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胆管結石の予後に関する臨床的研究：特に急性閉塞性化膿性胆管炎について
https://kindai.repo.nii.ac.jp/records/2002395
https://kindai.repo.nii.ac.jp/records/200239560594a9a-6b92-457d-b1b3-51c2328f8df2
| 名前 / ファイル | ライセンス | アクション |
|---|---|---|
AN00063584-19920925-0433.pdf (1.2 MB)
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| Item type | ☆紀要論文 / Departmental Bulletin Paper(1) | |||||||||
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| 公開日 | 2025-02-06 | |||||||||
| タイトル | ||||||||||
| タイトル | 胆管結石の予後に関する臨床的研究：特に急性閉塞性化膿性胆管炎について | |||||||||
| 言語 | ja | |||||||||
| タイトル | ||||||||||
| タイトル | Clinical observation on the prognosis of bile duct stone : especially about acute obstructive suppurative cholangitis | |||||||||
| 言語 | en | |||||||||
| 著者 |
粟田, 哲司
× 粟田, 哲司
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| 言語 | ||||||||||
| 言語 | jpn | |||||||||
| キーワード | ||||||||||
| 主題 | bile duct stone, acute obstructive suppurative cholongitis, disseminated intravascular coagulation (DIC), antithrombin III (ATIII), endoscopic nasobiliary drainage | |||||||||
| 資源タイプ | ||||||||||
| 資源タイプ識別子 | http://purl.org/coar/resource_type/c_6501 | |||||||||
| 資源タイプ | departmental bulletin paper | |||||||||
| 出版タイプ | ||||||||||
| 出版タイプ | AM | |||||||||
| 出版タイプResource | http://purl.org/coar/version/c_ab4af688f83e57aa | |||||||||
| 出版者 名前 | ||||||||||
| 出版者 | 近畿大学医学会 | |||||||||
| 言語 | ja | |||||||||
| bibliographic_information |
ja : 近畿大学医学雑誌 en : Medical Journal of Kinki University 巻 17, 号 3, p. 433-450, 発行日 1992-09-25 |
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| ISSN | ||||||||||
| 収録物識別子タイプ | PISSN | |||||||||
| 収録物識別子 | 03858367 | |||||||||
| 内容記述 | ||||||||||
| 内容記述タイプ | Abstract | |||||||||
| 内容記述 | We retrospectively studied 172 cases of bile duct stones including 106 cases (61.6%) of acute cholangitis (AC), 27 cases (15.7%) of acute obstructive suppurative cholangitis (AOSC) and 39 cases (22.7%) classified as mild case. Deaths occurred only among the patients with AOSC and the mortality rate of AOSC was 29.6%. There was a difference in mortality rate of AOSC between the emergency drainage set up group (16.7%) and the conservative therapy group (40.0%). Since the introduction of the endoscopic nasobiliary drainage (ENBD) method, the mortality rate of AOSC has improved to 0%. Emergency drainage with ENBD could be introduced easily and safely even though the patient had been complicated by disseminated intravascular coagulation (DIC). Significant increases of serum bilirubin, thrombocytopenias and decreases in antithrombin III (ATIII) activity were observed especially in the deaths from AOSC. Each level of serum bilirubin of more than 10.0mg/dl, platelet counts of less than 3.0×10^4/cmm and levels of ATIII activity less than 40% indicated a poor prognosis. It is noteworthy that fibrinogen levels exhibited a normal or high titer even in patients with DIC. Other factors related to the poor prognosis were male, the seventies, common duct stones, multiple organ failure and DIC. Especially when two or more of these factors were recognized simultaneously, prognosis was still poor. DIC or suspected DIC were observed in 70.8% of the patients with AOSC. It is important to start therapy as soon as possible before DIC becomes irreversible. Since a positive correlation between platelet counts and levels of ATIII activity (r=0.44, n=85, p<0.001) and a negative correlation between levels of fibrinogen degradation products and levels of ATIII activity (r=-0.32, n=70, p<0.001) were observed, the complication of DIC in patients with AOSC was thought to be closely related to the consumption of ATIII. Therefore, the treatment of patients with AOSC needs not only an early drainage set up but also an assay of ATIII in the early stage. When levels of ATIII activity are low, ATIII substitution is recommended. | |||||||||
| 言語 | en | |||||||||
| 内容記述 | ||||||||||
| 内容記述タイプ | Other | |||||||||
| 内容記述 | 本文データはCiNiiから複製したものである。 | |||||||||
| 言語 | ja | |||||||||
