Liu Zheng,Chai Chengwei,Yang Jiliang,et al.Perioperative blood pressure management of pheochromocytoma in children: a report of 6 cases[J].Journal of Clinical Pediatric Surgery,2022,21(07):675-679.[doi:10.3760/cma.j.cn101785-202008064-015]
儿童嗜铬细胞瘤围手术期血压管理
- Title:
- Perioperative blood pressure management of pheochromocytoma in children: a report of 6 cases
- Keywords:
- Pheochromocytoma; Perioperative; Blood Pressure; Child
- 摘要:
- 目的 探讨儿童嗜铬细胞瘤（pheochromocytoma，PHEO）围手术期的血压管理。方法 回顾性分析2009年1月至2019年12月广州医科大学附属广州市妇女儿童医疗中心收治的6例嗜铬细胞瘤患儿临床资料，并复习PubMed数据库中有关嗜铬细胞瘤的文献。结果 6例均为男性，表现为头痛2例（阵发性1例，反复发作且进行性加重1例），体检发现高血压3例（1例波动于120~160/60~110 mmHg，伴心悸、多汗；1例波动于150~190/80~110 mmHg，伴视物不清；1例波动于150~190/60~80 mmHg，伴腹痛），1例为复发病例。入院时主要症状：肿瘤切除术后出现心悸、多汗1例，视物不清1例，反复夜间头痛且进行性加重1例，生后检查发现肾上腺结合部肿块1例，腹痛伴血压升高1例，先心病术后检查发现肾上腺占位1例。6例均行手术治疗，控制围手术期血压，有高血压表现者适当使用降血压药物，缓慢使血压降至130/80 mmHg以内，同时避免血压低于80/45 mmHg。6例中3例为开放手术，3例为腹腔镜手术，均完整切除肿瘤。术后3例使用激素替代治疗。6例病理检查均提示良性嗜铬细胞瘤，随访无一例复发。结论 嗜铬细胞瘤儿童时期罕见，手术切除肿瘤是首选的治疗方法，恰当的围手术期血压管理能有效预防术中、术后可能出现的并发症，对于保障患儿手术安全、确保手术疗效至关重要。
- Abstract:
- Objective To explore the perioperative blood pressure management of pheochromocytoma to maintain relatively stable hemodynamics and prevent cardiovascular complications.Methods From January 2009 to December 2019, retrospective reviews of clinical data were conducted for 6 surgical children with pheochromocytoma.And the latest relevant domestic and foreign literatures were retrieved from PubMed.Results Preoperative blood pressures of 6 boys were controlled within a certain range according to the basis of blood pressure and physician advice.Hypertension was appropriately treated with blood pressure lowering drugs to gradually reduce their blood pressure to <130/80 mmHg and blood pressure <80/45 mmHg was avoided.After vigorous perioperative blood pressure managements, no such severe complications as malignant hypertension, adrenal crisis and myocardial infarction occurred during and after operation.Conclusion Perioperative blood pressure management of pheochromocytoma is essential and it can effectively prevent perioperative complications and safeguard patient safety.
参考文献/References:
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备注/Memo
收稿日期:2020-08-25。
通讯作者:邹焱,Email:monknut@126.com