Levine S N, McDonald J C
Adv Surg. 1984;17:281-313.
Despite the relative infrequency of pheochromocytomas, they remain a potentially curable yet lethal etiology of hypertension. Appropriate utilization of a modern clinical chemistry laboratory and sophisticated radiologic techniques should allow a suspecting physician to establish the presence or absence of such a catecholamine-secreting tumor. The treatment of pheochromocytoma remains surgical; however, strict attention to preoperative details is crucial if mortality is to be minimized. Judicious use of adrenergic blocking agents and measures to ensure a normal circulating blood volume are of utmost importance during the preoperative period. Surgery remains the ultimate diagnostic and therapeutic maneuver. A thorough and meticulous exploration of the entire abdominal cavity and both adrenal beds is essential in all patients with pheochromocytoma. Monitoring of electrocardiographic and hemodynamic parameters is critical during surgery and postoperatively, since changes in cardiovascular stability can be dramatic and rapid. Appropriate measures must be taken to reverse such changes but must be made based on a thorough understanding of the effects of catecholamines, the drugs available to alter these effects, and the potential problems that patients with pheochromocytomas are likely to experience.
尽管嗜铬细胞瘤相对少见，但它们仍然是高血压潜在可治愈却致命的病因。合理利用现代临床化学实验室和先进的放射学技术，应能让有怀疑的医生确定是否存在这种分泌儿茶酚胺的肿瘤。嗜铬细胞瘤的治疗仍然是手术治疗；然而，若要将死亡率降至最低，严格关注术前细节至关重要。在术前阶段，明智地使用肾上腺素能阻滞剂以及采取措施确保循环血容量正常极为重要。手术仍然是最终的诊断和治疗手段。对所有嗜铬细胞瘤患者而言，彻底细致地探查整个腹腔和双侧肾上腺床至关重要。手术期间及术后监测心电图和血流动力学参数至关重要，因为心血管稳定性的变化可能剧烈且迅速。必须采取适当措施来扭转这些变化，但必须基于对儿茶酚胺的作用、可改变这些作用的药物以及嗜铬细胞瘤患者可能遇到的潜在问题的透彻理解来进行。
