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外科的領域의 電解質에 關한 硏究

A Study on Electrolytes Concerned in the Field of Surgery

대한외과학회지 1962년 4권 10호 p.647 ~ 680
허탁,
소속 상세정보
허탁 (  ) - 경북대학교 의과대학 외과학교실

Abstract


The alteration in the electrolyte balance in the field of surgery can be confirmed by rapid and accurate measurment Tf the serum total base. Serum total base is known to be an essential factor in´ the- determination of acid-base balance and in preoperative care, during the operation, and in postoperative care. It is an important part in controlling the alteration of the acid base balance in order to give better treatment for the patient.
For this purpose, the author attempted to perform the measurement of serum total base by using "Cation" exchange Resin as suggested by Pol is and Reinhold and for the measurement of serum bicarbonate, the author used the micro-determination method- of Van Slyke.
1) Exchange Resin column, the filtration rate of the salt solution, the comparison of double measurement of each individual serum, comparative measurement of more than ten times on the same serum, the condition of aqua and its accuracy in function were determined as preliminary tests. In carrying out the experiment the author chose 100 random cases of healthy Korean males and females performed the measurements. The results are; serum total base from 150.2 mEq/L to 163.5mEq/L, mean value of total serum base 154.3 mEg/L, mean error 1.67, the tota Iserum bicarbonate from 22mEq/L to 3OmEq/L, mean value of serum bicarbonate 27.3mEq/L. These results equal those of Gamble.
2) For chronic wasting disease, the author chose 100 cases of leprosy patients and obtained the following results. Total serum base was from 145.8mEq/L, to 160.9mEq/L, mean value, 152.2 mEq/L and´ mean error was 3.06. This result shows average decrease of about 2.lmEq/L compared with that of healthy Korean Total serum bicarbonate was between 22mEq/L and 33mEq/L, mean value was 26.96mEq/L and there was no significant difference from normal healthy Korean. There was no significance difference between each type of disease and during the first two years of medication with D.D.S.; there was slight decrease but this decrease came back up to normal-as the medication period prolonged.
3) Fifty random surgical patients were examined from the days of admission until two - weeks after operation. The results are: those whose general condition were poor showed slight increase. In serum total base during the preoperative care and the value came down gradually after preoperative care. According to the kinds of anesthetics, there was an apparent decrease down to 1.2mEq/L-9mEq/L until 1 to 3 days after the operation and until 5 to 9 days after the operation when the value was back to normal. Total serum bicarbonate showed no significant alteration in all cases.
As it has been pointed out above, the measurement of total serum base and total serum bicarbonate in the surgical patients is important not only because of understanding the condition of the patient but also because it is necessary as a step in the preoperative care to prepare for the anesthesia and operation. It is also very important to have the patient in good condition in order to prevent any accidents during and after the operation.

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