【摘要】 <正> 嗜铬细胞瘤的根治是手术切除,麻醉处理一般认为是成败的关键。本文报道我院自1953年至1976年间25例的麻醉经过。 麻醉方法 麻醉前准备 早期有4例限于当时条件,未能合理应用肾上腺能受体阻滞药和适当地扩充血容量;另有5例口服苄胺唑啉(Regitine,Phentolamine)25毫克×3/天,3～7天。1970年后16例用酚苄胺(Phenoxybenzamine,Dibenzyline)10～20毫克×2～4/更多还原

【Abstract】 Lots of anesthetic problems, worthwhile to be considered, were existing in patients sufferred from phebohromocytoma. Hereby 25 cases, underwent 26 operations, were investigated with 15 males and 10 females while with the age varying from 24-61 years. General anesthesia was accepted before 1970, thereafter the continuous epidural block.To have a successful anesthesia, according to our limited clinical experiences we believed that it relied mainly upon 3 factors, namely (1) means to keep a normal blood volume, (2) anesthetic agents and techniques properly selected and (3) cardiovascular monitors carrying on thoughout the surgery.To keep the blood vessels in a well dilated condition so that the clinical pictures oould be definitely ameliorated, preoperative administration of an adrenergio blocking agent, phenoxybenzamine in particular, was quite essential. Just before the operation, phentolamine, daily intravenous infusion for 3 days, together with plasma expander or blood replacement whenever necessary, was taken in substitute. After the blood volume had approaching the normal, it was quite aware that the blood transfusion would be reduced and vasopressors, for instance noradrenaline etc., oould be held during the resection of the tumor. Few of our patients had not received any vasoconstrictors at all.Neither the anesthetic agent nor the technique was absolutely nondispensable. General anesthesia was usually preferred in those oases with the nature of the tumor obscured, misdiagnosed, indefinitely located, and with very poor general health. On the other hand, the continuous epidural block was generally wonderfully successful in oases with the diagnosis definite, site exact and the nature of tumor well reeongnized.Throughout the operation and afterward, nothing should be further emphasized except the monitors of CVP and ECG, which were no doubt quite valuable for the estimation of the cardiovascular functions.Phentolamine, indicated during the manipulation of the tumor mass and given, as a rule either by continuous intravenous infusion or by single injections, should be immediately discontinued and/or replaced by noradrenaline whenever the last evident adrenal vein been ligated.There were four deaths in our series. Two of them under the general anesthesia, were early cases since at that time neither the pathophysiology of the pheoohromocytoma nor the drug noradrenaline was available. The other two were emergency operations under the epidural block and were certainly misdiagnosed and ill-managed so as our present knowledge concerned.更多还原