[Evaluation of water-electrolyte metabolism in patients with upper GI tract cancer--the dynamic status of secretion of alpha-hANP levels].
For the purpose of evaluation of the water-electrolyte metabolism in upper GI tract surgery, I measured alpha-human atrial natriuretic polypeptide (alpha-hANP) and other parameters of twenty-eight patients daily for seven days after operation. The subjects were divided in four groups as follows; 6 r-thoracal and abdominal esophagectomy (r-TA group); 4 l-thoracoabdominal total gastrectomy (1-TA group), 8 abdominal total gastrectomy (TMR group) and 10 partial gastrectomy (PMR group). Plasma alpha hANP levels in r-TA group were significantly higher than those in PMR group on the first, second, third and seventh postoperative days (p less than 0.05). Furthermore, those in 1-TA group were also significantly higher compared to those in PMR group on the second and seventh postoperative days (p less than 0.05). Significant correlation between plasma alpha hANP level and water balance was detected in transabdominal groups (TMR, PMR). However, this correlation was not found in thoracoabdominal groups (r-TA, l-TA). There was no correlation among alpha hANP level, heart rate and blood pressure. Serum and urinary Na/K ratio was lower in r-TA group, l-TA group, TMR group, and PMR group in descending order. Consequently, plasma alpha hANP level plays an important role in water-electrolyte metabolism during the perioperative period. A good group of the dynamic status of the secretion of alpha hANP levels might be a very useful index for the evaluation of the magnitude of surgical stress.
Kojima
Y
Y
Department of Surgery, Kansai Medical University, Osaka, Japan.
D000368:Aged; D000369:Aged, 80 and over; D009320:Atrial Natriuretic Factor / Q000378:metabolism*; D001794:Blood Pressure; D004938:Esophageal Neoplasms / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D010446:Peptide Fragments / Q000378:metabolism*; D011184:Postoperative Period; D013274:Stomach Neoplasms / Q000503:physiopathology / Q000601:surgery*; D014882:Water-Electrolyte Balance
D010446:Peptide Fragments; D009320:Atrial Natriuretic Factor