血糖的病例。肿瘤切除术后7小时,患者出现严重低血糖,血糖值为1.67 mmol/L,癫痫发作后完全缓解,24小时内恢复正常。这种情况下的低血糖可能是由于α-肾上腺素能抑制作用被抑制,导致胰岛β细胞大量分泌胰岛素所致。预防这种并发症需要在术后反复测量毛细血管血糖。可能需要大量补充碳水化合物以维持血糖正常。

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