The Preoperative Preparation And The Analysis Of Influencing Factors Of Perioperative Blood Pressure Fluctuation Of Pheochromocytoma

Objective To improve the understanding of pheochromocytoma，analyze inlfuencingfactors of perioperative blood pressure，and explore the clinical experience ofpreoperative preparation.Methods A retrospective reviews of61pheochromocytoma patients in our hospital isconducted，who were treated by operation and diagnosed by pathology. Usingstatistical methods such as t test，chi-square test and pearson correlation analysis toanalyze their clinical manifestations，preoperative preparation and inlfuencing factorsof perioperative blood pressure fluctuation.Results (1)8.2%of these patients with pheochromocytoma have typical ‘triad，，hypertension (86.89%) is the most common manifestation.65.6%of these patientshave disorders of carbohydrate metabolism，11.5%of them have increasedmyocardial enzyme，78.69%of them have some changes in electrocardiogram.38patients did the cardiac ultrasound，and36.31%of them were turned out to havethickening ventricular septal.(2)Thepositive rate of plasma MNs is83.6%.(3)22patients were examed by B-ultrasound，all patients were examed byCT and MRI，the positive rate of these examination are all100%.(4)Thepreoperative average blood pressure within3days of patients whousing Ca-antagonist and a-R block is lower than (P=0.034) the blood pressure in thesame period of patients who using only a-R block. But the perioperative bloodpressure of the two groups shows no significant difference (P=0.755).(5)36patients’blood pressure lfuctuate in the operation. There is a positivelinear correlation between the blood pressure fluctuation and the maximumpreoperative systolic pressure(r=0.329，P=0.010). So is between the blood pressurefluctuation and the maximum tumor diameter (r=0.256，P=0.046)，and between theblood pressure fluctuation and the preoperative average blood pressure within3 days(r=0.356，P=0.004)Conclusion The a-R block is suggested to be used before operations. It hasantihypertensive effect.Then The blood pressure during operation will be easier tocontrol. In spite of the adequate preoperative preparation，great changes of bloodpressure would occur during the operation. Higher preoperative systolic pressure andlarger tumor increase the rate of the blood pressure fluctuation during operation. Weshould prepare drugs to reduce the operation risks and complications.