{"created":"2023-06-19T08:46:30.405090+00:00","id":2044,"links":{},"metadata":{"_buckets":{"deposit":"028c8c86-fec2-4ae6-a7ec-ccd96e0b3fbf"},"_deposit":{"created_by":25,"id":"2044","owners":[25],"pid":{"revision_id":0,"type":"depid","value":"2044"},"status":"published"},"_oai":{"id":"oai:ycu.repo.nii.ac.jp:00002044","sets":["4:71:433:435"]},"author_link":["3766","3768","2529","3770","3767","3769","2634"],"item_10002_biblio_info_7":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2020-04-30","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"2","bibliographicPageEnd":"82","bibliographicPageStart":"77","bibliographicVolumeNumber":"71","bibliographic_titles":[{"bibliographic_title":"横浜医学"},{"bibliographic_title":"Yokohama Medical Journal","bibliographic_titleLang":"en"}]}]},"item_10002_description_5":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"循環不全を伴う川崎病の重症型は川崎病ショック症候群（Kawasaki disease shock syndrome: KDSS）と呼ばれ，KDSSでは急性期の消化器症状の頻度が高いことが知られている．今回，消化器症状が長期に持続したKDSSの症例を経験した．症例は1歳6か月女児．発熱，嘔吐，下痢で発症し， 第3病日に川崎病主要症状5/6を認め，診断された.　免疫グロブリン大量静注療法（intravenous immunoglobulin: IVIG）が開始されたが，意識障害，呼吸障害，胆汁性嘔吐を認め，当院に転院搬送となった．来院時にはショックと多臓器不全を伴う播種性血管内凝固症候群を合併していた．ICUにて全身管理を行い，血漿交換療法（plasma exchange: PE）， IVIG，インフリキシマブ，シクロスポリンの追加投与等により，冠動脈の一過性拡張のみで全身炎症は改善した．一方，発症時から胆汁性嘔吐，腹部膨満，腸蠕動音の低下があり，イレウスと判断した．十二指腸チューブでの減圧管理で症状は一旦改善したが，回復期に消化器症状が再燃した．上部消化管造影検査の結果から，機械性腸閉塞の合併が疑われた．川崎病に合併する消化器症状にはイレウスと機械性腸閉塞，ふたつの機序があり， 機械性腸閉塞の場合には外科的介入を要することがある．本症例は保存的加療により改善したが，嘔吐，腹痛などの症状が遷延する場合には，消化管造影検査や消化管内視鏡検査等を考慮すべきである．\n","subitem_description_type":"Abstract"}]},"item_10002_publisher_8":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"横浜市立大学医学会"}]},"item_10002_source_id_9":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"0372-7726","subitem_source_identifier_type":"ISSN"}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"神山, 裕二"},{"creatorName":"カミヤマ, ユウジ","creatorNameLang":"ja-Kana"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"西村, 謙一"},{"creatorName":"ニシムラ, ケンイチ","creatorNameLang":"ja-Kana"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"大西, 愛"},{"creatorName":"オオニシ, アイ","creatorNameLang":"ja-Kana"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"服部, 成良"},{"creatorName":"ハットリ, セイラ","creatorNameLang":"ja-Kana"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"村瀬, 絢子"},{"creatorName":"ムラセ, アヤコ","creatorNameLang":"ja-Kana"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"原, 良紀"},{"creatorName":"ハラ, リョウキ","creatorNameLang":"ja-Kana"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"伊藤, 秀一"},{"creatorName":"イトウ, シュウイチ","creatorNameLang":"ja-Kana"}],"nameIdentifiers":[{}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2020-07-27"}],"displaytype":"detail","filename":"04_Kamiyama.pdf","filesize":[{"value":"2.7 MB"}],"format":"application/pdf","licensetype":"license_11","mimetype":"application/pdf","url":{"label":"横浜医学71巻2号（神山裕二）","url":"https://ycu.repo.nii.ac.jp/record/2044/files/04_Kamiyama.pdf"},"version_id":"b7ae9bd4-240f-43c7-bbb3-bc034eec57cc"}]},"item_keyword":{"attribute_name":"キーワード","attribute_value_mlt":[{"subitem_subject":"川崎病｜川崎病ショック症候群｜イレウス｜腸閉塞","subitem_subject_scheme":"Other"},{"subitem_subject":"Kawasaki disease｜Kawasaki disease shock syndrome｜Ileus｜intestinal obstruction","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":"departmental bulletin paper","resourceuri":"http://purl.org/coar/resource_type/c_6501"}]},"item_title":"消化器症状が長期に持続した川崎病ショック症候群","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"消化器症状が長期に持続した川崎病ショック症候群"},{"subitem_title":"PROLONGED GASTROINTESTINAL SYMPTOMS ASSOCIATED WITH KAWASAKI DISEASE SHOCK SYNDROME","subitem_title_language":"en"}]},"item_type_id":"10002","owner":"25","path":["435"],"pubdate":{"attribute_name":"公開日","attribute_value":"2020-07-27"},"publish_date":"2020-07-27","publish_status":"0","recid":"2044","relation_version_is_last":true,"title":["消化器症状が長期に持続した川崎病ショック症候群"],"weko_creator_id":"25","weko_shared_id":-1},"updated":"2023-06-19T09:26:25.255944+00:00"}