外科的黄疸の出血傾向に関する臨床的研究
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In performing the operation for "surgical" jaundice the hemorrhagic tendency resulting from liver damage should be taken into consideration. The abnormality of blood coagulating factors, most of which are proteins produced in the liver cells. Therefore, this study was made on the supposition that themeasurement of the changes in blood coagulating factors would foretell the hemorrhagic tendency and also that the measured values would reflect liver damage which caused it. Owren's Thrombotest values (hereinafter mentioned as T. T. values) in 58 cases of "surgical" jaundice were measured and these results lead to the following conclusions ; 1) On admission the T. T. values of 66.5 per cent of patients were lower than 70 per cent. 2) No interrelationship was found among the T. T. values, liver function and general clinical examination results. 3) In the vitamin K_1 loaded test, the improvement in T. T. values was observed in 80 per cent of the patients whose T. T. values had revealed low levels. Patients whose T. T. values did not change at the test were complicated by bile stagnation accompanied with cholangiohepatitis, and remarkable parenchymatous impediments, in a histopathological examination of their specimen. Also their post operative courses were unfavorable. 4) By the operation the T. T. values fell down transiently. However, the fall of their T. T. values after operation were remained a slight degree by giving vitamin Kx every day. As based on the above results, by the measurement of T. T. values, it was possible to grasp the pathological states of liver diseases so far undetected through other types of liver function examinations. Especially, as the degree of parenchymatous impediments in the liver can be demonstrated by the reaction of vitamin K_1 to T. T. values, this method serves as an index for deciding the proper types of anesthesia and operation and also can prevent unexpected bleeding.
- 千葉大学の論文
- 1966-05-28
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- 外科的黄疸の出血傾向に関する臨床的研究