Nakajima Yoshiyuki, Masaoka Naoki, Sodeyama Masako, Tsuduki Yoko, Sakai Masato
Department of Obstetrics and Gynecology, Tokyo Women's Medical University Yachiyo Medical Center, Chiba, Japan.
J Obstet Gynaecol Res. 2011 Jul;37(7):908-11. doi: 10.1111/j.1447-0756.2010.01423.x. Epub 2011 Mar 9.
We report a rare case of pheochromocytoma-related cardiomyopathy during the preterm period. The patient was a 33-year-old woman who was referred to our hospital at 34 weeks' gestation. Her pulse was 130 beats/min, blood pressure of 186/90 mmHg and oxygen saturation was 30-40%. Fetal bradycardia prompted an emergency cesarean section and, nine minutes after admission, a boy weighing 2774 g was delivered with Apgar scores of 2 at 1 min and 5 at 5 min. A preoperative echocardiogram showed reduced fractional shortening of 19%. At 8 h after the operation, cardiac arrest developed. An intra-aortic balloon pump and percutaneous cardiopulmonary support were inserted, and continuous hemodiafiltration was also commenced, after which her cardiac function and respiratory function gradually improved. Urinary catecholamine levels were elevated and abdominal computerized tomography confirmed the presence of a right suprarenal mass. Four months after delivery, she underwent a laparoscopic adrenalectomy and the mass was found to be a pheochromocytoma.
我们报告了1例早产期间发生的嗜铬细胞瘤相关性心肌病罕见病例。患者为一名33岁女性，妊娠34周时转诊至我院。她的脉搏为130次/分钟，血压为186/90 mmHg，血氧饱和度为30% - 40%。胎儿心动过缓促使进行急诊剖宫产，入院9分钟后，一名体重2774 g的男婴出生，1分钟时阿氏评分2分，5分钟时为5分。术前超声心动图显示射血分数缩短率降低至19%。术后8小时，发生心脏骤停。插入主动脉内球囊泵和经皮心肺支持，并开始持续血液透析滤过，此后她的心脏功能和呼吸功能逐渐改善。尿儿茶酚胺水平升高，腹部计算机断层扫描证实右肾上腺有肿块。分娩后4个月，她接受了腹腔镜肾上腺切除术，发现肿块为嗜铬细胞瘤。
