{"created":"2021-03-01T06:15:46.594618+00:00","id":11565,"links":{},"metadata":{"_buckets":{"deposit":"0a33f282-33b7-461d-b808-470cd4f5959c"},"_deposit":{"id":"11565","owners":[],"pid":{"revision_id":0,"type":"depid","value":"11565"},"status":"published"},"_oai":{"id":"oai:niigata-u.repo.nii.ac.jp:00011565","sets":["453:456","471:537:538:1000"]},"item_7_alternative_title_1":{"attribute_name":"その他のタイトル","attribute_value_mlt":[{"subitem_alternative_title":"Thromboembolism in cancer patients : Reports of two cases"}]},"item_7_biblio_info_6":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2007-08","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"8","bibliographicPageEnd":"476","bibliographicPageStart":"472","bibliographicVolumeNumber":"121","bibliographic_titles":[{"bibliographic_title":"新潟医学会雑誌"},{"bibliographic_title":"新潟医学会雑誌","bibliographic_titleLang":"en"}]}]},"item_7_description_4":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"静脈血栓塞栓症(肺血栓塞増加栓症ならびに深部静脈血栓症)は,その症例数の増加に伴い,外科手術の周術期に発生する重大な合併症として広く認識されるようになった.また,1865年にTrousseauらが悪性腫瘍の患者に静脈血栓症が多いことを報告して以来,癌と血栓症の関係が注目されるようになった.今回,担がん患者に生じた静脈血栓塞栓症の2例を経験したので,文献的検討を加え報告する.症例1は,上行結腸癌,直腸癌と診断された78歳の女性.術前の骨盤部CTにて,右大腿静脈内に血栓が認められた.狭窄による症状の強い癌で,準緊急的な手術となった.手術時,弾性ストッキングは使用したが,血栓のもみ出しを考慮し,間欠的空気圧迫法は併用しなかった.術後15日間1日あたりヘパリン1万単位を持続投与し,その後ワーファリンを用いた抗凝固療法へ切り替えた.肝転移,高度のリンパ節転移,腹膜播種を伴うStageIVの進行癌であり非治癒切除となった.術後,両下肢の浮腫は増悪したが,弾性ストッキングの着用のみで軽快した.術後2か月半目のCTで腹膜播種巣の増大と左右大腿静脈血栓の増大を認めた.さらに,右肺動脈内に血栓を認めたが,それによる症状の変化は認めなかったため,経過観察とした,術後7か月目に腹膜播種巣が急速に増大し原病死した.症例2は,72歳の男性で,直腸癌多発性肺転移の診断にて,5FUと1-ロイコボリンによる化学療法が行われていた.息切れが出現したため,胸部CTを施行したところ右肺動脈血栓症と診断された.下肢の超音波検査では,静脈血栓は認めなかったため,化学療法を中止し,ワーファリンによる抗凝固療法のみ施行した.呼吸困難は徐々に改善し,診断から1か月後より化学療法を再開した.担がん患者においては,術前から血栓を有する症例に対しては適切な周術期管理が求められ,また,化学療法中に血栓の発生するリスクがあることも常に意識する必要がある.","subitem_description_type":"Abstract"}]},"item_7_full_name_3":{"attribute_name":"著者別名","attribute_value_mlt":[{"nameIdentifiers":[{"nameIdentifier":"78412","nameIdentifierScheme":"WEKO"}],"names":[{"name":"Takaku, Hideya"}]},{"nameIdentifiers":[{"nameIdentifier":"78413","nameIdentifierScheme":"WEKO"}],"names":[{"name":"Okamoto, Haruhiko"}]},{"nameIdentifiers":[{"nameIdentifier":"78414","nameIdentifierScheme":"WEKO"}],"names":[{"name":"Matsuzawa, Takeaki"}]},{"nameIdentifiers":[{"nameIdentifier":"78415","nameIdentifierScheme":"WEKO"}],"names":[{"name":"Tamiya, Yoichi"}]}]},"item_7_publisher_7":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"新潟医学会"}]},"item_7_relation_31":{"attribute_name":"異版である","attribute_value_mlt":[{"subitem_relation_type":"isVersionOf","subitem_relation_type_id":{"subitem_relation_type_id_text":"http://ci.nii.ac.jp/naid/110007146254","subitem_relation_type_select":"URI"}}]},"item_7_rights_15":{"attribute_name":"権利","attribute_value_mlt":[{"subitem_rights":"本文データは学協会の許諾に基づきCiNiiから複製したものである"}]},"item_7_select_19":{"attribute_name":"著者版フラグ","attribute_value_mlt":[{"subitem_select_item":"publisher"}]},"item_7_source_id_11":{"attribute_name":"書誌レコードID","attribute_value_mlt":[{"subitem_source_identifier":"AN00182415","subitem_source_identifier_type":"NCID"}]},"item_7_source_id_9":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"00290440","subitem_source_identifier_type":"ISSN"}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"高久, 秀哉"}],"nameIdentifiers":[{"nameIdentifier":"78408","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"岡本, 春彦"}],"nameIdentifiers":[{"nameIdentifier":"78409","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"松澤, 岳晃"}],"nameIdentifiers":[{"nameIdentifier":"78410","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"田宮, 洋一"}],"nameIdentifiers":[{"nameIdentifier":"78411","nameIdentifierScheme":"WEKO"}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2019-08-07"}],"displaytype":"detail","filename":"110007146254.pdf","filesize":[{"value":"657.0 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