耳鼻咽喉科手術と循環機能に関する問題

　各種手術に於て最初に，又鋭敏に変化を示して来るものは循環器官の機能である。我々は手術施行に際して常に之の機能に注意を払つている事は周知の事実である。出血量，疼痛，術前後の自律神経緊張状態の変化，麻醉等は循環系に影響を及す。故に之が影響変化を手術の種類に分けて脈博血圧及び心電図に就て観察し，且之の変動と出血量との関係を調査した。

　尚手術が患者の循環系統に及す影響は種々な因子に支配されているので，その考案には慎重を要する。我々は臨床医であつて，循環機能の生理に対しては專門家ではない。従つてその方面の人々より見ると方法において不備な点や，解決妥当を欠く点が多々存する事と思うが，予め此の点に対して断つておきたい。

Hyo and associates investigate the effect of operative procedure on the general circula-tion by makinga special notes on pulse counts, blood pressure readings and recording the amount of blood loss. No specific effect is produced by the types of operations performed but similar effects are noted at a certain level in the amount of blood loss incurred. Immedi-ately after the start of the operation the pulse rate and blood pressure begin to take a rise. This rise in blood pressure is maintained at the same level if the amount of blood loss be less than 300cc: above 500cc the pressure begins to descend to approach that which might be present preoperatively; at 1,000cc the pressure begins to be decreased with rapi-didty. If the operation should be continued be-yond 30 minutes after the time when the blood pressure reading had approach to that reading recorded preoperatively the incurred blood loss must be compensated by equal volume of, either, blood or liquids by intravenous route. The pulse count will increase with the increase in the amount of blood loss, but, it is no means an indication in the amount of that loss.