Bracker L, Rath S, Dralle H, Bucher M
Klinik für Anästhesiologie und operative Intensivmedizin, Universitätsklinikum Halle (Saale), Ernst-Grube-Str. 40, 06120, Halle (Saale), Deutschland.
Chirurg. 2012 Jun;83(6):546-50. doi: 10.1007/s00104-011-2195-4.
In approximately 90% of all cases a pheochromocytoma causes sustained or paroxysmal hypertension. During surgical resection tumor manipulation can lead to excessive catecholamine release with the risk of life-threatening complications. Since the early 1950s a preoperative medical treatment with an α-adrenoceptor blocking agent has been successfully administered for prevention of hemodynamic instability but not all pheochromocytomas are associated with hypertension. Currently the discovery of asymptomatic pheochromocytomas is more frequent than in the time prior to modern imaging techniques (computed tomography, magnetic resonance imaging). There is little information about this type of pheochromocytoma in the literature. This article discusses the question if preoperative α-adrenoceptor block is also indicated in asymptomatic pheochromocytomas based on the current literature.
在所有病例中,约90%的嗜铬细胞瘤会导致持续性或阵发性高血压。手术切除过程中,肿瘤操作可导致儿茶酚胺过度释放,存在危及生命并发症的风险。自20世纪50年代初以来,术前使用α-肾上腺素能受体阻滞剂进行药物治疗已成功用于预防血流动力学不稳定,但并非所有嗜铬细胞瘤都与高血压有关。目前,无症状嗜铬细胞瘤的发现比现代成像技术(计算机断层扫描、磁共振成像)出现之前更为频繁。文献中关于这类嗜铬细胞瘤的信息很少。本文根据当前文献探讨无症状嗜铬细胞瘤术前是否也需要使用α-肾上腺素能受体阻滞剂的问题。