Bissonnette R T, Gibney R G, Berry B R, Buckley A R
Department of Radiology, University of British Columbia, Vancouver, Canada.
Radiology. 1990 Mar;174(3 Pt 1):751-2. doi: 10.1148/radiology.174.3.2406783.
Immediately after a fine-needle aspiration biopsy (FNAB) was performed of a carcinoid liver metastasis, a patient had severe flushing, nausea, and faintness, followed by generalized seizure activity, profound hypotension, and cardiopulmonary arrest refractory to resuscitative efforts. This was considered due to massive release of vasoactive substances into the systemic circulation, caused by manipulation of the tumor at biopsy and aggravated by resuscitative efforts. Hypotensive crisis should be considered a potential, although unusual, complication of FNAB of liver metastases in patients with carcinoid syndrome. If biopsy is necessary, an intravenous access line should be established before biopsy is performed, and personnel should be prepared to administer emergency resuscitation. Medication with a somatostatin analogue before biopsy is performed is suggested. Catecholamine administration should be avoided.
在对一名类癌肝转移患者进行细针穿刺活检（FNAB）后，患者立即出现严重潮红、恶心和头晕，随后出现全身性癫痫活动、严重低血压以及复苏努力无效的心肺骤停。这被认为是由于活检时对肿瘤的操作导致血管活性物质大量释放进入体循环，并因复苏努力而加重。低血压危象应被视为类癌综合征患者肝转移灶FNAB的一种潜在（尽管不常见）并发症。如果有必要进行活检，应在活检前建立静脉通路，并且工作人员应做好进行紧急复苏的准备。建议在活检前使用生长抑素类似物药物。应避免使用儿茶酚胺。
