| 特集名 | イレウス診療のpitfall -- いつ外科に送るか | |
|---|---|---|
| 題名 | 単純性イレウスの初期治療：減圧術を中心に | |
| 発刊年月 | 2004年 08月 | |
| 著者 | 炭山 嘉伸 | 東邦大学医学部外科学第三講座 |
| 著者 | 斉田 芳久 | 東邦大学医学部外科学第三講座 |
| 【 要旨 】 | イレウスの初期治療の原則は，輸液による脱水と電解質補正，抗菌薬投与による感染対策とともに，速やかな消化管内減圧による腸管浮腫の改善と血行動態の維持である．早期からの適切な診断と初期治療により保存的に治癒可能な症例も多く，手術移行を避けられることも少なくない．しかし絞扼や穿孔性腹膜炎などを伴う重症の場合はできるだけ早期の手術を行うことが救命のためには重要であり，保存的治療の限界を見極め，遅延なく外科的治療へ移行できるよう常に留意しながら，初期治療を行うことも忘れてはいけない．またとくに小児や高齢者では，保存的療法で改善しない場合は早期に外科的治療へ移行できるよう準備することが重要である． | |
| Theme | Diagnosis and Treatment of Intestinal Obstruction: Timing in Consulting a Surgeon | |
|---|---|---|
| Title | Primary Treatment for Mechanical Ileus | |
| Author | Yoshinobu Sumiyama | Third Department of Surgery, Toho University School of Medicine |
| Author | Yoshihisa Saida | Third Department of Surgery, Toho University School of Medicine |
| [ Summary ] | The principle behind primary medical treatment for mechanical ileus is the prompt decompression of the alimentary tract with improvements in hydration, electrolyte balance, and antibiotic treatment. It is common to see cases in which recover of health and preservation of tissue, are possible and where we may avoid an operation through suitable diagnoses and proper medical treatment from the early stages. However, with serious illnesses, accompanying strangulation, perforations, etc., operations, should be performed as soon as possible. This is the only treatment known to be a lifesaving one. Therefore, it is important, that the limits of preserving-medical treatment be discerned. We must remember to perform initial medical treatments properly, always keeping in mind that we may need to shift to surgical treatments quickly. Moreover, we must especially keep the above factors in mind when treating children or the elderly for these conditions. |
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