硝普钠降压联合扩容用于嗜铬细胞瘤切除术

Nitroprusside controlled hypotension and flui replacement in the operation of pheochromocytoma ectomy

  • 摘要: 目的:观察硝普钠控制性降压并扩容治疗对嗜铬细胞瘤切除围术期循环的影响。方法:12例患者在切下肿瘤前用0.01%硝普钠溶液经颈内静脉点滴调控血压,将MAP控制在8~10kPa,同时快速输入乳酸钠平衡液和代血浆各20~30ml·kg-1·h-1扩容至尿量100ml·h-1以上,之后根据出血量调整输液速度。监测指标: MAP,HR,,尿量SpO2结果:手术人均210min,硝普钠用量人均38.333mg,艾司洛尔330mg,输液总量7250ml (117ml·kg-1),尿量610ml,SpO298%~100%,血压和心率均在理想范围,无任何并发症。结论:硝普钠控制性降压配合及时大量扩容有利于维护嗜铬细胞瘤术中循环平稳和减少并发症。

     

    Abstract: Objective: To observe the effectiveness of nitroprusside controlled hypotension and fluid replacement on perioperative circulation of pheochromocytoma. Methods: Before the tumor was removed,0.01% nitroprusside was used to maintain MAP with in 8 and 10 kPa in 12 patients undergoing elective pheochromocytoma ectomy,Meanwhile Ringer lactic solution and succinyl gelation were infused at the rate of 20~30ml·kg-1·h-1 respectively,Adjust infusion rate according to bleeding and urine output after urine output was more than 100ml h-1.Monitoring: MAP,SpO2,ECG and urine output.Results: mean operation time: 210min,mean dosage of nitroprusside: 38.33mg,esmolol: 330mg,total infusion amount: 7250ml(117ml· kg-1),Urine output: 610ml,SpO2: 98%~100%,MAP and HR kept in desirable range with no operative complications. Conclusions: Nitroprusside controlled hypotension combined with prompt fluid replacement contribute more stable circulation and less operative complications in the operation of Pheochromocytoma ectomy.

     

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