前立腺肥大症手術の副腎皮質機能に及ぼす影響

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The adrenocortical function following surgery have been estimated in many ways in the literature, but the recent progress in this study suggests to use plasma cortisol activity. For the determination of this subtance, the fluorimetrical method of Rudd et al. with slight modification was used. The purpose of this paper is to compare the grade of stress to the adrenal cortex between open prostatectomy and transurethral resection of prostate (TUR-P) in geriatric patients. In our clinic, the determination of plasma cortisol was applied to clarify this problem. Fourteen benign prostatic hypertrophied patients (60 to 81 years old) were studied, in whom open prostatectomy (suprapubically and perineally) or TUR-P were performed. Successive determination of the plasma cortisol activity was done preoperatively and postoperatively (5 to 7 days following the surgery). The results were as follows: 1) Immediately after the surgery, the levels of cortisol activity rose significantly in the both groups. This was thought to be a normal response of the adrenal cortex. 2) On the first postoperative day, the cortisol levels of TUR-P groups returned to normal already and it resembled the stress pattern of response of "Minor surgery" group. 3) On the contrary, the cortisol levels of open surgery groups decreased gradually day after day and it returned to the usual value 1 week following the surgery. These findings resembled "Major surgery" group.
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前立腺肥大症手術の副腎皮質機能に及ぼす影響

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