嗜铬细胞瘤患者的麻醉管理:附3例报告

Imbelloni Le, Lemos Neto SV, Rivoli Alc, Rosário Ar, Salo Lv, Borges Tg
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摘要

1.1. 背景。本研究描述了一个病例系列,解决复杂的麻醉管理肾上腺切除术患者嗜铬细胞瘤。这是一种罕见的肿瘤,起源于肾上腺髓质的嗜铬细胞和一种儿茶酚胺分泌剂,其最常见的三联症状是头痛、出汗和心动过速。1.2. 病例:第一例患者为47岁女性,有三次急性心肌梗死史,病灶单侧位于左肾上腺。肾上腺切除后,由于高血压持续存在,必须行左肾切除术。第二个病例描述了一名26岁扩张型心肌病女性患者接受视频腹腔镜右肾上腺切除术的多模式和无阿片类药物麻醉的传导。第一个报告涉及一名14岁的von Hippel-Lindau综合征男性患者,他接受了双侧开放肾上腺切除术。3例患者均顺利完成术前准备和手术,于术后第5 ~ 6天出院,术后无生理变化。没有对这三名患者进行基因研究。2例患者行持续硬膜外麻醉,无低血压,无需血管加压药。1.3. 结论:在这种病理中,必须强调在这三个病例中进行多学科方法的极端重要性。我们可以肯定地说,良好的结果是由于内分泌科和儿科服务部门的共同努力和明智的监测,以及麻醉和外科团队之间的协调关系,这对于术后头六天出院至关重要
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Anesthetic Management for Patients With Pheochromocytoma : Series of Three Cases
1.1. Background. This study describes a case series that addresses the complex anesthetic management of adrenalectomy for patients with pheochromocytoma. It is a rare tumor, originating in the chromaffin cells of the adrenal medulla and a catecholamine-secreting agent, whose most common triad of symptoms is headache, sweating and tachycardia. 1.2. Cases: The first case corresponds to a 47-year-old woman with a history of three acute myocardial infarctions with a lesion located unilaterally in the left adrenal gland. After adrenal removal and due to persistence of hypertension, it was necessary to perform a left nephrectomy. The second case describes the conduction of a multimodal and opioid-free anesthesia of a 26-year-old female patient with dilated cardiomyopathy who underwent video laparoscopic right adrenalectomy The first report involves the case of a 14-year-old male patient with von Hippel-Lindau Syndrome, who underwent bilateral open adrenalectomy. All three cases were successfully preoperatively prepared and operated on and were discharged home between the 5th and 6th day compensated and without physiological changes. No genetic study of the three patients was performed. Continuous epidural anesthesia was performed in two patients, without hypotension and need for vasopressor. 1.3. Conclusion: In this pathology, it is essential to emphasize the extreme importance of the multidisciplinary approaches carried out in the three cases. We can affirm affirm that the favorable outcomes were only possible thanks to a great joint effort and judicious for monitoring the Endocrinology and Pediatrics services and for the coordinated relationship between the anesthetic and surgical teams, which were essential for obtaining hospital discharge in the first six days after surgery
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