| Japanese |
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| Title | 心刺創に対する経食道心エコー図の有用性 |
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| Subtitle | 症例 |
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| Authors | 早川峰司, 岡村篤, 松田直之, 森本裕二, 劔物修 |
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| Organization | 北海道大学大学院医学研究科高次診断治療学専攻侵襲制御医学講座 |
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| Journal | 循環制御 |
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| Volume | 21 |
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| Number | 2 |
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| Page | 205-208 |
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| Year/Month | 2000/ |
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| Article | 報告 |
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| Publisher | 日本循環制御医学会 |
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| Abstract | 「はじめに」 交通事故や自殺の増加, 暴力事件の過激化などにより, 胸部外傷の頻度は増加している. 救急医療の現場で, これらの症例に遭遇する機会も増えていると思われる. この様な状況の中で, 胸部外傷患者に対する診断と治療には種々の手段がある. 今回, 心臓に達していることが考えられる胸部刺創において, 経食道心エコー図(以下TEE)が有用であった症例を経験したので報告する. 「症例」 患者は56歳の女性である. 乳癌手術後に化学療法を目的に入院中であった. てんかんとうつ病の合併症があった. 8時00分:看護婦が巡視の際に患者は興奮状態にあった. 8時20分:同室者の叫び声で訪室するとナイフを前胸部に刺していた. 患者は興奮状態であった. なだめて処置室に収容し, 末梢静脈路確保後にジアゼパムの合計40mg静脈内投与にて鎮静を行った. 主治医の診察時にはナイフは柄の部分を残して第5肋間胸骨左縁に刺さったままの状態で残されていた. |
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| Practice | 基礎医学・関連科学 |
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| Keywords | 経食道心エコー図, 刺創, 心損傷, Transesophageal echocardiography, Stab wound, Cardiac injury |
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| English |
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| Title | Efficacy of Transesophageal Echocardiography in the Evaluation of Cardiac Stab Wound |
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| Authors | Mineji Hayakawa, Atsushi Okamura, Naoyuki Matsuda, Yuji Morimoto, Osamu Kemmotsu |
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| Organization | Department of Anesthesiology and Critical Care Medicine,Hokkaido University School of Medicine |
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| Journal | Circulation Control |
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| Volume | 21 |
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| Number | 2 |
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| Page | 205-208 |
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| Year/Month | 2000/ |
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| Article | Report |
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| Publisher | Japan Society of Circulation Control |
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| Abstract | A 56-year-old woman, admitted for chemotherapy of breast cancer, stabbed her left breast with a knife committing suicide in the ward. Soon after the event, she was intubated in the ward. She was transferred to the operating room for emergency surgery. The knife seemed stabbing the heart because its movement was synchronized with heart beats. Sternotomy was performed under general anesthesia. without removing the knife from her breast to avoid massive bleeding. A Cardiac surgeon directly confirmed that the knife tip was penetrating the left ventricular wall. Transesophageal echocardiography (TEE) was utilized to evaluate the knife tip in the heart. The TEE image demonstrated that the knife tip remained in the left ventricular wall and did not penetrate into the ventricular cavity. Based on the TEE information, the knife was taken out without massive bleeding. If the knife tip had penetrated into the ventricular cavity, cardio-pulmonary bypass (CPB) should be used for surgery. The use of CPB will increase cost and invasiveness to the patient. In this case, the knife was safely removed without CPB because the precise place of the knife tip was confirmed by TEE. TEE was useful for the diagnosis of cardiac stab wounds. |
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| Practice | Basic medicine |
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| Keywords | Transesophageal echocardiography, Stab wound, Cardiac injury |
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