腹腔内操作を伴わない泌尿器科手術における術後経口補水療法導入の試み

A trial of postoperative management with oral rehydration therapy in the urologic surgery without intraperitoneal procedure

　術後回復能力強化を図った術前経口補水療法に関する報告は多数あるが，泌尿器科領域における検討はなされていない。そこで腹腔内操作を伴わない泌尿器科手術40例に対し，術後輸液の代用として経口補水液OS-1^TM摂取を行い，術後尿量および術前，術後1日目，7日目に血算，腎機能，電解質を測定した。全症例で術後早期の経口補水が可能であった。血液検査値は術前に比し術後Ht値と一部の電解質値に有意な低下を認めたものの臨床的意義には乏しい範囲であった。術後尿量は平均2530mL/日と十分に保たれた。悪心嘔吐などの自覚的有害事象は皆無であった。泌尿器科領域における術後経口補水は比較的容易に，かつ安全に施行できることが示された。

There have been a lot of reports regarding the preoperative oral rehydration therapy as a way to reinforce postoperative recovery. However such assessment in the urology field has not been well accomplished. Therefore, we performed oral rehydration therapy using the oral rehydration solution（OS-1^TM）in substitution for fluid infusion after surgery. Postoperative urine volume and blood count, renal function and electrolytes were monitored in 40 patients who received urologic surgery without intraperitoneal procedure. Compared with the preoperative levels, there was significant decrease in hemoglobin levels and some electrolyte levels on the first or seventh postoperative day, but was negligible from a clinical point of view. The average postoperative urine volume amounted to 2,530 mL/day. There were no subjective adverse events such as nausea and vomiting. Taken together, the present study suggested that the postoperative oral rehydration therapy can be carried out easily and safely in the urologic patients as well.