Nose K, Yamaguchi T, Hasui Y, Osada Y
Department of Urology, Miyazaki Medical College.
Hinyokika Kiyo. 1996 Nov;42(11):835-9.
Surgical treatment of 18 tumors in 17 patients with pheochromocytoma, containing unsynchronous bilateral adrenal tumors, was performed at our department between 1978 and 1995. As an index of management of hypertension before and after surgery, maximum systolic blood pressure except critical region (more than mean + 2 SD) was used in this study. As an index of control of blood pressure during surgery, the difference between maximum and minimum systolic blood pressure during palpating tumor was also adopted. The index before surgery was closely correlated with the index in surgery (R = 0.646, P = 0.0038); maximum systolic blood pressure before surgery was a useful index forecasting the variation of blood pressure in surgery. The management of blood pressure before surgery was the most difficult in the group with sustained hypertension with superimposed paroxysms. After surgery, 2 patients without hypertension before surgery had hypotension, 2 others remained hypertensive and the others had normal blood pressure. Our findings indicated that the index of management of hypertension before surgery used in this study was a simple, noninvasive and important marker for variation of blood pressure in surgery.
1978年至1995年间,我们科室对17例嗜铬细胞瘤患者的18个肿瘤进行了手术治疗,其中包括不同步的双侧肾上腺肿瘤。本研究采用除临界区域(超过均值+2标准差)外的最高收缩压作为手术前后高血压管理的指标。作为手术期间血压控制的指标,还采用了触诊肿瘤时最高和最低收缩压之间的差值。术前指标与术中指标密切相关(R = 0.646,P = 0.0038);术前最高收缩压是预测术中血压变化的有用指标。在持续性高血压叠加阵发性发作的患者组中,术前血压管理最为困难。术后,术前无高血压的2例患者出现低血压,另外2例仍有高血压,其余患者血压正常。我们的研究结果表明,本研究中使用的术前高血压管理指标是手术中血压变化的一个简单、无创且重要的标志物。