下部尿路通過障碍の研究(第1報) : 下部尿路通過障碍における水と電解質の研究

概要

論文の詳細を見る
Studies of metabolism of water and electrolytes before and after continuous drainage were made for 27 patients with lower urinary tract obstructions, and 3 cases with ureterar obstructions as control. In about half the cases, plasma Na, K C1 concentrations, hematocrit findings, plasma total protein, urinary Na, K and C1 outputs, T-1824-space and SCN-space were studied at: 1, 2, 3, 6, 12 and every 24 hours after the relief of obstructions 1) In the cases whose renal functions were normal or slightly impaired, blood chemistry studies before urethral catheter drainage proved that plasma electrolyte abnormalities were not only slight or absent, but all of these patients presented also good general physiological conditions and no dehydration symptom excepting in water-restricted cases. After the drainage, considerable fluctuations of chemical components of plasma occurred during half a day. That is, the concentrations of plasma electrolytes (Na, K C1) were reduced temporarily after relief of obstructions, concentrations of plasma protein and hematocrit values decreased too at the same time. It was, therefore, suggested that a hydremic state had occurred within this short period. These levels became higher in all cases thereafter, and returned to normal level within 12 hours or one day after the relief. In many cases water balance became negative shortly after the relief of obstructions, but there were no cases which showed remarkable polyuric state. All of these patients in this group made smooth recoveries without particular fluid administration and could be operated upon successfully, excepting one hypertensive patient who died of cerebral hemorrhage which occurred after sudden hypotension caused by the relief of obstruction. 2) The results of animal experiments with dogs of acute urinary retention, in spite of insufficient fluid and salt supply, made it appear that transitory hydremia after the bladder drainage might occur, coinciding with ths clinical cases of slight renal dysfunction. 3) In advanced renal failure group, high degrees of water and electrolyte abnormality were exhibited already before admission to the hospital in may cases, and severe changes and great deviations of the plasma electrolytes level from normal took place after the relief of obstruction; especially negative balance of water and sodium persisted, and there was a great tendency to dehydration and hyponatremia. It is important that adequate fluid supply should be prescribed in such cases.
社団法人日本泌尿器科学会の論文

下部尿路通過障碍の研究(第1報) : 下部尿路通過障碍における水と電解質の研究

スポンサーリンク

概要

著者

関連論文

スポンサーリンク