老人外科における術後対策の研究

特に腎機能を中心として

抄録

The aged patients over 60 years-old who were undergone major operations were examined on the renal function pre-and post-operatively.
The younger age groups ranging from 20 to 40 years old were examined as control cases.
1) More post operative complications of the respiratory tract were seen in the aged.
2) Water-retention developed easily in the aged patients after major operation.
3) Less active and longer continuing catabolism was seen in the aged.
4) Renal hypofunction was generally pre-existed and remarkably exaggerated postoperatively. It was due to arteriosclerosis which is characteristic in the aged patients. Acute renal failure was developed easily, accompanied by circulatory disturbance.
5) Concentration of the serum Na and K stayed within normal limit post-operatively in both age groups.
Even in the cases of remarkable renal hypof unction, Na and K seldom changed' showing marked contrast to the level of NPN and BUN.
6) Renal function of the aged patients well reflected in the osmolality of the serum and the urine after both 14 hours dry test and 15 minutes result of intravenous P. S. P. test Renal protection should be carried out in the pre-oparative cases with urine osmolality below 800 mOsm. by 14 hours dry test and below 2.5 of U/P Ratio.
7) Osmotic diuretica was effective to keep the fluid-balance in the post-operative aged patients having renal hypo-function and it would prevent from developing acute renal failure.