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肺葉切除後ARDSに罹患した横隔神経麻痺症例に対する統合ケアの必要性


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Title: 肺葉切除後ARDSに罹患した横隔神経麻痺症例に対する統合ケアの必要性
Other Titles: A case of postoperative ARDS with n. phrenicus paralysis in need of comprehensive medical team and treatment.
Authors: 田川, 泰 / 横山, 茂樹 / 井口, 茂 / 中野, 裕之 / 浦田, 秀子 / 赤峰, 晋治 / 岡, 忠之
Authors (alternative): Tagawa, Yutaka / Yokoyama, Shigeki / Inokuchi, Shigeru / Nakano, Hiroyuki / Urata, Hideko / Akamine, Shinji / Oka, Tadayuki
Issue Date: Dec-2002
Citation: 長崎大学医学部保健学科紀要 = Bulletin of Nagasaki University School of Health Sciences. 2002, 15(2), p.27-31
Abstract: 胸部外科の術後呼吸器合併症で最も恐れられているものの一つに術後ARDS(adult respiratory distress syndrome)がある.このような患者は人工呼吸器の管理下におかれ,荒蕪肺やストレスにより,人工呼吸器からの離脱に苦慮することが多い.今回,転移性肺腫瘍(胸腺カルチノイド)の術後にARDSを併発し,人工呼吸器管理を必要とした患者で,医師,看護師,理学療法士ならびに家族の協力により,前回の手術と治療による横隔神経麻痺と軽度の放射線肺炎が併存しながら,人工呼吸器からの離脱と職場復帰に成功した症例を報告した.さらに,このような長期人工呼吸器管理下の患者には,統合ケア-総合的医療スタッフの構築とマニュアルの必要性を強調した. / ARDS (adult respiratory distress syndrome) is one of the most dangerous postoperative respiratory complications in thoracic surgery. ARDS patients are on ventilators and it is difficult to wean them from mechanical ventilators because of a destroyed lung and emotional depression. One case in which a patient developed postoperative ARDS after surgical resection of a metastatic lung tumor following the removal of thymic carcinoid, and who required long-term mechanical ventilation was reported. This subject was weaned successfully and returned to work with support from medical doctors, nurses, physical therapists and his family even though he had paralysis of n. phrenicus and mild radio-pneumonia from a previous operation. A demand for an organized comprehensive medical team for each patient and the necessity of creating a manual for long-term ventilator-dependent patients are emphasized in this report.
Keywords: 人工呼吸器管理 / 統合ケア / ARDS / 鬱病
URI: http://hdl.handle.net/10069/17987
ISSN: 09160841
Type: Departmental Bulletin Paper
Text Version: publisher
Appears in Collections:Volume 15, No. 2

Citable URI : http://hdl.handle.net/10069/17987

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