| Japanese |
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| Title | 非心臓手術の術前心血管系評価の集計 |
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| Subtitle | 原著 |
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| Authors | 山野上敬夫, 田中裕之, 弓削孟文 |
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| Authors(kana) | |
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| Organization | 広島大学医学部麻酔・蘇生学教室 |
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| Journal | 循環制御 |
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| Volume | 18 |
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| Number | 3 |
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| Page | 369-375 |
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| Year/Month | 1997/ |
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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」当施設での非心臓手術の術前心血管系評価の実態をretrospectiveに集計し, 米国ACC/AHAによる非心臓手術の術前心血管系評価のガイドラインと比較した. 循環器系に問題点を有した319例のうち, 重度の臨床徴候を2例に, 中等度を56例に, 軽度を261例に認めた. 中等度臨床徴候の4つの病態別の術前検査は, 糖尿病の症例では侵襲的検査を選択した頻度は低かった. 軽度臨床徴候を有する症例の中では, 病態(刺激伝導系障害, 心筋虚血疑い, 弁疾患)に応じて一定の傾向を呈していた. 糖尿病を狭心症や心筋梗塞, および心不全の既往と同列に中等度として扱うこと, および軽度臨床徴候の症例群を包括して扱うことの妥当性が, 今後議論になる可能性が考えられる. |
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| Practice | 基礎医学・関連科学 |
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| Keywords | Perioperative myocardial ischemia, Noncardiac surgery, Preoperative evaluation, Diabetes mellitus |
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| English |
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| Title | Preoperative Cardiovascular Evaluation for Noncardiac Surgery -Retrospective Survey- |
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| Subtitle | |
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| Authors | Takao Yamanoue, Hiroyuki Tanaka, Osafumi Yuge |
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| Authors(kana) | |
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| Organization | Department of Anesthesiology and Critical Care Medicine, Hiroshima University School of Medicine |
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| Journal | Circulation Control |
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| Volume | 18 |
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| Number | 3 |
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| Page | 369-375 |
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| Year/Month | 1997/ |
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| Article | Original article |
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| Publisher | Japan Society of Circulation Control |
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| Abstract | A retrospective analysis on preoperative cardiovascular evaluation for noncardiac surgery was performed. The results were compared to the guideline on perioperative cardiovascular evaluation in noncardiac surgery by ACC/AHA. Concerning clinical predictors, 2 patients possessed severe clinical predictors. Fifty-six patients were with moderate predictors, and 261were with mild ones. Among the patients with moderate predictors (angina pectoris, old myocardial infarction, history of heart failure, and diabetes mellitus), the diabetic patients took less preoperative invasive cardiac examinations than patients with the other three diseases. Among the patients with mild predictors (conduction disorder, suspected ischemic heart disease, and valvular disease), there was a tendency that preoperative cardiac examinations were undertaken according to the type of disease. One of the problem of ACC/AHA guideline is whether diabetic patients should be undertaken preoperative invasive cardiac examinations as same as patients with angina and myocardial infarction, which are direct manifestations of myocardial ischemia. Among patients with mild clinical predictors, there is another problem whether patients with conduction disorders, suspiction of myocardial ischemia, or valvular disease should undertake preoperative cardiac examination in the same direction in the algorithm. |
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| Practice | Basic medicine |
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| Keywords | Perioperative myocardial ischemia, Noncardiac surgery, Preoperative evaluation, Diabetes mellitus |
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