小児手術前後における糖代謝の検討
スポンサーリンク
概要
- 論文の詳細を見る
With 50 pediatric surgical patients including 7 neonates undergoing intravenous hyperalimentation (IVH) after operation, effects of surgical stresses on glucose metabolism were studied from pre- to immediate post-operative periods. Parameters used were blood sugar (BS), immunoreactive insulin (IRI) and immunoreactive glucagon (IRG) in addition to preoperative intravenous glucose tolerance test (IVGTT) with caluculation of glucose disappearance rate (K-value). In neonates, IRI levels were decreased preoperatively and they maintained the decreased level, even in the postoperative period when the blood sugar level was elevated. IRG levels did not differ from those observed in the adults. However, in cases with severe inflammation in particular, the levels were increased remarkably from pre-to postoperative periods. In infants, secretion of insulin was clearly seen and the level of it showed a pararell move with blood sugar level. IRG levels showed no remarkable changes. However, in patients with congenital bile duct atresia, hyperglucagonemia was observed. In children both IRI and IRG showed similar changes as observed in infants. However, in patients with portal hypertension, hyperglucagonemia was observed. All patients for whom K-values were obtained showed the normal level, irrespective of the ages. But, in neonates, insulin secretion in response to the glucose load was considerable diminished at 5min. after the commencement of the test. These results appear to suggest that, in neonates, comsumption of glucose is not diminished, but the secretion of insulin in response to the glucose load is decreased, indicating no immediate accomodation to a large amount of glucose load. Thus, in prescribing IVH on neonates, it seems important to realize that accommodation to a new concentration of IVH solution takes a rather long time. It is advisable to start with 10% solution and an incremental dose of 3% or less to a maintenance dose of less than 18%.
著者
関連論文
- 438 膵癌25例の血管造影について(第20回日本消化器外科学会総会)
- 314 小児熱傷における初期輸液療法の検討
- 9.先天性胆道閉鎖症肝細胞における microfilament に関する研究(第1報)(第10回胆道閉鎖症研究会)
- 117 傍乳頭憩室及び憩室内乳頭開口例の外科的立場からの検討(第22回日本消化器外科学会総会)
- 16 腹膜炎症例における乏尿の検討 : とくにRenin Angiotensin系のうごきを中心に
- 308 耐糖能低下例におけるインスリン少量持続注入法による術中・術後の管理 : 血糖・インスリン・グルカゴンの変動について(第16回日本消化器外科学会総会)
- I-C-1 新生児・乳児手術における糖代謝の検討 : 特にインスリン, グルカゴンの面から
- 215 高カロリー輸液の基礎的研究(第一報) : 特にインスリン・グリカゴンよりみた耐糖能について(第13回日本消化器外科学会総会)
- 147 門脈圧亢進症における術中輸液の術後代謝におよぼす影響(第12回日本消化器外科学会総会)
- 32.小児の小腸小腸重積症の4治験例(第15回日本小児外科学会関東甲信越地方会)
- III-C-28 新生児手術後の高カロリー輸液導入法の検討 : 特にインスリン、グルカゴンの面から
- 80 小児外科的コレスターシスにおける胆汁中胆汁酸の変動
- 357 消化器疾患に対する Transcathter embolization(第18回日本消化器外科学会総会)
- 小児手術前後における糖代謝の検討