The Analysis Of Factors Associate With Intraoperative Blood Pressure Fluctuation In 15 Cases With Extra-adrenal Pheochromocytoma

Objetive To analyze the clinical features of extra-adrenal pheochromocytoma ,evaluate the factors associate with intraoperative blood pressure fluctuation.Methods A retrospective reviews of 15 patients in our hospital is conductded,who were pathologically diagnosed with extra-adrenal pheochromacytoma in the past 12 years.The reviews show the clinical features about the blood pressure fluctuation during the intraoperative period and factors that affect it.Results(1) There are 9 persons with typical clinical features of catecholaminism,9 persons were diagnosed accurately in the 15 cases of extra-adrenal pheochromocytoma patients.The positive rate of plasma free adrenalin is 63.6%(7/12),plasma free noradrenalin' positve rate is 90.9% (10/11) and the urine VMA' s is 25%(1/4).(2) The mean arterial pressure fluctuate from 10 to 140 mmHg during intraoperative period.It has linear correlation with the level of preoperative systolic blood pressure.The correlation coefficient is 0.618, P<0.05(P=0.015).There is not linear correlation between the preoperative diastolic blood pressure and intraoperative mean arteral pressure fluctuation,P>0.05(P=0.06).(3) The mean arteral pressure shows more equability in those patients who using Ca-antagonist combin withα-R block than those usingα-R block only.However,the statistics analysis does not prompt significance. P>0.05(P=0.302) (4) The mean arteral pressure shows more equability in those patients who using nonselectiveα-receptor antagonist than that usingα₁-R block.Their average value are 63mmHg and 80mmHg,respectively.The statistics analysis doesn' t prompt significance,P<0.05(P=0.0.048).Conclusion:The fluctuation of mean arterial pressure has relationships with the level of systolic blood pressure preoperative.The application of Ca-antagonist may take a role in decreasing the fluctuation of blood pressure. The application ofα₁-R block doesn' t intensify the mean arteral pressure fluctuation compare with using nonselectiveα-R block.