虫垂瘻からのステロイド antedrug 注入療法を施行した潰瘍性大腸炎の3例 Three Cases of Ulcerative Colitis Patients Treated by Antedrug Steroid Hormone Injection Therapy via Appendicostomy

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著者

    • 宮澤 智徳 MIYAZAWA T.
    • 新潟大学大学院消化器・一般外科分野 Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Science
    • 岡本 春彦 OKAMOTO H.
    • 新潟大学大学院消化器・一般外科分野 Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Science
    • 谷 達夫 TANI T.
    • 新潟大学大学院消化器・一般外科分野 Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Science
    • 飯合 恒夫 IIAI T.
    • 新潟大学大学院消化器・一般外科分野 Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Science
    • 畠山 勝義 HATAKEYAMA K.
    • 新潟大学大学院消化器・一般外科分野 Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Science
    • 本間 照 HONMA T.
    • 新潟県立新発田病院内科 Department of Internal Medicine, Niigata Prefectural Shibata Hospital
    • 杉村 一仁 SUGIMURA K.
    • 新潟大学大学院消化器内科学分野 Division of Gastroenterology, Niigata University Graduate School of Medical and Dental Science
    • 青柳 豊 AOYAGI Y.
    • 新潟大学大学院消化器内科学分野 Division of Gastroenterology, Niigata University Graduate School of Medical and Dental Science

抄録

ステロイド(以下SH)依存性の全大腸炎型の潰瘍性大腸炎(以下UC)3例に,虫垂瘻からのSH antedrug注入療法を施行したので報告する.症例1 21歳女性.腰椎麻酔下に虫垂瘻を作製しSH antedrugのフルオシノニド(以下FLU)注入療法を行った.緩解導入・維持が可能となり,25カ月後に本法を中止しその後も緩解を維持している.症例2 24歳女性.本法にてSH全身投与を中止できたが,施行後24カ月後に末梢関節炎を発症したためSH全身投与を再開した.症例3 25歳男性.本法を6カ月施行したが,狭窄病変により薬剤分布に差が生じ十分な効果が得られず,免疫抑制剤の投与を必要とした.考察:本法は,全大腸炎型UCに対する局所療法として十分な効果があり,管理が容易で在宅療法が可能であること,副作用が少ないことなどの利点から,ステロイド依存性UCに対する治療法として有用であると考えられた.

We present three cases of steroid hormone (SH) dependent total-colitis-type ulcerative colitis (UC) patients who underwent antedrug SH injection therapy via appendicostomy.<BR>Case 1 : A 21-year-old woman. She had suffered from UC for 3 years. An appendicostomy was surgically made, and fluocinonide (FLU) was administered via appendicostomy. Her symptoms abated owing to the administration of FLU, and 25 months after receiving the therapy, she was able to abandon this therapy. Case 2 : A 24-year-old woman. She had suffered from UC for 2 years. Her symptoms abated owing to the administration of FLU, but 24 months after receiving the therapy, she developed colitic arthropathy, and so it became necessary to administer SH. Case 3 : A 25-year-old man. He had suffered from UC for 5 years. This therapy was given to him for 6 months. Because of the narrow lesion of the sigmoid colon, FLU seemed to spread not equally in the large intestine, and it did not work. Therefore, administration of immunosuppressant agents became necessary.<BR>This therapy is effective in total-colitis-type UC, self-medication is possible, and the therapy causes few side effects. Therefore, this therapy seems to be useful for SH dependent total-colitis-type UC patients.

収録刊行物

  • 日本大腸肛門病学会雑誌  

    日本大腸肛門病学会雑誌 59(4), 203-207, 2006-04-01 

    The Japan Society of Coloproctology

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