沖縄消化器病学会の展望

PROSPECTIVE OF OKINAWA GASTROENTEROLOGICAL SOCIETY.

Ⅰ．はじめに

　沖縄は，沖縄本島，宮古島，八重山島の他60余の島々からなり，人口90万余人．医師会々員数は，開業医，勤務医，公務員医師合わせて319名である．医師の約9割が沖縄本島に，又開業医の約半数が，沖縄の政治経済の中心地那覇市に集中し，社会保障制度も最近やっとその緒についたばかりである．

　医学会は沖縄医学会が春秋2回開催されるだけで，琉球政府の重要政策の一つである肺結核を除いては演題も症例報告が多い．しかし最近各科に分科会が誕生，分科会活動として各種疾患を合同調査する機運が起っている．沖縄内視鏡同好会（1962年結成）も結成以来現在迄会員の技術向上のため，X線関係では，白壁彦夫，市川平三郎，山田達哉，内視鏡関係では，芦沢真六，森純伸，斎藤利彦，病理学関係では村上忠重先生等の技術指導を仰ぎ，現在会員数48名，使用されている内視鏡の数は37式（V型22，V_A型11，GTF4）である．同好会所属の医療機関は38ヵ所（政府立病院3，公立病院1，診療所34）で，診療科別にみると，内科18，外科20，これを沖縄本島についてみると，内科の約1/3．外科の大部分が同好会に所属していることになる．

　従って，与えられた題目の主旨とは些か異なるが，沖縄医学会に発表された業績を随時引用しつつ，沖縄内視鏡同好会の調査した2，3の成績について述べたいと思いますので御了承願います．

　At twelve of the medical institutions in Okinawa, 876 patients suffering from gastroenterological diseases were operated upon in the past two years. To give some statistical analysis; of 876 cases, 493 cases (56.3%) with stomach diseases were the greatest in number and diseases of the bile duct found in 180 cases (20.5%) were second in number. Cancer in the digestive organs found in 147 cases represented 16.8%. Gastric cancer showed the highest rate. Operations on esophageal cancer showed a low percentage but this does not necessarily indicate a low rate of incidence. Many such patients were treated radiologically. This cancer showed a rather high rate statistically of mortality and clinical aspects. Fourteen cases of early gastric cancer were found (Ⅱc+Ⅲ 7, Ⅱc 4, Ⅲ 3). The number of cases of digestive ulcer was 380 and represented more than 70%. Duodenal ulcers were more frequently found than gastric ulcers. The ratio of incidence between gastric cancer, gastric ulcers and duodenal ulcers was 1 : 1.4 : 2.5. 54 cases of perforation of ulcers were experienced representing 14.2% of all ulcers. Perforations of the duodenum were more frequent than those of the stomach. In 180 cases of bile duct diseases, 153 cases (85%) of cholelithiasis represented the major number and 19 cases (10.6%) of cholecystitis were the second number group. Cholesterine stones were seen most often. 4 cases of gastric cancer (1 %), 16 cases of gastric ulcers (4 %), 29 cases of duodenal ulcers (7.2%) and 4 cases of stomach polyp (1%) were found during group examinations. Nematode infection showed various clinical symptom and roentogenological finding in digestive organs, therefore, it is necessary to pay attention to this when gastroenterological disease is treated in Okinawa.