胃切除後の水分代謝の研究

For supplying fluid and nutriment and for preventing the stagnation in the stomach after gastrectomy the author employed a modified Abbott-Rawson's doule lumen tube with satissfactory results.<br>Continuous suction of stomach contents on one hand and instillation of casein hydrolysate, sugar, salt mixture, and vitamins on the other were made after gastric resection. The instillation was started six hours after operation. The amount given was as follows: 500-800cc on the day of operation (during operation 1, 000-1, 500cc of 5% glucose in Ringer solution was injected intravenously), 1, 000-1, 200cc on the next day, and, from the second day on 1, 500-2, 000cc was given. This was continued for 4 to 5 days, thereafter, the patients were allowed to take food and fluid by mouth. Above treatments were applied to 13 cases of gastric cancer, 25 cases of gastroduodenal ulcer, and 4 other cases totaling 42 cases.<br>Conclusions:<br>1) The urinary output was 400-500cc on the day of operation. The amount was gradually increased, reaching to 1, 000cc in 6 days.<br>2) During the first 3 post-operative days, the urinary output did not balance the fluid intake. However, after the third day they ran parallel.<br>3) The specific gravity of urine was found inversely proportional to the amount of output.<br>4) In order to keep the specific gravity under 1, 030 the urinary output had to be maintained above 1, 000cc Since the daily fluid loss through skin and respiration is over 500cc per day, the fluid intake should be over 1, 500cc.<br>5) The author states that he cannot agree with the opinion that the fluid intake is adequate if the amount of fluid consumed is equal to that of urinary output.<br>6) The salt loss incident to gastric suction was 1.2-4.5g. per day and the salt excreted in the urine decreased 2.4g. on the 4th postoperative day which was found to be the minimal amount. Thus the daily salt loss was 5-10g.