大腸穿孔症例に対するエンドトキシン吸着法の有効性について  [in Japanese] EFFECTIVENESS OF THE EDNDOTOXIN ADSORPTION METHOD IN PATIENTS WITH PERFORATION OF THE COLON  [in Japanese]

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Author(s)

    • 佐藤 浩一 SATO Koichi
    • 順天堂大学順天堂伊豆長岡病院外科 Department of Surgery, Juntendo University, Izunagaoka Hospital
    • 河井 健 KAWAI Ken
    • 順天堂大学順天堂伊豆長岡病院外科 Department of Surgery, Juntendo University, Izunagaoka Hospital
    • 関根 庸 SEKINE You
    • 順天堂大学順天堂伊豆長岡病院外科 Department of Surgery, Juntendo University, Izunagaoka Hospital

Abstract

1989年より8年間に当外科で29例の大腸穿孔症例を経験した.これらの各群のsystemic inflammatory response syndrome (SIRS)・術後7日までの白血球数・血小板数・尿素窒素について比較検討した. I群はSIRS陰性例. II群はSIRS陽性例で,うち生存例をII-1群,死亡例をII-2群. III群はSIRS陽性でエンドトキシン吸着 (PMX) 施行例.白血球数ではI群は術前7,400 ± 4,100/mm<sup>3</sup>に対し, II群は8,800 ± 6,600/mm<sup>3</sup>であったが, II-1群は12,900 ± 5,200/mm<sup>3</sup>と上昇しており, II-2群は2,400±1,600/mm<sup>3</sup>, III群は2,500 ± 1,200/mm<sup>3</sup>と極端に減少していた. PMX施行例は術後経過とともに上昇し,術後7日目には9800 ± 4,300/mm<sup>3</sup>とII-2群に比べ有意に増加した.また, SIRS陽性例にPMXを施行することは,血小板数・尿素窒素の改善に有効であった.

In a recent 8-year period since January 1989, 29 patients with perforation of the colon were treated at the department. The leukocyte count, platelet count, and urea nitrogen concentration up to postoperative day 7 were compared according to systemic inflammatory response syndrome (SIRS) status. Group I (7 patients) was negative for SIRS. Group II (13 patients) was positive for SIRS and Group II patients were subdivided into group II-1, consisting of eight survivors and group II-2, consisting of five patients who died. Group III (9 patients) was positive for SIRS and underwent PMX. As compared with the<br>preoperative leukocyte counts in group I (7400 ± 4100/mm<sup>3</sup>) and group II (8800 ± 6600/mm<sup>3</sup>), the value in group II-1 (12900 ± 1600/mm<sup>3</sup>) was high and those in group II-2 (2400 ± 1600/mm<sup>3</sup>) and group III were very low (2500 ± 1200/mm<sup>3</sup>).<br> Postoperatively, however, the leukocyte count increased with time to 9800 ± 4300/mm<sup>3</sup> on postperative day 7 in patients who underwent PMX, which was significantly higher than the value in group II-2. Similar trends were seen for the platelet count and urea nitrogen concentration. Our results suggest that PMX is effective for improving the status of patients who are positive for SIRS.

Journal

  • Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association)

    Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) 59(11), 2734-2739, 1998-11-25

    Japan Surgical Association

References:  13

Cited by:  10

Codes

  • NII Article ID (NAID)
    10008437060
  • NII NACSIS-CAT ID (NCID)
    AA11189709
  • Text Lang
    JPN
  • Article Type
    Journal Article
  • ISSN
    13452843
  • Data Source
    CJP  CJPref  J-STAGE 
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