{"created":"2021-03-01T06:13:08.229923+00:00","id":9084,"links":{},"metadata":{"_buckets":{"deposit":"da9c68d3-c99f-4b32-b48d-b55b60290d1c"},"_deposit":{"id":"9084","owners":[],"pid":{"revision_id":0,"type":"depid","value":"9084"},"status":"published"},"_oai":{"id":"oai:niigata-u.repo.nii.ac.jp:00009084","sets":["453:456","471:537:538:542"]},"item_7_alternative_title_1":{"attribute_name":"その他のタイトル","attribute_value_mlt":[{"subitem_alternative_title":"Surgical Outcomes of Abdominal Operation in Patients Undergoing Hemodialysis for Chronic Renal Failure"}]},"item_7_biblio_info_6":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2014-01","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"1","bibliographicPageEnd":"32","bibliographicPageStart":"28","bibliographicVolumeNumber":"128","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":"【目的】血液透析患者数の増加に伴い, 腹部手術を要する血液透析患者が近年, 増加している. 本研究では, 慢性腎不全による血液透析患者の腹部手術症例の術後成績からその問題点を明らかにする. 【対象と方法】2011年1月から2012年12月までの2年間で当科で実施された手術1592例中, 腹部手術を実施された血液透析患者13例(0.8%)を対象とした. その内訳は, 待機手術6例(十二指腸乳頭部癌, 胃カルチノイド, 胆嚢癌, 横行結腸癌, 小腸潰瘍, 胆嚢ポリープ, 各々1例), 緊急手術7例(非閉塞性腸管虚血症2例, 穿孔性腹膜炎・腹腔内膿瘍, S状結腸憩室穿孔, 持続的腹膜透析カテーテル関連腹膜炎, 脳死膵腎同時移植, 出血性直腸ポリープ, 各々1例)であった. 待機手術症例と緊急手術症例との間で, 術後合併症, 術後在院死亡の発生率を比較した. 【結果】待機手術症例では2例(33%)に術後合併症(麻痺性イレウス, 胃内容排出遅延, 各々1例)を認めたが, いずれも軽症で比較的早期に退院が可能であった. 一方, 緊急手術症例では3例(43%)に術後合併症(敗血症性ショック, 敗血症性ショック+多臓器不全, 腹腔内膿瘍・出血+下大静脈血栓+髄膜炎, 各々1例)を認め, そのうち2例(緊急手術症例の29%)が在院死亡した. 待機手術症例と比較して緊急手術症例では, 術後合併症および在院死亡の発生率が高率であった. 【結論】日常の透析管理や周術期管理の進歩により, 血液透析患者の腹部待機手術は安全に施行されるようになったが, 腹部緊急手術の術後短期成績は未だ不良である. その原因として, 免疫力の低下, 易感染性といった特徴をもつ血液透析患者では病態が早期に重篤化しやすいことが示唆される. 血液透析患者の病態理解, 早期診断・治療が, 血液透析患者に対する腹部緊急手術の術後成績向上に必要と考えられる.","subitem_description_type":"Abstract"}]},"item_7_full_name_3":{"attribute_name":"著者別名","attribute_value_mlt":[{"nameIdentifiers":[{"nameIdentifier":"63265","nameIdentifierScheme":"WEKO"}],"names":[{"name":"Katada, Tomohiro"}]},{"nameIdentifiers":[{"nameIdentifier":"63266","nameIdentifierScheme":"WEKO"}],"names":[{"name":"Sakata, Jun"}]},{"nameIdentifiers":[{"nameIdentifier":"63267","nameIdentifierScheme":"WEKO"}],"names":[{"name":"Nakano, Tetyuya"}]},{"nameIdentifiers":[{"nameIdentifier":"63268","nameIdentifierScheme":"WEKO"}],"names":[{"name":"Hirose, Yuki"}]},{"nameIdentifiers":[{"nameIdentifier":"63269","nameIdentifierScheme":"WEKO"}],"names":[{"name":"Sudo, Natsuru"}]},{"nameIdentifiers":[{"nameIdentifier":"63270","nameIdentifierScheme":"WEKO"}],"names":[{"name":"Takano, Kabuto"}]},{"nameIdentifiers":[{"nameIdentifier":"63271","nameIdentifierScheme":"WEKO"}],"names":[{"name":"Kobayashi, Takashi"}]},{"nameIdentifiers":[{"nameIdentifier":"63272","nameIdentifierScheme":"WEKO"}],"names":[{"name":"Minagawa, Masahiro"}]},{"nameIdentifiers":[{"nameIdentifier":"63273","nameIdentifierScheme":"WEKO"}],"names":[{"name":"Wakai, Toshifumi"}]},{"nameIdentifiers":[{"nameIdentifier":"63274","nameIdentifierScheme":"WEKO"}],"names":[{"name":"Ajioka, Yoichi"}]}]},"item_7_publisher_7":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"新潟医学会"}]},"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":"堅田, 朋大"}],"nameIdentifiers":[{"nameIdentifier":"63255","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"坂田, 純"}],"nameIdentifiers":[{"nameIdentifier":"63256","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"仲野, 哲矢"}],"nameIdentifiers":[{"nameIdentifier":"63257","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"廣瀬, 雄己"}],"nameIdentifiers":[{"nameIdentifier":"63258","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"須藤, 翔"}],"nameIdentifiers":[{"nameIdentifier":"63259","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"高野, 可赴"}],"nameIdentifiers":[{"nameIdentifier":"63260","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"小林, 隆"}],"nameIdentifiers":[{"nameIdentifier":"63261","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"皆川, 昌広"}],"nameIdentifiers":[{"nameIdentifier":"63262","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"若井, 俊文"}],"nameIdentifiers":[{"nameIdentifier":"63263","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"味岡, 洋一"}],"nameIdentifiers":[{"nameIdentifier":"63264","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":"2019-08-06"}],"displaytype":"detail","filename":"128(1)_28-32.pdf","filesize":[{"value":"411.3 kB"}],"format":"application/pdf","licensetype":"license_note","mimetype":"application/pdf","url":{"label":"128(1)_28-32.pdf","url":"https://niigata-u.repo.nii.ac.jp/record/9084/files/128(1)_28-32.pdf"},"version_id":"58f15932-6463-4930-aff7-68a7285b748c"}]},"item_keyword":{"attribute_name":"キーワード","attribute_value_mlt":[{"subitem_subject":"血液透析","subitem_subject_scheme":"Other"},{"subitem_subject":"慢性腎不全","subitem_subject_scheme":"Other"},{"subitem_subject":"腹部手術","subitem_subject_scheme":"Other"},{"subitem_subject":"緊急手術","subitem_subject_scheme":"Other"},{"subitem_subject":"非閉塞性腸管虚血症","subitem_subject_scheme":"Other"}]},"item_language":{"attribute_name":"言語","attribute_value_mlt":[{"subitem_language":"jpn"}]},"item_resource_type":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"resourcetype":"departmental bulletin 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