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妊娠期偶发性嗜铬细胞瘤所致阵发性高血压的管理

Management of paroxysmal hypertension due to incidental pheochromocytoma in pregnancy.

作者信息

Lata Indu, Sahu Sandeep

机构信息

Department of Maternal and Reproductive Health, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.

出版信息

J Emerg Trauma Shock. 2011 Jul;4(3):415-7. doi: 10.4103/0974-2700.83876.

Abstract

A 25-year-old, full-term pregnant woman diagnosed with pre-eclampsia was referred to our tertiary care hospital with severe resistant hypertension. Her blood pressure remained labile despite the usual medications, which led to the suspicion of an underlying endocrinological problem. Further biochemical and radiological investigations confirmed the diagnosis of pheochromocytoma. The patient was invasively monitored and treated with alpha blockade, beta blocker, and vasodilators. The primary goals for the management of pheochromocytoma in pregnancy are early diagnosis, avoidance of a hypertensive crisis during delivery, and definitive surgical treatment. This case illustrates that one needs to be cautious when such a presentation of paroxysmal hypertension is present. With a multidisciplinary team approach, proper planning, and adequate preoperative medical management, pheochromocytoma in pregnancy can be managed successfully.

摘要

一名25岁的足月孕妇被诊断为子痫前期,因严重难治性高血压被转诊至我们的三级护理医院。尽管使用了常规药物,她的血压仍不稳定,这引发了对潜在内分泌问题的怀疑。进一步的生化和放射学检查确诊为嗜铬细胞瘤。对该患者进行了侵入性监测,并使用α受体阻滞剂、β受体阻滞剂和血管扩张剂进行治疗。妊娠期嗜铬细胞瘤管理的主要目标是早期诊断、避免分娩期间发生高血压危象以及进行确定性手术治疗。该病例表明,当出现这种阵发性高血压表现时需要谨慎。通过多学科团队方法、合理规划和充分的术前药物管理,妊娠期嗜铬细胞瘤可以得到成功管理。

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