建议在嗜铬细胞瘤肾上腺切除术期间控制血流动力学特征，以尽量减少围手术期心血管并发症。然而，在肾上腺切除术中，除了嗜铬细胞瘤以外，还观察到了术中血流动力学不稳定的情况。本研究的目的是将在没有术前医疗准备的单侧肾上腺嗜铬细胞瘤切除术中评估的血流动力学不稳定评分与非分泌性肿瘤的血流动力学不稳定评分进行比较。这是一项前瞻性术中血流动力学数据收集（每 20 秒）和回顾性分析的观察性研究。在研究期间，共纳入了 60 名连续患者（30 名嗜铬细胞瘤 vs 30 名非分泌性肿瘤），总手术时间期间收集的数据中位数为 318（四分位距，257-388）。超出目标血压范围的平均累积术中时间占总手术时间的百分比，收缩压 >160 mm Hg 时分别为 13.3% 和 6.8% (P = .01)，平均动脉压 <60 时分别为 2.4% 和 2.8%分别为毫米汞柱 (P = ns)。嗜铬细胞瘤组和非分泌性肿瘤组在总手术时间内的中位血流动力学不稳定评分分别为 33（四分位距，27-43）和 20（四分位距，11-26）（P < .01）。每个患者组中接受长期抗高血压治疗的患者与未接受长期抗高血压治疗的患者的血流动力学不稳定评分相似（P = ns）。平均住院时间为2.0±1.5天，30天发病率为6.6%（4/60），两组之间没有观察到显着差异。尽管在没有术前准备的情况下，嗜铬细胞瘤组术中血流动力学不稳定仍然较大，两组都有相似的低血压发作。这些数据强调需要更好地了解术前医疗准备对嗜铬细胞瘤患者的作用。版权所有 © 2024 Elsevier Inc. 保留所有权利。

Control of hemodynamic features during adrenalectomy for pheochromocytoma is recommended to minimize perioperative cardiovascular complications. However, episodes of intraoperative hemodynamic instability have been observed during adrenalectomies with other indications than pheochromocytoma. The objective of this study was to compare the hemodynamic instability score assessed during unilateral adrenalectomy for pheochromocytoma without preoperative medical preparation to hemodynamic instability score in nonsecreting tumor.This was an observational study with prospective intraoperative hemodynamic data collection (every 20 seconds) and retrospective analysis.During the study period, 60 consecutive patients (30 pheochromocytomas vs 30 nonsecreting tumors) were included with a median number of data collections during total procedure time of 318 (interquartile range, 257-388). Mean cumulative intraoperative time outside the target blood pressure range expressed as a percentage of total procedure time was 13.3% vs 6.8% for systolic blood pressure >160 mm Hg (P = .01) and 2.4% vs 2.8% for mean arterial pressure <60 mm Hg (P = ns), respectively. The median hemodynamic instability score during total procedure time was 33 (interquartile range, 27-43) and 20 (interquartile range, 11-26) in the pheochromocytoma and nonsecreting tumor group, respectively (P < .01). Hemodynamic instability score were similar in patients with compared with without long-term antihypertensive treatment in each patient group (P = ns). The mean length of hospital stay was 2.0 ± 1.5 days, and 30-day morbidity rate was 6.6% (4/60) with no significant difference observed between both groups.Although intraoperative hemodynamic instability remains greater in the pheochromocytoma group without preoperative medical preparation, both groups have similar hypotensive episodes. These data highlight the need to better understand the role of preoperative medical preparation in pheochromocytoma patients.Copyright © 2024 Elsevier Inc. All rights reserved.