原発性アルドステロン症の外科的検討 (II)

第4編 術前後の電解質代謝と患者管理

抄録

A clinical study with some surgical aspects was performed on 23 cases of primary aldosteronism treated in our clinic from July, 1957 to March, 1969. Results were summarized as follows:
C. Electrolyte balance and replacement during pre- and postoperative course.
1) During few days after removal of the adrenal tumor, a remarkable loss of both sodium and potassium was observed in the majority of the cases.
2) In this period, sodium supplement resulted in more sodium loss. The potassium loss was regulated under the direct influence of serum potassium level.
3) These responses might be caused by following three factors; proximal tubular rejection of sodium, disturbance of distal tubular function, and inactivation of renin-angiotensin-aldosterone system.
4) A restoration of proper electrolyte regulation mechanism was being apparent during the second postoperative week.
5) An excessive preoperative potassium conservation with sodium elimination, accordingly, might be followed by postoperative sodium deficiency. A low sodium and high potassium supplement during approximately five postoperative days and a high sodium administration after that period would be necessary. A program of the electrolyte supplement based on above-mentioned findings was demonstrated on Table 1.
6) An administration of mineral corticoids or anti-aldosterone drugs might be no effect to improve such postoperative electrolyte unbalance.