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原发性醛固酮增多症的麻醉与腹腔镜肾上腺切除术

Anesthesia and laparoscopic adrenalectomy for primary aldosteronism.

作者信息

Lertakyamanee N, Somprakit P, Buranakijaroen P, Lertakyamanee J, Nimmanwudipong T, Sriussadaporn S

机构信息

Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.

出版信息

J Med Assoc Thai. 2001 Jun;84(6):798-803.

Abstract

Adrenalectomy is the curative treatment of primary aldosteronism or Conn's syndrome. Laparoscopic adrenalectomy, a new method, should result in less pain and shorter hospitalization. We reported 25 patients who received anesthesia and laparoscopic adrenalectomy from 1995-1999. There were 17 females and 8 males. The mean age was 41.9 years (range 25-59). Ninety-six per cent had hypertension, 76 per cent had weakness of the extremities. When these patients sought medical care, their serum potassium and bicarbonate were 2.4 and 30.9 mEq/l respectively. Before operation, after treatment with spinorolactone, they were 4.3 and 24.4 mEq/l respectively. Associated diseases and cardiovascular abnormalities were reported. General anesthesia was the anesthetic technique of choice. Laparoscopic adrenalectomy was described in detail. Sixteen patients had adenomas on the left adrenal gland, 9 were on the right. Twenty-four patients had unilateral adrenalectomy, one had enucleation of the tumor. The size of the adenoma was 1.8 cm (range 1-3). There was no morbidity or mortality. All patients were discharged on the third postoperative day.

摘要

肾上腺切除术是原发性醛固酮增多症或康恩综合征的根治性治疗方法。腹腔镜肾上腺切除术作为一种新方法,应能减少疼痛并缩短住院时间。我们报告了1995年至1999年间接受麻醉和腹腔镜肾上腺切除术的25例患者。其中女性17例,男性8例。平均年龄为41.9岁(范围25至59岁)。96%的患者患有高血压,76%的患者有四肢无力症状。这些患者就医时,血清钾和碳酸氢盐分别为2.4和30.9 mEq/L。术前,在使用螺内酯治疗后,分别为4.3和24.4 mEq/L。报告了相关疾病和心血管异常情况。全身麻醉是首选的麻醉技术。详细描述了腹腔镜肾上腺切除术。16例患者左肾上腺有腺瘤,9例右肾上腺有腺瘤。24例患者接受了单侧肾上腺切除术,1例进行了肿瘤摘除术。腺瘤大小为1.8 cm(范围1至3 cm)。无并发症或死亡病例。所有患者术后第三天出院。

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