下垂体，視床下部腫瘍術後の水，電解質代謝異常の発生原因とその対策—低Na血症例について

Hyponatremia Following Surgery for Tumors in the Hypophyseal or Hypothalamic Region

Ⅰ．緒言

　頭蓋内手術，なかんずく，下垂体・視床下部腫瘍手術後に招来する水分，電解質代謝異常の問題は，脳神経外科医がしばしば経験するきわめて重要な問題の1つである．電解質代謝異常の内，特に血清Naが低下する場合は^{3，5，7，8，15）}，時にきわめて重篤な状態に陥ることがあり注意を要する．我々も，日常の術後管理の中で，この低Na血症の対策に苦い経験を持っており，本稿では，下垂体・視床下部腫瘍手術後に生じた低Na血症に焦点をしぼり，検討した結果を報告し，諸家の御批判を受けたい．

Following surgery for tumors in the hypophyseal or hypothalamic region, low serum Na level (hyponatremia) is sometimes noted and causes clinical manifestations. Therefore, on the care of patients within 1 to 2 weeks following operation for tumors in this region, stabilization of serum Na level is one of the most important problems.

The authors experienced 16 cases of hyponatremia ranging less than 130mEq/L after surgery for tumors in this region (Fig. 1). Sixteen cases were analyzed in details and the results were summarized as follows.

(1) Pathogenesis of hyponatremia (Table 2):