各種胃手術後下痢の水分・電解質代謝に関する研究

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概要

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• It has become common practice to operate on patients with various diseases of the stomach. Sometimes these patients develop diarrhea postoperatively, and consequently their restoration is delayed. Statistical survey made on patients operated on for stomach troubles in our clinic shows that the incidence of diarrhea is higher among patients treated with gastrectomy than among those with similar diseases who have not been operated on, and that patients who have undergone total gastrectomy have by far the higher incidence of diarrhea than those who have undergone partial gastrectomy. Experiments were carried out in dogs in which diarrhea was caused to develop, as well as in patients with diarrhea following gastrectomy, to study water and electrolyte metabolism. The following observations were made: Diarrhea is due to the loss of function of the stomach and hypofunction of the residual alimentary tract. Large amounts of sodium and potassium, as well as water, were detected in the feces. Serum sodium levels were below normal levels in patients with diarrhea following partial gastrectomy, potassium levels also falling when diarrhea was prolonged. A reduction in the amount of extracellular fluid was more marked than that in serum volume. In patients with diarrhea following total gastrectomy, serum sodium, potassium and chloride levels were lower than normal levels, and there was a marked reduction in serum volume. Changes in water and electrolyte levels in patients with diarrhea followed different patterns after partial and total gastrectomy. Patients who have undergone total gastrectomy was marked by disturbance of water and electrolyte metabolism, due primarily to the absence of compensatory process.

• 千葉大学の論文

著者

• 関谷 仁彦

  千葉大学医学部中山外科教室

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