目的 对比嗜铬细胞瘤（pheochromocytoma，PCC）与腹部副神经节瘤（paraganglioma，PGL）患者围麻醉手术期的临床特征及血流动力学稳定性差异，为制定个体化围术期管理策略提供循证依据。 方法 回顾性收集2005年1月至2024年12月在北京大学第一医院接受手术治疗的692例患者临床资料，其中PCC组535例，腹部PGL组157例。采用标准化数据收集流程，通过多重填补法处理缺失数据，对关键结局指标进行多因素回归分析以控制混杂因素。比较两组术前基线资料、术前准备情况、术中关键指标及术后恢复结局。 结果 与PCC组相比，PGL组肿瘤最大径更大（P < 0.001），术前最高收缩压（P = 0.019）和舒张压（P = 0.023）更高，血浆去甲肾上腺素水平更高（P = 0.044），血浆甲氧基肾上腺素水平更低（P = 0.006），α受体阻滞剂使用时长更长（P = 0.015），且更倾向于使用非选择性α受体阻滞剂。术中PGL组开放手术占比更高（P < 0.001），手术时长更长（P < 0.001），术中改良血流动力学不稳定评分更高（P < 0.001），出血量更多（P < 0.001）。术后PGL组入住ICU比例、机械通气使用率更高，ICU停留时间、机械通气时间及术后住院时间更长（P < 0.05），两组术后主要并发症发生率差异无统计学意义（P = 0.343）。多因素回归分析显示，肿瘤类型PGL是术中血流动力学不稳定的独立危险因素。 结论 与PCC相比，PGL患者围术期呈现术中血流动力学稳定性更差、出血量更多、术后恢复时间更长等特征。

Objective To compare perioperative clinical characteristics and hemodynamic stability between patients with pheochromocytoma （PCC） and abdominal paraganglioma （PGL）， and to provide evidence-based recommendations for individualized perioperative management. Methods This retrospective study analyzed clinical data from 692 patients who underwent surgical resection at Peking University First Hospital between January 2005 and December 2023. Patients were stratified into the PCC group （n = 535） and the abdominal PGL group （n = 157）. Data were collected using a standardized protocol； missing values were addressed via multiple imputation. Multivariate regression analysis was employed to control for confounding factors. Comparisons were made regarding preoperative baseline characteristics， preparation protocols， intraoperative metrics， and postoperative recovery outcomes. Results Compared to the PCC group， patients with PGL presented with larger tumor diameters （P < 0.001）， higher preoperative systolic （P = 0.019） and diastolic blood pressure （P = 0.023）， elevated plasma norepinephrine levels （P = 0.044）， and reduced plasma metanephrine levels （P = 0.006）. PGL patients required a longer duration of α-blockade （P = 0.015） and showed a higher utilization rate of non-selective α-blockers. Intraoperatively， the PGL group underwent open surgery more frequently （P < 0.001）， experienced longer operative times （P < 0.001）， exhibited higher modified hemodynamic instability scores （P < 0.001）， and sustained greater blood loss （P < 0.001）. Postoperatively， the PGL group demonstrated higher rates of ICU admission and mechanical ventilation， along with prolonged ICU stays， ventilation duration， and hospitalization （all P < 0.05）. No significant difference was observed in the incidence of major complications （P = 0.343）. Multivariate analysis identified PGL as an independent risk factor for intraoperative hemodynamic instability. Conclusion PGL patients face greater perioperative challenges than PCC patients， characterized by inferior hemodynamic stability， increased blood loss， and delayed recovery.