外科手術時のＶｉｔａｍｉｎ Ｋ投与の意義 特に食道癌，肝胆道系疾患手術例について，ＶＫ投与群と非投与群の比較検討

Abstract

The authors reported previously that an administration of hemostatic drugs including VK has no significant roles on the prevention of hemorrhage during immediate postoperative period. In this article, we studied the effect, of VK on the prevention of hemorrhage in postoperative patients treated with antibiotics.For this purpose, we measured prothrombin time (PT), Factor II (F-II), Factor, VII (F-VII), protein C, PIVKA II (P-II) and plasma level of VK in two groups of patients with or without VK administration. In the group of patients with VK administration 120mg/day of VK2 were given intravenously everyday. The patients of both groups were fasted and treated with antibiotics for two weeks after the operation.In the group without VK administration, PT was prolonged and F-II levels were decreased from the seventh postoperative day. Although F-VII and PC levels were decreased on the first postoperative day and returned subsequently on the seventh day, no significant difference was observed between the levels of two groups. P-II levels were significantly increased in the group without VK administration, whereas no significant changes was observed in the group with VK administration. The plasma level of VK1 decreased in both groups, but the level of, VK2, especiall MK-4, was high in the group with VK administration.These results indicate that patients treated with antibiotics during postoperative fasting period may have a VK deficiency from the seventh day. Although no bleeding disorders were observed, an administration of VK is recommended for these patients.