{"created":"2023-06-20T16:00:26.595841+00:00","id":18866,"links":{},"metadata":{"_buckets":{"deposit":"d8ae7e53-7cca-4ca5-a6b5-cb97851847de"},"_deposit":{"created_by":41,"id":"18866","owners":[41],"pid":{"revision_id":0,"type":"depid","value":"18866"},"status":"published"},"_oai":{"id":"oai:redcross.repo.nii.ac.jp:00018866","sets":["340:341:733"]},"author_link":["70741","70746","70743","70744","70745","70739","70742","70747","70740","70738"],"item_10001_biblio_info_7":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2023-03-31","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"1","bibliographicPageEnd":"96","bibliographicPageStart":"93","bibliographicVolumeNumber":"27","bibliographic_titles":[{"bibliographic_title":"高知赤十字病院医学雑誌"}]}]},"item_10001_description_5":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"症例は 80 歳女性．約 X-50 年に子宮全摘術を受け，術後早期より神経因性膀胱による排尿障害とリンパ還流障害による両下肢の浮腫を認めていた．X-1年9月頃の感冒を契機に両下肢の浮腫が増悪し，アゾセミド 60 mg/ 日を開始したが改善せず，X 年3月に体動困難となり，当院に紹介となった．来院時，身長 148 cm，体重 73.8 kg．両下肢を主体に全身性の著明な浮腫を認めた．血液検査で FT3 1.74 pg/ml，FT4 ＜0.4 ng/dl，TSH 128μIU/ml と甲状腺機能低下を認め，抗 TP O 抗体，抗 Tg 抗体は陰性であった．エコー所見で甲状腺は軽度腫大し，辺縁は不整，内部は不均一な低エコーであった．CT では心嚢液貯留，下肢優位の皮下脂肪織の浮腫性変化と両側水腎症，膀胱拡張を認めたが，結石や腫瘍等による尿路の閉塞は認めなかった．入院後，膀胱留置カテーテルを挿入したところ最大 6,000 ml/ 日の排尿を認め，橋本病に対してはレボチロキシンナトリウムを 12.5μg/ 日で開始した．治療開始後1週間で体重は約10 kg 低下，２ヶ月後には TSH は正常化し，体重は更に10 kg 低下し，浮腫も著明に改善した．本症例は子宮全摘術後の神経因性膀胱とリンパ還流障害があり，甲状腺機能低下症の影響が加わったため，著明な浮腫を来したと考えられた．","subitem_description_type":"Abstract"}]},"item_10001_publisher_8":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"高知赤十字病院"}]},"item_10001_rights_15":{"attribute_name":"権利","attribute_value_mlt":[{"subitem_rights":"高知赤十字病院"}]},"item_10001_source_id_9":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"0919-7427","subitem_source_identifier_type":"ISSN"}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"小嶋, 咲絵"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"矢山, 貴之"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"松本, 秀志"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"窪田, 綾子"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"大家, 力矢"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"岩﨑, 丈紘"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"小島, 康司"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"辻, 和也"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"内多, 訓久"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"岡﨑, 三千代"}],"nameIdentifiers":[{}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2023-06-02"}],"displaytype":"simple","filename":"初期臨床研修医 小嶋咲絵.pdf","filesize":[{"value":"1.1 MB"}],"format":"application/pdf","licensetype":"license_note","mimetype":"application/pdf","url":{"label":"高知赤十字病院医学雑誌Vol.27-19  ","url":"https://redcross.repo.nii.ac.jp/record/18866/files/初期臨床研修医 小嶋咲絵.pdf"},"version_id":"78788c2b-7877-44ad-a75f-7fc7674f818f"}]},"item_keyword":{"attribute_name":"キーワード","attribute_value_mlt":[{"subitem_subject":"甲状腺機能低下症","subitem_subject_scheme":"Other"},{"subitem_subject":"神経因性膀胱","subitem_subject_scheme":"Other"},{"subitem_subject":"両下肢浮腫","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":"子宮全摘後のリンパ還流障害に甲状腺機能低下症が付随し， 著明な両下肢浮腫を来した一","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"子宮全摘後のリンパ還流障害に甲状腺機能低下症が付随し， 著明な両下肢浮腫を来した一"}]},"item_type_id":"10001","owner":"41","path":["733"],"pubdate":{"attribute_name":"公開日","attribute_value":"2023-06-02"},"publish_date":"2023-06-02","publish_status":"0","recid":"18866","relation_version_is_last":true,"title":["子宮全摘後のリンパ還流障害に甲状腺機能低下症が付随し， 著明な両下肢浮腫を来した一"],"weko_creator_id":"41","weko_shared_id":-1},"updated":"2023-06-20T17:34:28.524496+00:00"}