{"created":"2023-06-20T16:48:19.318731+00:00","id":20169,"links":{},"metadata":{"_buckets":{"deposit":"5a32f166-3065-4a6e-acdd-269966a889fc"},"_deposit":{"created_by":3,"id":"20169","owners":[3],"pid":{"revision_id":0,"type":"depid","value":"20169"},"status":"published"},"_oai":{"id":"oai:kindai.repo.nii.ac.jp:00020169","sets":["14:923:1477:4518"]},"author_link":["34374","34378","34383","34379","34380","34375","34377","34381","34384","34382","34372","34373","34376"],"item_2_biblio_info_21":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2019-06-19","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"1-2","bibliographicPageEnd":"104","bibliographicPageStart":"99","bibliographicVolumeNumber":"44","bibliographic_titles":[{"bibliographic_title":"近畿大学医学雑誌"},{"bibliographic_title":"Medical Journal of Kindai University","bibliographic_titleLang":"en"}]}]},"item_2_description_33":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"[抄録]口腔癌切除後遊離皮弁にて即時再建を施行した患者において術後の皮弁生着を目指すために，近畿大学奈良病院で実践している周術期管理について，1例報告する．【症例】患者：46歳，男性．【臨床診断】左側舌扁平上皮癌（T3N0M0）．【手術】手術開始前に末梢挿入中心静脈カテーテル（PICC）を留置した．気管切開術，左側保存的全頸部郭清術，左側舌可動部亜全摘，前外側大腿遊離皮弁による舌再建術を施行した．【術後経過】１．ICU管理：ICUに入室し，鎮静，呼吸および循環管理を行った．鎮静方法は，まずデクスメデトミジン（0.5g/kg/h）とプロポフォール（3.0mg/kg/h）を2剤併用で維持投与し，術後48時間前後で2剤を漸減しながら，術後58時間で鎮静を解除した．循環管理は，収縮期血圧が160mmHgを超えず，かつ80mmHg未満にならないように，また脈圧が40mmHg未満にならないように留意した．術後皮弁の血流も良好で，術後60時間目一般病棟へ転棟した．2．栄養管理：術後6日目まではPICCから高カロリー輸液を継続し，術後７日目から経腸栄養を開始した．経腸栄養量は，エネルギー；30kcal×IBW（理想体重），たんぱく質；1.1 g×IBW，水分；30ml×IBWを目安に投与し，術後の栄養状態は良好であった．【結語】口腔癌切除遊離皮弁再建後の皮弁生着のためにICUでの集中治療と術後の栄養管理など，多職種連携によって最適な周術期管理を確立していく必要があると考える．","subitem_description_type":"Abstract"}]},"item_2_description_41":{"attribute_name":"フォーマット","attribute_value_mlt":[{"subitem_description":"application/pdf","subitem_description_type":"Other"}]},"item_2_publisher_14":{"attribute_name":"出版者 名前","attribute_value_mlt":[{"subitem_publisher":"近畿大学医学会"}]},"item_2_source_id_22":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"03858367","subitem_source_identifier_type":"ISSN"}]},"item_2_text_7":{"attribute_name":"著者(英)","attribute_value_mlt":[{"subitem_text_language":"en","subitem_text_value":"Matsunaga,Kazuhide"},{"subitem_text_language":"en","subitem_text_value":"Futagawa,Koichi"},{"subitem_text_language":"en","subitem_text_value":"Okamoto,Shinji"},{"subitem_text_language":"en","subitem_text_value":"Ueda,Yoshio"},{"subitem_text_language":"en","subitem_text_value":"Yane,Katsunari"},{"subitem_text_language":"en","subitem_text_value":"Nakai,Yoshinori"},{"subitem_text_language":"en","subitem_text_value":"Iguchi,Masahiro"},{"subitem_text_language":"en","subitem_text_value":"Toyodome,Soichiro"},{"subitem_text_language":"en","subitem_text_value":"Suzuki,Seiya"},{"subitem_text_language":"en","subitem_text_value":"Iwamoto,Noriko"},{"subitem_text_language":"en","subitem_text_value":"Kusuhara,Hirohisa"},{"subitem_text_language":"en","subitem_text_value":"Enomoto,Akifumi"},{"subitem_text_language":"en","subitem_text_value":"Nagata,Tetsuji"}]},"item_2_text_8":{"attribute_name":"著者 所属","attribute_value_mlt":[{"subitem_text_value":"近畿大学奈良病院歯科口腔外科: 大阪大学大学院歯学研究科顎口腔病因病態制御学講座口腔外科学第二教室"},{"subitem_text_value":"近畿大学奈良病院麻酔科"},{"subitem_text_value":"近畿大学奈良病院麻酔科"},{"subitem_text_value":"近畿大学奈良病院形成外科・美容外科"},{"subitem_text_value":"近畿大学奈良病院耳鼻咽喉科・頭頸部外科"},{"subitem_text_value":"近畿大学奈良病院耳鼻咽喉科・頭頸部外科"},{"subitem_text_value":"近畿大学奈良病院栄養部"},{"subitem_text_value":"近畿大学奈良病院歯科口腔外科"},{"subitem_text_value":"近畿大学奈良病院歯科口腔外科"},{"subitem_text_value":"近畿大学奈良病院歯科口腔外科"},{"subitem_text_value":"近畿大学大学院医学研究科形成再建外科学講座"},{"subitem_text_value":"近畿大学病院歯科口腔外科"},{"subitem_text_value":"近畿大学奈良病院歯科口腔外科"}]},"item_2_text_9":{"attribute_name":"著者所属(翻訳)","attribute_value_mlt":[{"subitem_text_value":"Department of Oral and Maxillofacial Surgery, Nara Hospital Kindai University, Faculty of Medicine: The ２nd Department of Oral and Maxillofacial Surgery, School & Graduate School of Dentistry Osaka University"},{"subitem_text_value":"Department of Anesthesiology, Nara Hospital Kindai University, Faculty of Medicine"},{"subitem_text_value":"Department of Anesthesiology, Nara Hospital Kindai University, Faculty of Medicine"},{"subitem_text_value":"Department of Plastic and Reconstructive Surgery, Nara Hospital Kindai University, Faculty of Medicine"},{"subitem_text_value":"Department of Otorhinolaryngology, Nara Hospital Kindai University, Faculty of Medicine"},{"subitem_text_value":"Department of Otorhinolaryngology, Nara Hospital Kindai University, Faculty of Medicine"},{"subitem_text_value":"Department of nourishment, Nara Hospital Kindai University Hospital, Faculty of Medicine"},{"subitem_text_value":"Department of Oral and Maxillofacial Surgery, Nara Hospital Kindai University, Faculty of Medicine"},{"subitem_text_value":"Department of Oral and Maxillofacial Surgery, Nara Hospital Kindai University, Faculty of Medicine"},{"subitem_text_value":"Department of Oral and Maxillofacial Surgery, Nara Hospital Kindai University, Faculty of Medicine"},{"subitem_text_value":"Department of Plastic and Reconstructive Surgery, Kindai University, Faculty of Medicine"},{"subitem_text_value":"Department of Oral and Maxillofacial Surgery, Kindai University, Faculty of Medicine"},{"subitem_text_value":"Department of Oral and Maxillofacial Surgery, Nara Hospital Kindai University, Faculty of Medicine"}]},"item_2_version_type_12":{"attribute_name":"版","attribute_value_mlt":[{"subitem_version_resource":"http://purl.org/coar/version/c_be7fb7dd8ff6fe43","subitem_version_type":"NA"}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"松永, 和秀"},{"creatorName":"マツナガ, カズヒデ","creatorNameLang":"ja-Kana"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"二川, 晃一"},{"creatorName":"フタガワ, コウイチ","creatorNameLang":"ja-Kana"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"岡本, 慎司"},{"creatorName":"オカモト, シンジ","creatorNameLang":"ja-Kana"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"上田, 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明史"},{"creatorName":"エノモト, アキフミ","creatorNameLang":"ja-Kana"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"長田, 哲次"},{"creatorName":"ナガタ, テツジ","creatorNameLang":"ja-Kana"}],"nameIdentifiers":[{}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2019-07-29"}],"displaytype":"detail","filename":"AN00063584-20190619-0099.pdf","filesize":[{"value":"1.3 MB"}],"format":"application/pdf","licensetype":"license_note","mimetype":"application/pdf","url":{"label":"AN00063584-20190619-0099.pdf","url":"https://kindai.repo.nii.ac.jp/record/20169/files/AN00063584-20190619-0099.pdf"},"version_id":"bb0376e0-9ad1-4bdc-8a05-328c112a4e08"}]},"item_keyword":{"attribute_name":"キーワード","attribute_value_mlt":[{"subitem_subject":"周術期管理（perioperative care）","subitem_subject_scheme":"Other"},{"subitem_subject":"口腔癌（oral cancer）","subitem_subject_scheme":"Other"},{"subitem_subject":"遊離皮弁（free flap）","subitem_subject_scheme":"Other"},{"subitem_subject":"脈圧（pulse pressure）","subitem_subject_scheme":"Other"}]},"item_language":{"attribute_name":"言語","attribute_value_mlt":[{"subitem_language":"jpn"}]},"item_resource_type":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"resourcetype":"departmental bulletin paper","resourceuri":"http://purl.org/coar/resource_type/c_6501"}]},"item_title":"〈症例〉近畿大学奈良病院における口腔癌切除・遊離皮弁再建後の皮弁生着を目指すための周術期管理―症例報告―","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"〈症例〉近畿大学奈良病院における口腔癌切除・遊離皮弁再建後の皮弁生着を目指すための周術期管理―症例報告―"},{"subitem_title":"Perioperative care for enhancing free flap survival after oral cancer resection in Nara Hospital Kindai University -a case report-","subitem_title_language":"en"}]},"item_type_id":"2","owner":"3","path":["4518"],"pubdate":{"attribute_name":"公開日","attribute_value":"2019-07-29"},"publish_date":"2019-07-29","publish_status":"0","recid":"20169","relation_version_is_last":true,"title":["〈症例〉近畿大学奈良病院における口腔癌切除・遊離皮弁再建後の皮弁生着を目指すための周術期管理―症例報告―"],"weko_creator_id":"3","weko_shared_id":3},"updated":"2023-06-20T21:28:50.019860+00:00"}