Costello G T, Moorthy S S, Vane D W, Dierdorf S F
Department of Anesthesia, Indiana University Medical Center, Indianapolis 46223.
Crit Care Med. 1988 May;16(5):562-3. doi: 10.1097/00003246-198805000-00018.
Severe hypoglycemia with delayed emergence occurred in a 12-yr-old boy following bilateral adrenalectomy for pheochromocytoma. Hypoglycemia after resection of pheochromocytoma may be due to release of insulin from the beta cells of the pancreas due to sudden withdrawal of catecholamines. Beta blockade with the use of propranolol impairs both hepatic glucose production and glucagon secretion mechanism. For early detection and treatment of hypoglycemia, perioperative blood glucose monitoring is important in patients undergoing adrenalectomy for pheochromocytoma.
一名12岁男孩在因嗜铬细胞瘤接受双侧肾上腺切除术后出现严重低血糖并伴有苏醒延迟。嗜铬细胞瘤切除术后的低血糖可能是由于儿茶酚胺突然撤除,导致胰腺β细胞释放胰岛素。使用普萘洛尔进行β受体阻滞会损害肝脏葡萄糖生成和胰高血糖素分泌机制。为了早期检测和治疗低血糖,对于接受嗜铬细胞瘤肾上腺切除术的患者,围手术期血糖监测很重要。