摘要
Abstract
Objective To investigate the influencing factors of hemodynamic instability in patients with pheochromocytoma after lap-aroscopic adrenalectomy.Methods Seventy-eight patients with pheochromocytoma who underwent laparoscopic adrenalectomy in our urology department from January 2015 to June 2022 were collected.Patients with and without postoperative hemodynamic instability were divided into the unstable(n=13)and stable(n=65)groups,respectively.The differences in gender,age,body mass index(BMI),history of hypertension,preoperative hematocrit(HCT),preoperative hemoglobin level,tumor location,tumor diameter,operation duration,anesthesia duration,intraoperative bleeding,whether intraoperative hemodynamics was stable,and postoperative lactate concentration were analyzed between the two groups.The comparison of postoperative extubation time,the number of postoperative intensive care unit(ICU)admissions,the duration of postoperative ICU stay,the number of postoperative cases needing continued mechanical ventilation,the duration of post-operative continued mechanical ventilation,postoperative complications,and hospitalization time between the two groups,and univariate and multivariate logistic regression analyses on the unstable group were performed.Results A total of 13 cases showed postoperative he-modynamic instability,with an incidence rate of 16.7％.Multivariate logistic regression analysis showed that bilateral tumors,postoperative lactate concentration,and anesthesia duration were the independent risk factors for postoperative hemodynamic instability(all P＜0.05).The receiver operating characteristic(ROC)curve analysis showed that for the prediction of postoperative hemodynamic instability in patients undergoing laparoscopic adrenalectomy for pheochromocytoma,the critical point of postoperative lactate concentration was 4.2 mmol/L,with a sensitivity of 84.2％and a specificity of 78.3％.Conclusions Bilateral tumors,postoperative lactate concentration,and the duration of anesthesia are the independent risk factors for postoperative hemodynamic instability in patients undergoing laparoscopic adrenalectomy for pheochromocytoma.Postoperative lactate concentration has a diagnostic value for postoperative hemodynamic instability.关键词
嗜铬细胞瘤/血流动力学不稳定/肾上腺切除术/危险因素Key words
pheochromocytoma/hemodynamic instability/adrenalectomy/risk factors
