| Japanese |
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| Title | 保存的治療により救命し得た重症肺塞栓症の一症例 |
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| Subtitle | 症例 |
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| Authors | 斉藤政仁, 村井則之, 今関隆雄, 岡田修一, 千葉知史, 汐口壮一, 権重好, 垣伸明, 木山宏, 入江嘉仁 |
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| Organization | 獨協医科大学越谷病院心臓血管外科 |
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| Journal | 循環制御 |
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| Volume | 22 |
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| Number | 4 |
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| Page | 365-369 |
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| Year/Month | 2001/ |
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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」肺塞栓症は, 従来本国での発症率は欧米の1/10程度とされており1), まれな疾患として扱われる傾向にあり, あまり注目されなかった. しかし, 近年, 本症に対する認識の向上とそれに伴う診断技術の向上によって, 注目されるようになった. 本症は, 塞栓の原因物質(血栓, 脂肪, 腫瘍など)が肺動脈を閉塞する事によって発症し, しばしば重篤な状態となり, 時に突然死をもきたす. よって, 肺塞栓症は急性肺塞栓症と慢性肺塞栓症に分類されるが, 特に急性肺塞栓症の迅速かつ的確な治療方針の決定は極めて重要である. 治療法は保存療法と手術療法に大別されるが, 手術療法の適応は確立されていない2). 今回, 著者らはショックにて発症した急性重症肺塞栓症に対し, 保存療法を選択し, 良好な治療結果が得られたので報告する. 「症例」症例：51才, 男性 主訴：両下肢腫脹, 疼痛, 右下肢チアノーゼ 既往歴：高血圧, 高脂血症, 糖尿病 現病歴：3年前から間歇性破行が出現するも放置. |
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| Practice | 基礎医学・関連科学 |
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| Keywords | Massive pulmonary embolism, Conservative treatment, IVC filter |
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| English |
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| Title | A Case Report of Thrombolytic Treatment and Prophylactic Inferior Vena Cava (IVC) Filter Placement as A Conservative Therapy of Massive Pulmonary Embolism |
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| Authors | Saitou Masahito, Murai Noriyuki, Imazeki Takao, Okada Syuichi, Tiba Tomofumi, Sioguti Soichi, Gon Sigeyoshi, Kaki Nobuaki, Kiyama Hiroshi, Irie Yoshihito |
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| Organization | Derpartment of Cardiovascular Sargery, Dokkyou University of Medicine Kosigaya Hospital |
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| Journal | Circulation Control |
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| Volume | 22 |
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| Number | 4 |
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| Page | 365-369 |
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| Year/Month | 2001/ |
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| Article | Report |
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| Publisher | Japan Society of Circulation Control |
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| Abstract | A patient was transported to our institution with swelling and pain in both legs. He was diagnosed as deep vein thrombosis (DVT), and thrombolytic and anticoagulation treatment were started . At the 8th day , dyspnea and chest pain suddenly occurred with a fall in blood pressure . Pulmonary angiography showed bilateral main pulmonary artery was extensively defect and a massive pulmonary embolism (PE) was diagnosed. The second turn of thrombolytic treatment were started again. Furthermore a temporary IVC filter was implanted to prevent reccurent PE. Pulmonary angiogram showed PE was fairly improved at 7 days after PE occuring . But IVC thrombosis and DVT still existed and a permanent IVC filter was implanted therefore. A total dose 1920000 unit urokinase and 20000 unit / day heparin was administered during 21 days after PE occuring. He discharged with a angiography showing no thrombus in pulmonary artery. There are conservative and surgical treatments for PE. Thromboenborectomy is reported as poor result. In this paper, we presented a patient been rescued by thrombolytic treatment and prophylactic IVC filter placement. |
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| Practice | Basic medicine |
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| Keywords | Massive pulmonary embolism, Conservative treatment, IVC filter |
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