剖検例よりみた薬物の副作用 : 輸液による急性尿細管変性

概要

論文の詳細を見る
Difference of acute degeneration of renal tubules which was caused by four kinds of the intravenous fluids (Dextran 40, Dextran 40-hypertonic solution, hypertonic solution, hypertonic solution-antibiotics) was examined with 20 autopsy cases. Though only 20 cases of serious underlying diseases were examined, following findings were obtained : 1) Acute degeneration of renal tubules due to the intravenous fluid therapy is caused by the continual administration of fluid. 2) Of acute degeneration of renal tubules, "hydropic" degeneration should be differentiated from "vacuolated" one. 3) Dextran 40 produces marked hydropic degeneration of renal tubules. 4) Hypertonic solution causes marked vacuolated degeneration and mild hydropic change. But when it is administered together with Dextran 40, hydropic change due to Dextran 40 is prominent, and vacuolated change due to hypertonic solution is reduced. 5) Antibiotics produce vacuolated degeneration. 6) In order to prevent acute degeneration of renal tubules due to the fluid therapy, the continual administration of fluid and the administration of Dextran 40 combined with hypertonic solution and antibiotics should be avoided. 7) Dextran 40 should be administered in conjunction with electrolyte solution.
日本医療薬学会の論文
1977-08-20