泌尿器科領域に於ける血清蛋白の研究 第II篇:手術前後に於ける血清蛋白の変化

Abstract

薯者は結核を主とした泌尿器疾患々者3i例に手術を行い其の術前術後に於ける血清蛋白濃度並びに各分劃値を測定し次の如き結果を得た.(1)結核腎別除術によりALbは増加しGLbは特にγ一GLbが著明な減少を示す・従つてA/Gの改善が認められた.(2)此のγ一GLbの減少は手術の予後に関係し術後の7-GLbの増加持続は手術の予後不良を意味する.(3)入院時より手術施行迄の間に抗結核剤による治療を行う事により血清蛋白値にも改善が見られた.(4)手術前後に輸血, 輸液を行う事により手術侵襲による血清蛋白値の変動の恢復が早い.(5)除睾術, 副睾丸切除術等副睾及結核の手術にては血清蛋白値の変動は極めて軽度である.(6)膿腫腎に於いては術前に輸血輸液を行うもT.P.の上昇を見ず, 手術施行により低T・P・, 低ALb.高γ一GLb状態の恢復は早い.(7)高令者の膀胱裁石術に於いてはT・P・, ALbの恢復は遅れた(8)前立腺別除術にあつては其の出血量に相当し'て多量の輸血, 輸液を行つたがT.P., ALb・の減少薯しく又其の恢復も遅い二(9)尿管S状腸吻合術に於いては術前より術後週余に亘る食事摂取の制限に手術侵襲が加わる為T.P., ALb共低下, 減少が著しく多量の輸血並びに蛋白製剤の投与を必要と寸る.(10)膀胱癌に対する膀胱部分切除術に際しては相当量の輸血, 輸液を行つたがT.P・, ALb共低下の一路を辿り恢復を示さなかつた.

In the urologic deseases, mainly urinary tuberculosis, I measured the concentration and fraction of serum protein in the cases before and after operation. 1. By removal of the tuberculous kidney, albumin is increased, r-globulin is remarkably decreased and it's showed the A/G is improved. The continuation a high level of γ-globulin in the blood means a poor prognosis. 2. Before operation I administered anti-tuberculous medicine, and found improvement in the quality of serum protein. 3. Before and after operation, giving transfusion and infusion promoted the recovery of the variation of serum protein. 4. In the cases who had castration and epididymectomy, the variation of serum protein quality is just a little. 5. In the cases of old age who had cystolithotomy, the recovery of serum protein is delayed. 6. In the cases of prostatectomy where I did transfusion and infusion in quantities, but the concentration of serum protein and albumin were conspicuously decreased and the recovery of them was delayed. 7. In cases of ureterocolostomy, changes of them were very remarkable. Those cases need more transfusion and infusion than others because they are limited in their food and water for more than one week after the operation.