臨牀消化器内科 Vol.23 No.10(3)


特集名 膵炎診療をめぐる最近の動向 -- ガイドライン,診断基準を含めて
題名 急性膵炎の治療 -- 初期診療指針の改訂案と問題点を中心に
発刊年月 2008年 09月
著者 伊藤 鉄英 九州大学大学院医学研究院病態制御内科学
著者 五十嵐 久人 九州大学大学院医学研究院病態制御内科学
著者 木原 康之 産業医科大学消化器・代謝内科
著者 大槻 眞 産業医科大学消化器・代謝内科
【 要旨 】 急性膵炎では発症早期に死に至る症例が多いため,発症早期での的確な診療が重要である.厚生労働省難治性膵疾患調査班では,治療成績の改善を目指し,「急性勝炎における初期診療のコンセンサス」(2005年3月31日発刊) を作成し,発症早期 (とくに発症48時間以内) の具体的な診療指針を提示することで,救命率向上に貢献している.発刊して数年が経過し,さらに2008年に同班により急性膵炎重症度判定基準が改訂されたため,「急性藤炎における初期診療のコンセンサス (第2版)」を作成し,さらなる急性膵炎の治療成績の改善を目指すものである.本稿ではおもに初期診療の改訂案と問題点を中心に総説した.
Theme A Trend in the Practice of Pancreatitis
Title Interpretation of Consensus of Primary Care in Acute Pancreatitis Revised in 2008
Author Tetsuhide Ito Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University
Author Hisato Igarashi Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University
Author Yasuyuki Kihara Department of Gastroenterology and Metabolism, University of Occupational and Environmental Health
Author Makoto Otsuki Department of Gastroenterology and Metabolism, University of Occupational and Environmental Health
[ Summary ] The management of patients with acute pancreatitis is complicated by an unpredictable outcome. Many patients initially identified as having mild disease progress to severe disease indolently over the initial 48 h. Consensus of primary care in acute pancreatitis published by Research Committee of Intractable Diseases of the Pancreas supported by the Japanese Ministry of Health, Labour and Welfare is the consensus of experts in pancreatitis in Japan and focuses on the practical aspects in the early management of patients with acute pancreatitis and decisions needed within the first 48 h of care and has been revised in 2008 with the revise of the diagnostic criteria for severity assessment of acute pancreatitis in Japan. This consensus guideline on acute pancreatitis is intended for general clinicians in primary care and emergency patients, and specialists in gastrointestinal diseases who do not have expertise in pancreatitis. In the present paper, we made a brief interpretation of consensus of primary care in acute pancreatitis revised in 2008.
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