Peramunage Dasun, Nikravan Sara
Department of Anesthesiology, Virginia Mason Medical Center, 1100 Ninth Avenue, B2-AN, Seattle, WA 98101, USA.
Division of Cardiothoracic Anesthesiology, Department of Anesthesiology, Virginia Mason Medical Center, 1100 Ninth Avenue, B2-AN, Seattle, WA 98101, USA; Division of Critical Care Medicine, Virginia Mason Medical Center, 1100 Ninth Avenue, B2-AN, Seattle, WA 98101, USA.
Anesthesiol Clin. 2020 Mar;38(1):149-163. doi: 10.1016/j.anclin.2019.10.006. Epub 2020 Jan 2.
Although endocrine emergencies are not common occurrences, their identification and careful perioperative management are of paramount importance for reduction of patient morbidity and mortality. The most common critical endocrine abnormalities are associated with functional tumors, such as pheochromocytomas, insulinomas, and carcinoid tumors, leading to carcinoid syndrome, abnormal thyroid function, or disturbances in the hypothalamus-pituitary-adrenal axis, causing adrenal insufficiency. This article aims to discuss the pathophysiology, diagnosis, and perioperative management of pheochromocytomas, hyperthyroidism, hypothyroidism, adrenal insufficiency, carcinoid disease, and insulinomas.
尽管内分泌急症并不常见，但对其进行识别并在围手术期进行仔细管理对于降低患者的发病率和死亡率至关重要。最常见的严重内分泌异常与功能性肿瘤有关，如嗜铬细胞瘤、胰岛素瘤和类癌肿瘤，可导致类癌综合征、甲状腺功能异常或下丘脑 - 垂体 - 肾上腺轴紊乱，引起肾上腺功能不全。本文旨在讨论嗜铬细胞瘤、甲状腺功能亢进、甲状腺功能减退、肾上腺功能不全、类癌病和胰岛素瘤的病理生理学、诊断及围手术期管理。
