Sand J, Salmi J, Saaristo J, Auvinen O
Departments of Surgery and Medicine, Tampere University Hospital, Finland.
Ann Chir Gynaecol. 1997;86(3):230-2.
Operative treatment is the method of choice for pheochromocytomas. The best success of the operation requires both good operative technique and effective preoperative medication. Phenoxybenzamine hydrochloride, an alpha-receptor blocker, has been our traditional premedication. Since 1988 we have used it in a combination with alpha-methylthyrosine, a catecholamine-synthesis blocker.
To evaluate different preoperative medications.
Between 1984 and 1994 22 patients were operated on for pheochromocytomas in Tampere University Hospital. Five patients received alpha-receptor blocker, three patients received catecholamine-synthesis blocker, and 14 patients received their combination for a median of 33 days prior to the operation.
Three of the five patients receiving alpha-receptor blocker, two of the three patients receiving catecholamine-synthesis blocker, and four of the 14 patients receiving combination therapy demonstrated high systolic blood pressure during the operation. Three patients, one in the alpha-receptor blocker group and two in the combination therapy group, demonstrated a short hypotensive period during the operation. None of the patients experienced severe perioperative cardiac arrhythmias. Mild sedation occurred similarly in either premedications, but the treatment did not need to be discontinued due to adverse reactions. There was no hospital mortality. Two patients had postoperative complications.
Our initial experience with the combination therapy with alpha-receptor blocker and catecholamine-synthesis blocker is encouraging.
手术治疗是嗜铬细胞瘤的首选方法。手术的最佳效果需要良好的手术技术和有效的术前药物治疗。盐酸酚苄明，一种α受体阻滞剂，一直是我们传统的术前用药。自1988年以来，我们将其与儿茶酚胺合成阻滞剂α-甲基酪氨酸联合使用。
评估不同的术前用药。
1984年至1994年间，坦佩雷大学医院对22例嗜铬细胞瘤患者进行了手术。5例患者接受α受体阻滞剂治疗，3例患者接受儿茶酚胺合成阻滞剂治疗，14例患者在手术前中位数33天接受联合治疗。
接受α受体阻滞剂治疗的5例患者中有3例，接受儿茶酚胺合成阻滞剂治疗的3例患者中有2例，接受联合治疗的14例患者中有4例在手术期间出现高收缩压。3例患者，1例在α受体阻滞剂组，2例在联合治疗组，在手术期间出现短暂的低血压期。所有患者均未发生严重的围手术期心律失常。两种术前用药中轻度镇静的发生率相似，但治疗未因不良反应而中断。无医院死亡病例。2例患者有术后并发症。
我们使用α受体阻滞剂和儿茶酚胺合成阻滞剂联合治疗的初步经验令人鼓舞。
