アブストラクト
| Title | 敗血症性DICの病態と管理Up to date |
|---|---|
| Subtitle | 特集 敗血症Up to date 2020 |
| Authors | 石倉宏恭*1 |
| Authors (kana) | |
| Organization | *1福岡大学医学部救命救急医学講座 |
| Journal | ICUとCCU |
| Volume | 44 |
| Number | 2 |
| Page | 101-109 |
| Year/Month | 2020 / 2 |
| Article | 報告 |
| Publisher | 医学図書出版 |
| Abstract | 「要約」敗血症患者は年々増加傾向にあり, その死亡率は18〜35%といまだ高い. 敗血症は炎症と凝固が密接にクロストークしている病態であり, それゆえ, 播種性血管内凝固症候群(DIC)を頻繁に合併し, その合併率は20〜40%である. 敗血症性DICは線溶抑制型DICのひとつで, 凝固の活性化に比べて, 線溶活性はそれほど強くない. このため, 微小循環系で血栓融解が進行せずに, 循環障害が生じ, 最終的に臓器機能障害へと進展する. ただし, 出血性合併症は比較的軽度である. 敗血症性DICの治療は, 何よりも基礎疾患である感染症の治療が最優先されるが, 同時に抗凝固療法を実施して, 血栓形成を制御しなければならない. 抗凝固療法(とくに, 遺伝子組換えヒトトロンボモジュリンやアンチトロンビン製剤による治療)の対象患者は, DIC(とくに, 国際血栓止血学会のovert DIC基準)患者でかつ疾患重症度が高い(APACHE IIやSOFAスコアで高スコア)患者で, このような患者に対する抗凝固療法は転帰改善が期待できる. |
| Practice | 臨床医学：一般 |
| Keywords |
- 全文ダウンロード： 従量制、基本料金制の方共に1,023円(税込) です。
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