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SCI REP:腹腔镜嗜铬细胞瘤切除术后严重高乳酸血症和乳酸酸中毒的危险因素

2017-03-27 xingxiaowei MedSci原创

嗜铬细胞瘤是一种较少见的分泌儿茶酚胺的神经内分泌肿瘤。腹腔镜手术已成为嗜铬细胞瘤的一线治疗方式。严重的高乳酸血症(Severe hyperlactatemia,SH)和乳酸酸中毒(lactic acidosis,LA)是腹腔镜嗜铬细胞瘤切除术后的常见并发症,对患者预后产生不良影响。明确SH/LA发生的危险因素有利于术后患者的治疗。

嗜铬细胞瘤是一种较少见的分泌儿茶酚胺的神经内分泌肿瘤。腹腔镜手术已成为嗜铬细胞瘤的一线治疗方式。严重的高乳酸血症(Severe hyperlactatemia,SH)和乳酸酸中毒(lactic acidosis,LA)是腹腔镜嗜铬细胞瘤切除术后的常见并发症,对患者预后产生不良影响。明确SH/LA发生的危险因素有利于术后患者的治疗。

近期发表在SCI REP上的一篇文章对这种并发症的危险因素进行了分析。乳酸酸中毒的判断标准为:pH<7.35,碳酸氢钠<20mmol/L,血清乳酸>5mmol/L;严重高乳酸血症:乳酸≥5mmol/L;适度高乳酸血症(MH):乳酸2.5-5.0mmol/L,无酸中毒征象(pH>7.35,碳酸氢钠>20mmol/L)。研究共145例患者,统计了人口学、临床病史以及实验室检查结果等数据进行分析。术后有59例患者出现高乳酸血症,MH25.5%,SH/LA15.2%。多因素分析表明BMI、24小时尿肾上腺素浓度以及肿瘤大小是术后严重高乳酸血症及乳酸酸中毒的独立预测因素。

作者最后得出结论:较高的24小时尿肾上腺素水平、较大的肿瘤尺寸以及较高的BMI是嗜铬细胞瘤术后SH/LA发生的独立危险因素。下一步仍需多中心的前瞻性研究来判断本文得出的结论是否可靠。

原始出处:


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time=2017-03-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=183042, encodeId=3e1518304287, content=学习了,有意思, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20161019/IMG580762DBECE003340.jpg, createdBy=93fe1431842, createdName=FrankL, createdTime=Mon Mar 27 10:51:23 CST 2017, time=2017-03-27, status=1, ipAttribution=)]
    2017-05-02 laoli

    谢谢分享,学习了!

    0

  4. 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  5. 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time=2017-03-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=183042, encodeId=3e1518304287, content=学习了,有意思, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20161019/IMG580762DBECE003340.jpg, createdBy=93fe1431842, createdName=FrankL, createdTime=Mon Mar 27 10:51:23 CST 2017, time=2017-03-27, status=1, ipAttribution=)]
    2017-04-01 ylzr123

    不错的方式,努力学习,刻苦专研,不断总结出来新经验。

    0

  6. 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content=<a href='/topic/show?id=2bcee797732' target=_blank style='color:#2F92EE;'>#细胞瘤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=77977, encryptionId=2bcee797732, topicName=细胞瘤)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf5e7252474, createdName=spoonycyy, createdTime=Wed Mar 29 00:03:00 CST 2017, time=2017-03-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=183264, encodeId=3633183264ed, content=文章不错,值得分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Tue Mar 28 11:32:22 CST 2017, time=2017-03-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=183042, encodeId=3e1518304287, content=学习了,有意思, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20161019/IMG580762DBECE003340.jpg, createdBy=93fe1431842, createdName=FrankL, createdTime=Mon Mar 27 10:51:23 CST 2017, time=2017-03-27, status=1, ipAttribution=)]
    2017-03-29 mashirong
  8. [GetPortalCommentsPageByObjectIdResponse(id=1876861, encodeId=cf2018e686173, content=<a href='/topic/show?id=67c5319121e' target=_blank style='color:#2F92EE;'>#切除术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31912, encryptionId=67c5319121e, topicName=切除术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=9d8a96, createdName=doctorzheng, createdTime=Sat Jun 24 09:03:00 CST 2017, time=2017-06-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2057845, encodeId=d03d205e845c4, content=<a href='/topic/show?id=81132381959' target=_blank style='color:#2F92EE;'>#乳酸酸中毒#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23819, encryptionId=81132381959, topicName=乳酸酸中毒)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6779163, 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  9. [GetPortalCommentsPageByObjectIdResponse(id=1876861, encodeId=cf2018e686173, content=<a href='/topic/show?id=67c5319121e' target=_blank style='color:#2F92EE;'>#切除术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31912, encryptionId=67c5319121e, topicName=切除术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=9d8a96, createdName=doctorzheng, createdTime=Sat Jun 24 09:03:00 CST 2017, time=2017-06-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2057845, encodeId=d03d205e845c4, content=<a href='/topic/show?id=81132381959' target=_blank style='color:#2F92EE;'>#乳酸酸中毒#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23819, encryptionId=81132381959, topicName=乳酸酸中毒)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6779163, 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content=<a href='/topic/show?id=2bcee797732' target=_blank style='color:#2F92EE;'>#细胞瘤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=77977, encryptionId=2bcee797732, topicName=细胞瘤)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf5e7252474, createdName=spoonycyy, createdTime=Wed Mar 29 00:03:00 CST 2017, time=2017-03-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=183264, encodeId=3633183264ed, content=文章不错,值得分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Tue Mar 28 11:32:22 CST 2017, time=2017-03-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=183042, encodeId=3e1518304287, content=学习了,有意思, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20161019/IMG580762DBECE003340.jpg, createdBy=93fe1431842, createdName=FrankL, createdTime=Mon Mar 27 10:51:23 CST 2017, time=2017-03-27, status=1, ipAttribution=)]
    2017-03-28 1e10c84am36(暂无匿称)

    文章不错,值得分享

    0

  10. 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content=<a href='/topic/show?id=2bcee797732' target=_blank style='color:#2F92EE;'>#细胞瘤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=77977, encryptionId=2bcee797732, topicName=细胞瘤)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf5e7252474, createdName=spoonycyy, createdTime=Wed Mar 29 00:03:00 CST 2017, time=2017-03-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=183264, encodeId=3633183264ed, content=文章不错,值得分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Tue Mar 28 11:32:22 CST 2017, time=2017-03-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=183042, encodeId=3e1518304287, content=学习了,有意思, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20161019/IMG580762DBECE003340.jpg, createdBy=93fe1431842, createdName=FrankL, createdTime=Mon Mar 27 10:51:23 CST 2017, time=2017-03-27, status=1, ipAttribution=)]
    2017-03-27 FrankL

    学习了,有意思

    0

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