膵頭部癌術後の消化吸収障害に対する高力価・腸溶性膵消化酵素剤投与の有用性についての検討 Usefulness of enteric coated pancrelipase for digestive and absorption disorder after pancreatoduodenectomy for pancreatic head carcinomas

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著者

    • 北川 裕久 KITAGAWA Hirohisa
    • 金沢大学附属病院消化器・乳腺・移植再生外科 Department of Gastroenterologic Surgery, Division of Cancer Medicine, Graduate School of Medical Science, Kanazawa University
    • 中川原 寿俊 NAKAGAWARA Hisatoshi
    • 金沢大学附属病院消化器・乳腺・移植再生外科 Department of Gastroenterologic Surgery, Division of Cancer Medicine, Graduate School of Medical Science, Kanazawa University
    • 牧野 勇 MAKINO Isamu
    • 金沢大学附属病院消化器・乳腺・移植再生外科 Department of Gastroenterologic Surgery, Division of Cancer Medicine, Graduate School of Medical Science, Kanazawa University
    • 中沼 伸一 NAKANUMA Shinichi
    • 金沢大学附属病院消化器・乳腺・移植再生外科 Department of Gastroenterologic Surgery, Division of Cancer Medicine, Graduate School of Medical Science, Kanazawa University
    • 林 泰寛 HAYASHI Hironori
    • 金沢大学附属病院消化器・乳腺・移植再生外科 Department of Gastroenterologic Surgery, Division of Cancer Medicine, Graduate School of Medical Science, Kanazawa University
    • 高村 博之 TAKAMURA Hiroyuki
    • 金沢大学附属病院消化器・乳腺・移植再生外科 Department of Gastroenterologic Surgery, Division of Cancer Medicine, Graduate School of Medical Science, Kanazawa University
    • 二宮 致 NINOMIYA Itasu
    • 金沢大学附属病院消化器・乳腺・移植再生外科 Department of Gastroenterologic Surgery, Division of Cancer Medicine, Graduate School of Medical Science, Kanazawa University
    • 伏田 幸夫 FUSHIDA Sachio
    • 金沢大学附属病院消化器・乳腺・移植再生外科 Department of Gastroenterologic Surgery, Division of Cancer Medicine, Graduate School of Medical Science, Kanazawa University
    • 太田 哲生 OHTA Tetsuo
    • 金沢大学附属病院消化器・乳腺・移植再生外科 Department of Gastroenterologic Surgery, Division of Cancer Medicine, Graduate School of Medical Science, Kanazawa University

抄録

膵頭部癌の膵頭十二指腸切除術後消化吸収障害に対する,腸溶性高力価膵消化酵素剤パンクレリパーゼの有効性を,従来の膵消化酵素剤から本剤に切り替えた7症例で評価した.消化吸収障害は下痢の程度,体重の増減,日常生活の活動性,消化不良の症状を織り交ぜWong-Bakerのフェイススケールにあわせて,0から5までのGrade分類を新たに作成して評価した.1例で重度の下痢がみられ投与中止した.他の6例では腸溶性パンクレリパーゼへの変更によって,5例で体重増加がみられ,4例で止痢剤減量を要した.消化吸収障害Gradeは,体重増加のなかった症例,止痢剤減量ができなかった症例も含め6例全例で0または1にまで改善していた.膵頭部癌術後の消化吸収障害の改善に,腸溶性パンクレリパーゼの投与は,有用であることが示唆された.また,今回考案した臨床に即したGrade分類は,消化吸収障害の評価に有用であった.<br>

We assessed the efficacy of enteric coated pancrelipase for digestive and absorption disorder in patients after pancreatoduodenectomy for pancreatic head carcinomas. For the clinically assessment of digestive disorder, we developed a new classification system based on clinical findings that include diarrhea, body weight, activity and symptoms of maldigestion. This classification consists of 6 grades which are matched to the Wong-Baker Faces Pain Rating Scale. Included in this study are seven cases that were administered pancreatin and converted to enteric coated pancrelipase. In one case, the administration of pancrelipase was stopped due to severe diarrhea. In the other 6 cases, digestive disorder significantly improved and these grades were 0 or 1. Our study suggests that enteric coated pancrelipase is more effective than pancreatin for digestive and absorption disorder after pancreatoduodenectomy for pancreatic head carcinomas. The new clinical classification is also useful to more precisely assess general digestive disorder.<br>

収録刊行物

  • 膵臓 = The Journal of Japan Pancreas Society

    膵臓 = The Journal of Japan Pancreas Society 28(2), 178-184, 2013-04-25

    日本膵臓学会

参考文献:  13件中 1-13件 を表示

各種コード

  • NII論文ID(NAID)
    10031178027
  • NII書誌ID(NCID)
    AN10043798
  • 本文言語コード
    JPN
  • 資料種別
    ART
  • ISSN
    09130071
  • データ提供元
    CJP書誌  J-STAGE 
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