急性虫垂炎における保存的治療の限界 その成否にかかわる経時的予知:その成否にかかわる経時的予知  [in Japanese] The Limitation of Conservative Therapy in Acute Appendicitis. The Criteria How to Foreknow It's Result.:The Criteria How to Foreknow It's Result  [in Japanese]

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Abstract

平鹿総合病院外科で過去3年9か月に急性虫垂炎として入院加療を要した206例中, 保存的治療を1次選択とした症例は65例であった.このうち保存的治療にて治癒しえた50例をA群, 保存的治療を試みたものの治癒せず結局手術となった15例をB群として, 保存的治療の限界とその成否にかかわる経時的予知についてretrospectiveに比較検討した.その結果, 虫垂超音波診断陽性率はA群18.8% (9例/48例), B群86.7% (13例/15例) であり両群間に有意差を認めた.A群の臨床経過の特徴として白血球数は第1病日で入院時の60%, 第2病日で50%以下に減少した.C反応性蛋白は初診時, 第1病日とも3 (+) (3.2~5.9mg/dl) 以下, 第2病日あるいは第3病日をピークに漸減した.体温は第1病日で37.0℃以下となり以降漸減した.これに対しB群では有意差をもって遷延する傾向を示し, これらが保存的治療の成否を予知する有用な指標になりうると考えられた.

Of 206 patients with acute appendicitis who visited our hospital during the last 3 years and 9 months, 65 patients did not undergo immediate surgery: 50 were successfully treated conservatively (group A), and 15 underwent surgery after conservative treatment (group B). We compared group A with group B as to clinical course and examined the criteria how to foreknow the result of conservative therapy. On ultrasonographic examination, the cases whose ultrasonographic diagnosis was positive were 18.8% in group A, 86.7% in group B. On clinical course in group A, WBC had decreased to 60% on day 1, 50% on day 2 incomparison with the WBC at admmition. C-reactive protein was less than 3 plus (3.2-5.9mg/dl) at admission and on day 1, and had decreased after day 2 or day 3. Body temperature was less than 37.0°C on day 1 and had decreased after day 2. There was not this tendency in group B. These results were usefull in how to foreknow the result of conservative therapy in acute appendicitis.

Journal

  • The Japanese Journal of Gastroenterological Surgery

    The Japanese Journal of Gastroenterological Surgery 27(5), 1044-1048, 1994

    The Japanese Society of Gastroenterological Surgery

Codes

  • NII Article ID (NAID)
    130004342625
  • Text Lang
    JPN
  • ISSN
    0386-9768
  • Data Source
    J-STAGE 
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