查詢結果分析
來源資料
相關文獻
- Unexpected Pheochromocytoma--A Case Report of Anesthesia in a Uremic Patient
- A Case of Clinically "Nonfunctioning" Pheochromocytoma
- 兒茶酚胺對腎功能之影響
- 耐力運動對脂肪代謝之影響
- Adrenal Ganglioneuroma: 3 Cases Report
- Localization of Pheochromocytoma: [fef3]I-MIBG Scintigraphy Correlated with Computed Tomography
- 嗜鉻細胞瘤
- 針刺陽陵泉穴對肌運動前後兒茶酚胺與自律神經趨策力的影響
- Effects of Dobutamine, Epinephrine and Norepinephrine on the Hemodynamics of Dogs during Hemorrhagic Shock
- Low-dose Vasopressin Infusion Can Be an Alternative in Treating Patients with Refractory Septic Shock Combined with Chronic Pulmonary Hypertension--A Case Report
頁籤選單縮合
題名 | Unexpected Pheochromocytoma--A Case Report of Anesthesia in a Uremic Patient=尿毒症病人於麻醉中意外發現之嗜鉻性細胞瘤病例報告 |
---|---|
作者 | 黃耀清; 楊巽智; 何謂明; | 書刊名 | 麻醉學雜誌 |
卷期 | 36:3 1998.09[民87.09] |
頁次 | 頁169-172 |
分類號 | 416.5 |
關鍵詞 | 嗜鉻性細胞瘤; 惡性高血壓; 兒茶酚胺; Pheochromocytoma; Hypertension; Malignant; Catecholamine; |
語文 | 英文(English) |
中文摘要 | 嗜鉻性細胞瘤若發生在患有尿毒症病人身上,臨床診斷的困難度會增加很多。一 方面尿毒症病人就常合併有高血壓,而被忽略掉嗜鉻性細胞廇的可能性,一方面測量尿中與 血中兒茶酚胺濃度的作法,對尿毒症病人並不適用。我們最近就發現這樣一個病例,在手術 前並未被發現有嗜鉻性細胞瘤。在手術中,因突然的血壓上升至高血壓危象而被懷疑。我們 選用了一些血管擴張劑,並加深麻醉深度來控制血壓,可惜血壓變化依然很大。作者回顧了 近幾年相關文獻,作診斷與治療上的討論與建議。總之,高度的警覺,小心地用藥,和足夠 的監測器加上術後的勤加追蹤,才能應付這種少見而棘手的危機。 |
英文摘要 | Pheochromocytoma is an uncommon neoplasm causing blood pressure changes. It may go undiagnosed in uremic patients in whom hypertension is common. The preferential diagnostic work- up, including urine and serum cate-cholamine measurements, is unsuitable for uremic patients due to anuria and inherent increases in serum cate-cholamine levels. Here, we present a case of uremia, scheduled for right adrenalectomy and simple nephrectomy, who had been sustaining hypertension. Malignant hypertension was only discovered during surgical manipulation of the adrenal tumor. Pheochromocytoma was highly suspected. The patient was treated with nitroglycerin, fentanyl, and increased concentration of isoflurane to deepen the anesthesia. However, the results were only fair and after ligation of the tumor veins, hypotension ensued. Pathological examination verified the diagnosis of pheochromocytoma. In reviewal of the whole course of treatment, it was considered that the placement of a pulmonary artery catheter to detect volume shifts and changes in hemodynamic status was indicated. Related papers were reviewed and application of diagnostic tools and their limitations, safety and efficacy of anesthetics and vasodilators, and possible complications relevant to management of pheochromocytoma were also discussed. In conclusion, it is important to remain alert, administer agents cautiously, and set up complete monitoring if needed, and carry out postoperative intensive care to lessen complications in the anesthetic management of this rare and dangerous incidentaloma encountered during anesthesia. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。