Bizouarn P, Villalon L, Campion J P, Saint-Marc C, Launois B
Département d'Anesthésie-Réanimation, CHR, Rennes.
Ann Fr Anesth Reanim. 1990;9(2):180-2. doi: 10.1016/s0750-7658(05)80057-7.
A 30-year-old woman underwent a liver transplantation for metastasis of a carcinoid tumor of the midgut previously resected. Operative manipulation of the liver resulted in arterial hypotension, tachycardia, high pulmonary arterial pressure, oedema of the face and peripheral cyanosis, although the patient was given somatostatin (Modustatine, Clin-Midy) (300 micrograms a hour) prior to the procedure. The improvement of the symptoms was obtained by the increase of somatostatin infusion rate to 750 micrograms a hour associated with dopamine (6 micrograms.kg-1.min-1) and fluid replacement. The diagnosis of carcinoid syndrome is discussed. This unusual observation stresses the difficulty in preventing and/or treating a carcinoid shock. If somatostatin seems to be the treatment of choice of such a syndrome, its role in that case was limited.
一名30岁女性因先前切除的中肠类癌转移而接受肝移植。尽管在手术前给患者使用了生长抑素（善得定，Clin-Midy）（每小时300微克），但肝脏的手术操作仍导致动脉低血压、心动过速、肺动脉高压、面部水肿和外周发绀。通过将生长抑素输注速率提高到每小时750微克，同时使用多巴胺（6微克·千克-1·分钟-1）并补充液体，症状得到改善。文中讨论了类癌综合征的诊断。这一不寻常的观察结果强调了预防和/或治疗类癌休克的困难。如果生长抑素似乎是此类综合征的首选治疗方法，那么它在该病例中的作用是有限的。
