{"created":"2023-06-20T15:50:22.681112+00:00","id":3083,"links":{},"metadata":{"_buckets":{"deposit":"aef8bcc7-5636-48d3-821a-fcb1db0745ce"},"_deposit":{"created_by":22,"id":"3083","owners":[22],"pid":{"revision_id":0,"type":"depid","value":"3083"},"status":"published"},"_oai":{"id":"oai:redcross.repo.nii.ac.jp:00003083","sets":["100:90:168"]},"author_link":["7159","7162","7165","7161","7164","7160","7163"],"item_10001_biblio_info_7":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2012-12","bibliographicIssueDateType":"Issued"},"bibliographicPageEnd":"55","bibliographicPageStart":"51","bibliographicVolumeNumber":"33","bibliographic_titles":[{"bibliographic_title":"京都第二赤十字病院医学雑誌"},{"bibliographic_title":"Medical journal of Kyoto Second Red Cross Hospital","bibliographic_titleLang":"en"}]}]},"item_10001_description_5":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"急性A 型大動脈解離はその内科治療成績が不良であることから緊急手術の適応であると考えられている．超高齢化社会を迎え急性A 型大動脈解離の手術をうける高齢者の症例が今後増加すると予測される．当科でも2007 年以降90 歳代の症例を認めるようになった．当科では低侵襲および救命を主眼に置いた上行部分弓部置換術を基本術式としている．今回2004 年1 月から2012 年6 月までに急性A 型大動脈解離に対し上行部分弓部置換術のみを行った70 歳以上の症例77 例についてその手術成績を検討した．対象者を70 歳以上80 歳未満の40例；A 群，80 歳以上の37 例；B 群とし二群比較した．術前危険因子，患者術前状態において両群間に有意差は認めなかった．平均人工心肺時間はA 群136.7±22.1 分B 群136.7±19.4 分．循環停止時間はA 群27.8±5.0 分B 群28.2±6.8 分．周術期死亡はA 群2 例（肺塞栓，腹部大動脈破裂）B 群4 例（肺炎1 例，多臓器不全3 例）．在院死亡はA 群4 例（肺炎2 例，縦隔洞炎，胆のう炎）B 群3 例（肺炎1 例，急性冠症候群2 例）でありいずれも有意差は認めなかった．遠隔期観察における死因はA 群1 例（卵巣がん）B 群1 例（大腸がん）であった．救命率はA 群85.0％ B 群81.1％，3 年生存率はA 群80.9％，B 群80.3％ であった．一般に高齢者ではさまざまな合併症の危険性が高く手術成績も若年者のものに比較し不良であると言われている．このため手術における年齢上限制限については議論の余地がある．しかし今回の我々の結果からは本人，家族の希望を前提条件に手術を可及的短時間で終えられるような術式を選択すれば年齢の上限はないと考えられた．","subitem_description_type":"Abstract"}]},"item_10001_full_name_3":{"attribute_name":"著者別名","attribute_value_mlt":[{"nameIdentifiers":[{}],"names":[{"name":"Masuda, Noriyasu"}]}]},"item_10001_publisher_8":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"京都第二赤十字病院"}]},"item_10001_source_id_11":{"attribute_name":"書誌レコードID","attribute_value_mlt":[{"subitem_source_identifier":"AN00357778","subitem_source_identifier_type":"NCID"}]},"item_10001_source_id_9":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"0389-4908","subitem_source_identifier_type":"ISSN"}]},"item_10001_version_type_20":{"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_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"増田, 憲保"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"武内, 瑛子"}],"nameIdentifiers":[{},{}]},{"creatorNames":[{"creatorName":"吉良, 浩勝"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"小林, 卓馬"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"山﨑, 琢磨"}],"nameIdentifiers":[{},{}]},{"creatorNames":[{"creatorName":"高, 英成"}],"nameIdentifiers":[{},{}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2013-01-20"}],"displaytype":"simple","filename":"MJKSRCH33_51.pdf","filesize":[{"value":"303.2 kB"}],"format":"application/pdf","licensetype":"license_note","mimetype":"application/pdf","url":{"label":"kyo2_pdf000025","url":"https://redcross.repo.nii.ac.jp/record/3083/files/MJKSRCH33_51.pdf"},"version_id":"4f2240e4-7020-401a-9c52-a08339e079d7"}]},"item_keyword":{"attribute_name":"キーワード","attribute_value_mlt":[{"subitem_subject":"急性A 型大動脈解離","subitem_subject_scheme":"Other"},{"subitem_subject":"高齢者","subitem_subject_scheme":"Other"},{"subitem_subject":"外科的治療","subitem_subject_scheme":"Other"},{"subitem_subject":"type A acute aortic dissection","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"elderly patients","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"surgical therapy","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":"高齢者急性A 型大動脈解離への上行部分弓部置換術の手術成績検討","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"高齢者急性A 型大動脈解離への上行部分弓部置換術の手術成績検討"},{"subitem_title":"The outcome of hemiarch replacement for type A acute aortic dissection in elderly patients","subitem_title_language":"en"}]},"item_type_id":"10001","owner":"22","path":["168"],"pubdate":{"attribute_name":"公開日","attribute_value":"2013-01-20"},"publish_date":"2013-01-20","publish_status":"0","recid":"3083","relation_version_is_last":true,"title":["高齢者急性A 型大動脈解離への上行部分弓部置換術の手術成績検討"],"weko_creator_id":"22","weko_shared_id":22},"updated":"2023-06-20T21:57:47.928094+00:00"}