Japanese

Title	Dダイマーと下肢静脈エコーによる深部静脈血栓症スクリーニングの検討
Subtitle	研究
Authors	小柳佳子1), 伊達有作2), 波多純一3)
Authors (kana)
Organization	1)一般社団法人巨樹の会新武雄病院検査科, 2)一般社団法人巨樹の会新武雄病院外科, 3)一般社団法人巨樹の会新武雄病院医療安全部門
Journal	医学検査
Volume	71
Number	1
Page	176-181
Year/Month	2022 / 1
Article	報告
Publisher	日本臨床衛生検査技師会
Abstract	「要旨」 当院では, 2018年7月から12月までに入院患者の6例に急性肺血栓塞栓症(pulmonary thromboembolism; PTE)が発生した. そこで, 深部静脈血栓症(deep vein thrombosis; DVT)のスクリーニングのために全入院患者に対して「DVT診断のアルゴリズム」の運用を開始した. 【対象と方法】アルゴリズムの運用前後それぞれ12か月間の入院患者6,341例を対象とした. 下肢静脈エコー検査を施行した1,676例を(1)DVT陽性群と陰性群に分けて比較した. (2)血栓存在部位別に近位型と遠位型に分けて比較した. (3)DVTの検出率と陽性率を運用前後で比較し, さらに, 既存例・新規発生例・時期不明例に分けて比較した. (4)運用前後で, PTE発生率を比較し, ショックあり・なしに分けて比較した. 【結果】(1)DVT陽性群は, 有意に女性が多く, 高齢, BMI低値, Dダイマー高値であった. (2)近位型は, 有意にDダイマー高値であった. (3)運用前後の比較では, 既存例の割合が増加し, DVT検出率が増加した. (4)運用前後で, PTE発生率に有意差はないが, 運用後はショックを伴う重症例は認めなかった. 【結論】この運用でDVT既存例をスクリーニングできるようになったことで, 重症のPTEの発生を抑制できたと考えられる.
Practice	医療技術
Keywords	急性肺血栓塞栓症, 深部静脈血栓症, アルゴリズム, Dダイマー, 下肢静脈エコー検査, pulmonary thromboembolism (PTE), deep vein thrombosis (DVT), algorithm, D-dimer, lower extremity vein ultrasound

English

Title	Examination of deep vein thrombosis screening based on D-dimer levels and lower extremity vein ultrasound findings
Subtitle	Study
Authors	Yoshiko KOYANAGI1), Yusaku DATE2), Junichi HATA3)
Authors (kana)
Organization	1)Department of Clinical Laboratory, Shintakeo Hospital, 2)Department of Surgery, Shintakeo Hospital, 3)Department of Medical Safety, Shintakeo Hospital
Journal	Japanese Journal of Medical Technology
Volume	71
Number	1
Page	176-181
Year/Month	2022 / 1
Article	Report
Publisher	Japanese Association of Medical Technologists
Abstract	[Summary] [Background] Acute pulmonary thromboembolism (PTE) occurred in six patients in our hospital from July to December 2018. We have started using a system developed on the basis of an "algorithm for deep vein thrombosis (DVT) diagnosis" for all hospitalized patients. [Materials and Methods] This study included 6,341 patients hospitalized 12 months before and 12 months after application of the system. We performed lower extremity venous ultrasound in 1,676 patients. We compared the characteristics of patients (1)with and without DVT and in terms of (2)thrombus site classified into the proximal or distal type. Additionally, we compared (3)the rate of DVT detection and the positivity rate of DVT before and after application. We also compared the three categories of DVT, namely, already existing, formed during hospitalization, and of unknown time of onset, and (4)the incidence of PTE with and without shock. [Results] (1)Patients with DVT were significantly more likely to be female, older, have a lower BMI, and have higher D-dimer levels. (2)Patients with the proximal-type thrombus showed significantly higher D-dimer levels. (3)The detection rate of the group with already existing DVT and the rate of DVT detection increased significantly. (4)There was no significant difference in the incidence rate of PTE before and after the application of the system. However, there were no severe cases with shock after the application. [Conclusion] We were able to screen for cases of already existing DVT by using the system. This prevented the occurrence of severe PTE.
Practice	Medical technology
Keywords	pulmonary thromboembolism (PTE), deep vein thrombosis (DVT), algorithm, D-dimer, lower extremity vein ultrasound

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