老年嗜铬细胞瘤围手术期临床特点分析

Wei Zhu, Shao-Qing Wang, Guang-hui Du, Hailang Liu, Jinjin Lu
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摘要

目的探讨60岁及以上患者嗜铬细胞瘤围手术期的临床特点。方法回顾性分析2008年1月至2018年10月我院经腹膜后腹腔镜肾上腺切除术治疗嗜铬细胞瘤患者的年龄、性别、肿瘤大小、麻醉时间、术中出血量、术中血压、并发症及住院时间等资料。分析年龄与术中血液动力学不稳定及术后并发症的关系。结果共有203例符合纳入标准的嗜铬细胞瘤患者入选。60岁以上的年龄(OR1.771,95%可信区间1.015-3.089,P=0.044)是术中血液动力学不稳定的独立危险因素。结论腹腔镜腹膜后肾上腺切除术是治疗60岁及以上嗜铬细胞瘤的一种安全的手术方法。对于老年嗜铬细胞瘤患者,尤其是肿瘤直径超过5厘米的患者,应特别注意术中高血压危象的预防。关键词:嗜铬细胞瘤;围手术期
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Clinical characteristics during the perioperative period of pheochromocytomas in the elderly
Objective To investigate the clinical characteristics during the perioperative period of pheochromocytoma in patients aged 60 years and over. Methods Data of age, sex, tumor size, anesthesia time, intraoperative bleeding volume, intraoperative blood pressure, complications and hospitalization time from patients with pheochromocytoma in our hospital treated by the retroperitoneal laparoscopic adrenalectomy from January 2008 to October 2018 were retrospectively analyzed.The relationships of age with the intraoperative hemodynamic instability and postoperative complications were analyzed. Results A total of 203 patients with pheochromocytoma met the inclusion criteria were enrolled.Age over 60 years(OR1.771, 95%CI=1.015-3.089, P=0.044)was an independent risk factor for intraoperative hemodynamic instability. Conclusions Laparoscopic retroperitoneal adrenalectomy is a safe surgical method for pheochromocytoma patients aged 60 years and over.For elderly patients with pheochromocytoma, especially those with a tumor diameter of more than 5 cm, special attention should be paid to the prevention of intraoperative hypertension crisis. Key words: Pheochromocytoma; Perioperative period
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