後壁固定に依る胃切除術(中山式胃切除術)前後に於ける血中焦性葡萄酸及び乳酸の消長に就いて

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概要

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• The advent of the Nakayama's gastrectomy, one of the modification of the Billroth I procedure, has made it pssible to perform gastrectomy with much ease and astonishedly low mortality and ' morbidity. The author performed quantative measurement of serum pyruvic acid and lactic acid content throughout the pre- and postoperative period (including the follow-up period) upon 177 cases undergoing the Nakayama's gastrectomy. A new information assured in this study shall be epitomized herein. The methods used in this study are the Shimizu's method, a modification of the Friedmann's, for pyruvic acid, Barker and Summerson's method for lactic acid, and colorimetry was done by the Leitz Rouy photrometer. Results: 1) Quiet Stage: The determination of these two substances showed a high level, especially in cases with cancer, prior tooperation, whereas it revealed a trend toward correction after. operation. 2) Exercise Test: These substances showed a specific curve with the maximum level in 10 minites after exercise test preoperatively, while these approached to the normal curve postoperatively. 3) Oral Glucose Duplicate Administration Test: This test did not evoke appreciable untoward ill-effect, which are presumably attributable to the principle of our postoperative care, that is, an early ambulation and early intake of highly nutritous diet. 4) Thiamine Administration Test (10 mg) Gastrectomized patients are apt to be accompanished by a shortage of thiamine, especially in patients with cancerous disease. After operation, however, a definite improvement was confirmed. 5) Changes in these substances during operation indicated no fear of gastrectomy itself under spinal anesthesia, whereas these suggested the possibility of a risk of gastrectomy under general anesthesia unless intelligent care is exercised. 6) In the postoperative course, these levels were the highest on the day of operation, after when these level returned to the normal, proportional to recovery of the general condition. The occurrence of complications induced an increase in these levels, and the recovery from illnesses brought a reduction in these. The author shall be happy if this study might be of help for physiological evaluation of gastrectomized patients through pre- and postoperative stage.

• 千葉大学の論文

著者

• 土屋 律

  千葉大学

• 土屋 律

  千葉大学医学部第二外科学教室

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