{"created":"2023-06-20T15:45:33.942897+00:00","id":72,"links":{},"metadata":{"_buckets":{"deposit":"0129decc-0e35-4f57-8a76-ff1a3b8b0994"},"_deposit":{"created_by":4,"id":"72","owners":[4],"pid":{"revision_id":0,"type":"depid","value":"72"},"status":"published"},"_oai":{"id":"oai:hama-med.repo.nii.ac.jp:00000072","sets":["1:11"]},"author_link":["194"],"item_3_alternative_title_1":{"attribute_name":"その他のタイトル","attribute_value_mlt":[{"subitem_alternative_title":"第55回学術講演会　＜教育講演＞","subitem_alternative_title_language":"ja"}]},"item_3_biblio_info_5":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2003-08-01","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"8","bibliographicPageEnd":"1081","bibliographicPageStart":"1075","bibliographicVolumeNumber":"55","bibliographic_titles":[{"bibliographic_title":"日本産科婦人科學會雜誌","bibliographic_titleLang":"ja"},{"bibliographic_title":"Acta Obstetrica et Gynaecologica Japonica","bibliographic_titleLang":"en"}]}]},"item_3_description_9":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"羊水塞栓症の補助診断のため全国から送られた検体の症例111例を解析した. 111例中20例が確定羊水塞栓症,68例が臨床的羊水塞栓症であり,それら以外の診断がついた症例を非羊水塞栓症群とした.これら3群を臨床的に比較検討した.分娩歴,分娩誘発の有無,発症時期についてみてみると羊水塞栓症は経産婦に多い傾向がみられ,分娩誘発症例が多いのが特徴であった.羊水塞栓症の初発症状として呼吸困難,血圧低下が高頻度にみられた.分娩合併症においては,羊水混濁は非羊水塞栓症では1例もなかったのに対して確定羊水塞栓症では28%,臨床的羊水塞栓症では18%占めていて,羊水混濁は羊水塞栓症のリスクファクターと考えられた.出血量は,臨床的羊水塞栓症で平均5,000mlであり,多くの症例でDICを伴っていた.妊娠合併症として,羊水塞栓症は妊娠中毒症妊婦に発生しやすい傾向にあった.羊水塞栓症の発症機序としてアナフィラキシーショックが発生しそれを乗り越えた症例はARDSや多臓器不全. systemic inflammatory response syndrome (SIRS)の病態に移行すると推測された.羊水塞栓症患者の救命のためには羊水塞栓症のステージにあわせた治療が必要である.羊水塞栓症のリスク因子として羊水混濁,誘発分娩,帝王切開があり,分娩経過が遷延しているいわゆる難産症例は羊水塞栓症を念頭において管理する必要がある.肺血栓塞栓症は産褥早期の発生が最も頻度が高い.産褥期に血栓症が発生しやすい理由の一つにステロイドホルモンの消退か挙げられる.エストロゲンの消退を動物で再現すると,エストロゲンの消退にともないトロンビン産生能が上昇した.今まであまり注目されなかったホルモン変動は産褥の易血栓症の一因と考えられた.産褥血栓症のリスクファクターとして肥満,高齢妊娠,帝王切開,長期臥床,分娩時の脱水が挙げられる.リスクに応じてヘパリン,間歇的下肢加圧マッサージ,弾性ストッキングなどの予防対策を立てることが大切である.プロテインC感受性比が静脈血栓症の予知マーカーの候補として示唆された.","subitem_description_language":"ja","subitem_description_type":"Abstract"}]},"item_3_publisher_6":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"日本産科婦人科学会","subitem_publisher_language":"ja"}]},"item_3_relation_22":{"attribute_name":"NII論文ID","attribute_value_mlt":[{"subitem_relation_type":"isIdenticalTo","subitem_relation_type_id":{"subitem_relation_type_id_text":"110002100228","subitem_relation_type_select":"NAID"}}]},"item_3_rights_7":{"attribute_name":"権利","attribute_value_mlt":[{"subitem_rights":"(C) 日本産科婦人科学会","subitem_rights_language":"ja"},{"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","subitem_rights_language":"ja"}]},"item_3_source_id_19":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"0300-9165","subitem_source_identifier_type":"PISSN"}]},"item_3_version_type_32":{"attribute_name":"著者版フラグ","attribute_value_mlt":[{"subitem_version_resource":"http://purl.org/coar/version/c_970fb48d4fbd8a85","subitem_version_type":"VoR"}]},"item_access_right":{"attribute_name":"アクセス権","attribute_value_mlt":[{"subitem_access_right":"open access","subitem_access_right_uri":"http://purl.org/coar/access_right/c_abf2"}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"金山, 尚裕","creatorNameLang":"ja"}],"nameIdentifiers":[{"nameIdentifier":"194","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":"2018-08-27"}],"displaytype":"detail","filename":"110002100228.pdf","filesize":[{"value":"577.2 kB"}],"format":"application/pdf","licensetype":"license_note","mimetype":"application/pdf","url":{"label":"110002100228.pdf","objectType":"fulltext","url":"https://hama-med.repo.nii.ac.jp/record/72/files/110002100228.pdf"},"version_id":"1ca9825b-71a4-484f-9bbf-80e759929d63"}]},"item_keyword":{"attribute_name":"キーワード","attribute_value_mlt":[{"subitem_subject":"Amniotic fluid embolism","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"ARDS","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"SIRS","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"Deep vein thrombosis","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"Pulmonary embolism","subitem_subject_language":"en","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":"journal article","resourceuri":"http://purl.org/coar/resource_type/c_6501"}]},"item_title":"妊産婦死亡と肺塞栓","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"妊産婦死亡と肺塞栓","subitem_title_language":"ja"},{"subitem_title":"Maternal Mortality and Lung Embolism","subitem_title_language":"en"}]},"item_type_id":"3","owner":"4","path":["11"],"pubdate":{"attribute_name":"PubDate","attribute_value":"2013-08-27"},"publish_date":"2013-08-27","publish_status":"0","recid":"72","relation_version_is_last":true,"title":["妊産婦死亡と肺塞栓"],"weko_creator_id":"4","weko_shared_id":-1},"updated":"2024-03-04T02:58:44.581209+00:00"}