無胃管胃液検査法に関する研究 (後篇) 無胃管法の不一致の原因について

By the use of methylene blue resin 2 G, causes of the discrepancy between the results of the tube and tubeless tests were investigated, and the rate of disagreement between the results of the tubeless and gastric screening tests was discussed.<BR>The results can be summarized as follows:<BR>1. As for dye liberation in methylene blue resin solutions with various pH values, the amount of the free dye showed a sudden decrease above pH 2. From a viewpoint of the rate of urinary dye excretion after the introduction of 10 mg of methylene blue dye into the stomach, there is the great possibility that hypoacidity in the tube gastric method is interpreted as anaacidity in tubeless gastric analysis.<BR>2. Methylene blue resin 2 G was repeatedly administered to the same cases in an attempt to study the urinary excretion of the dye. It was found that the greater the excretion was, the more marked was a fluctuation in gastric acidity. Fluctuations between hypoacidity or normal acidity and hyperacidity were noticed in 9 (60%) out of 15 cases. This can be considered to be responsible for the fact that the method in question is limited to qualitative analysis.<BR>3. From time-to-time changes in the free dye in the stomach due to the oral administration of methylene blue resin 2 G, discrepancies were seldom caused by the shortening of the time of contact between gastric juice and resin attributable to the hyperperistalsis of the stomach. The effects of the impaired secretion of the dye from the stomach into the intestine seem rather profound.<BR>4. Even if organic pyloric stenosis is not present, caffaine sodium benzonate administration augmented gastric secretion in hyperacidity, thereby causing pyloric occlusion in a reflexive manner. Thus this case sometimes is assessed as false negative.<BR>5. The rete of disagreement concerning anacidity was high with the tubeless gastric analysis procedure in hepatic and renal diseases. In liver disease there was a correlation between B. S. P. values and the rate of disagreement. Even if the B. S. P. values were normal in renal disease, false negative cases were frequent. This finding is in agreementwith the report of Rodman et al.<BR>6. That anacidity in the tube test showed normal acidity in the tubeless test seems to be attributable to great quantities of the dye liberated by intestinal juice.<BR>7. Analyses by regions of the rate of disagreement between the results of the gasteic screening and tubeless tests showed that improvements were made possible by thoroughgoing instructions regarding the oral administration of resin and the method of urine collection. Errors in collection time can be reduced by increasing the amount of resin to be orally administered.