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华西医学  2015 

妊娠合并嗜铬细胞瘤的诊断与围手术期处理

DOI: 10.7507/1002-0179.20150599, PP. 2118-2120

Keywords: 嗜铬细胞瘤,妊娠,术前准备

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Abstract:

目的?探讨妊娠合并嗜铬细胞瘤的诊断与围手术期处理方法。方法?回顾性分析2004年3月-2014年3月妊娠合并嗜铬细胞瘤接受剖宫产手术的3例患者的临床资料。3例患者术前予以扩充血容量,给予α和(或)β肾上腺素能受体阻滞药控制病情。在蛛网膜下隙与硬脊膜外隙联合阻滞麻醉下实施纵切口剖宫产手术。术中严密监测有创动脉压、中心静脉压、血糖浓度与电解质。结果?3例患者纵切口剖宫产手术均成功实施。1例患者术中血流动力学平稳,2例患者术中血流动力学有波动。3例患者胎儿1、5minApgar评分均为10分。剖宫产术后转入泌尿外科行肿瘤切除术,经病理确诊腹膜后占位为肾上腺嗜铬细胞瘤。结论?术前正确的诊断、充分的准备、严密的监测与术中管理,是妊娠合并嗜铬细胞瘤手术麻醉成功的关键所在。

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