The analysis of influencing factors of perioperative blood pressure fluctuation of pheochromocytoma / 中国医师进修杂志

ABSTRACT

ObjectiveTo analyze the influencing factors of the blood pressure fluctuation during the perioperative period of pheochromocytoma,and discuss the ways to improve the hemodynamics.Methods The clinical data of patients with pheochromocytoma who had received operation from 2000 to 2010 werestudied retrospectively.The influencing factors of perioperative blood pressure fluctuation were analyzed by statistical methods including Pearson correlation analysis and Logistic regression.ResultsAccording to Pearson correlation analysis,the influencing factors of the highest fluctuation value of the systolic blood pressure ( △ SBP) during the operation included the preoperative highest systolic blood pressure (r =0.196,P =0.013 ),the content of preoperative 24-hour urine epinephrine ( r =0.207,P =0.008 ) and the lost blood volume during the operation (r =0.253,P=0.003).Logistic regression analysis showed that the postoperative persisting hypotension was influenced by the content of preoperative 24-hour urine norepinephrine(OR =1.273,P =0.002) and preoperative preparation duration(OR =0.921,P =0.034);the risk factors of postoperative hypertension were residual tumor (OR =16.920,P =0.001 ) and the preoperative hematocritchange(OR =1.467,P =0.018).ConclusionsIn spite of the adequate preoperative preparation,great changes of blood pressure would still occur during the perioperative period of pheochromocytoma,and it is influenced by many factors.Corresponding measures aiming to these factors should be taken to decrease the perioperative blood pressure fluctuation and surgical risks.