下部消化管穿孔における術前血清IgG値と術後経過についての検討  [in Japanese] Evaluation of Serum IgG Levels and the Postoperative Course of Patients with a Colorectal Perforation  [in Japanese]

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Abstract

下部消化管穿孔における術前血清IgG値と術後経過との関係について検討した。2011年9月1日より2013年6月30日まで当科で施行した汎発性腹膜炎を伴う下部消化管穿孔を対象とした。来院時の血清IgG値が800mg/dL以上(以下,N群)と800mg/dL未満(以下,H群)の2群間で比較を行った。対象期間の症例は27例でN群は18例,低下群は9例であった。SIRS期間はN群に対してH群は長期化していた(6.4±9.1日vs 12.9±14.2日)。また,人工呼吸管理期間もN群に対してH群のほうが延長し(2.0±2.8日vs 8.1±7.0日),それに伴いICU滞在期間もN群に対してH群が長期化していた(5.7±4.5日vs 14.4±13.1日)。下部消化管穿孔における術前IgG値が低下している症例は重症化しており,IgG値補正による予後改善の可能性が示唆された。

In this study, the relationship between serum lgG levels and the prognosis for colorectal perforations was examined. The subjects of this study were patients with generalized peritonitis due to colorectal perforations who were treated at our hospital between September 1st, 2011 and June 30th, 2013. Comparisons on the systemic inflammatory response syndrome (SIRS) period after surgery, duration of respirator use, and ICU duration were made between two groups of patients with normal IgG levels of 800 mg/dL or more and with hypo-lgG levels of less than 800 mg/dL. There were 27 cases during the study period, out of which 18 had normal IgG levels and the remaining 9 had hypo-lgG levels. The SIRS period of the hypo-lgG group was longer compared to the normal IgG group (12.9±14.2 days vs. 6.4±9.1 days). In addition, the hypo-lgG group had a longer duration of respirator use (8.1±7.0 days vs. 2.0±2.8 days), which resulted in prolonged ICU duration compared to the normal IgG group (14.4±13.1 days vs. 5.7±4.5 days). Hypo-lgG levels prior to surgery for colorectal perforation were associated with severe conditions. Thus, our results suggest improvement of the prognosis can be achieved by compensating for the IgG levels.

Journal

  • Nihon Fukubu Kyukyu Igakkai Zasshi (Journal of Abdominal Emergency Medicine)

    Nihon Fukubu Kyukyu Igakkai Zasshi (Journal of Abdominal Emergency Medicine) 34(7), 1253-1257, 2014

    Japanese Society for Abdominal Emergency Medicine

Keywords

Codes

  • NII Article ID (NAID)
    130004890929
  • Text Lang
    JPN
  • ISSN
    1340-2242
  • Data Source
    J-STAGE 
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