原发性醛固酮瘤切除术后并发严重高钾血症1例报告

Severe hyperkalemia after aldosteroneoma resection:a case report

本文报道1例18岁男性患者,因四肢乏力伴低钾血症6个月入院。CT检查示左肾上腺腺瘤。术前实验室检查示低钾血症、高醛固酮血症。予补钾、降血压治疗后行后腹腔镜左肾上腺腺瘤切除术,术后2 h内并发严重高钾血症,血钾7.02 mmol/L。予高渗透糖+胰岛素+阳离子交换树脂治疗,术后12 h血钾恢复正常。术后随访5个月,血浆醛固酮、血钾、血压恢复正常。对于肾上腺醛固酮瘤切除术后患者应警惕高钾血症的发生。

We reviewed the data of an 18-year-old male patient complained of weakness of limbs and hypokalemia for 6 months.CT scan revealed left adrenal adenoma.He was diagnosed as primary aldosteronism(PA).Laboratory tests showed hypokalemia and hyperaldosteronemia.After potassium supplement and blood pressure lowering treatment,laparoscopic resection of the left adrenal adenoma was performed,and severe hyperkalemia occured 2 hours after surgery(maximum serum potassium 7.02 mmol/L).After hyperrisotonic glucose+insulin(10%glucose 200 ml+50%glucose 40 ml+insulin 8U)+cation exchange resin(Sodium Polystyrene Sulfonate 20 g)treatment,serum potassium returned to normal range within 12 hours.The plasma aldosterone,blood potassium and blood pressure returned to normal during the 5-month follow-up.According to the experience of this case report,after resection of aldosteronoma,the changes of serum electrolyte should be closely monitored,the occurrence of hyperkalemia should be vigilant.