| Japanese |
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| Title | 冠動脈再建術と薬物アレルギー |
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| Subtitle | 原著 |
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| Authors | 若松正樹**, 北村豊*, 三宅均*, 堀之口典子*, 高木治*, 畔政和* |
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| Authors(kana) | |
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| Organization | *国立循環器病センター麻酔科, **中部労災病院麻酔科 |
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| Journal | 循環制御 |
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| Volume | 10 |
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| Number | 4 |
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| Page | 623-627 |
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| Year/Month | 1989/ |
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| Article | 原著 |
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| Publisher | 日本循環制御医学会 |
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| Abstract | 「要旨」心臓手術中の循環合併症に薬物アレルギーが如何に関与しているかを検討した. まず過去3年間の冠動脈再建術(CABG)と弁修復術において術中の薬物性ショックの発生頻度を調査した. 次に体外循環後の蕁麻疹・顔面紅潮の出現頻度および血中ヒスタミン濃度の変化を最近の症例において比較した. その結果, 薬物性ショックはCABG(314例)では6例発生したが, 弁修復術(501例)ではみられなかった. 一方, 最近の153例では9例において蕁麻疹・顔面紅潮が出現し, その頻度はCABG(8/68, 11.8%)が弁修復術(1/85, 1.2%)に比べて高かった, 体外循環離脱後の血中ヒスタミン濃度も弁修復術では変化がみられなかったが, CABGでは増加する症例が認められた. このようにCABGでは薬物アレルギーの発生頻度が高く, 術中の血圧低下時には常に皮膚性状を観察することがショック対策には重要であると考えられた. |
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| Practice | 基礎医学・関連科学 |
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| Keywords | drug-induced allergy, intraoperative complication, coronary artery bypass graft surgery |
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| English |
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| Title | Drug-induced allergy in coronary artery, bypass graft surgery |
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| Subtitle | |
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| Authors | Masaki Wakamatsu, Yutaka Kitamura, Hitoshi Miyake, Noriko Horinokuchi, Osamu Takaki, Masakazu Kuro |
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| Authors(kana) | |
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| Organization | Department of Anesthesiology National Cardiovascular Center |
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| Journal | Circulation Control |
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| Volume | 10 |
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| Number | 4 |
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| Page | 623-627 |
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| Year/Month | 1989/ |
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| Article | Original article |
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| Publisher | Japan Society of Circulation Control |
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| Abstract | During cardiac surgery allergic reactions are expected to occur mainly due to use of various kinds of drugs and complement activation by cardiopulmonary bypass. The purpose of this paper is to elucidate whether patients with coronary artery disease (CAD) are more susceptible to drug-induced allergy than those with valvular heart disease (VHD). In 314 patients with CAD undergoing coronary artery bypass graft (CABG) surgery 6 cases developed drug-induced shock after cardiopulmonary bypass, while no case precipitated into the shock in 501 patients with VHD undergoing valve plasty or replacement. Affecting drug could not be determined in any shock case. In the prospective study, emergence of skin rash was recognized more frequently in CAD group (8/68, 11.8%) than in VHD group (1/85, 1.2%). Plasma histamine concentration also increased after cardiopulmonary bypass in some CAD group, unlike VHD group. These results suggest a close relationship between CAD and occurrence of drug-induced allergy. It is thus important for anesthesiologist, It is thus important for anesthesiologist to observe patient's skin when unexplainable hypotension occurred in CABG surgery. |
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| Practice | Basic medicine |
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| Keywords | drug-induced allergy, intraoperative complication, coronary artery bypass graft surgery |
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