@article{oai:air.repo.nii.ac.jp:00000601,
 author = {小玉, 光子 and 伊藤, 登茂子 and 安齋, 眞一 and 浅沼, 義博 and Kodama, Mitsuko and Ito, Tomoko and Ansai, Shinichi and Asanuma, Yoshihiro},
 issue = {2},
 journal = {秋田大学医学部 保健学科紀要},
 month = {Oct},
 note = {本院褥瘡外来を開設して以来1年3ヶ月間に受診した144名の患者を,手術の有無や褥瘡発生の背景因子の観点から検討した.非手術例93名の診療科別内訳は,呼吸器内科が17名 (18%) と最多であった.しかし,消化器内科と消化器外科 (肝胆膵外科,胃腸外科,食道外科) を合せると29名 (31%) に達した.手術例51名の診療科別内訳は,心臓血管外科が12名 (24%) と最多であった.しかし,消化器外科 (肝胆膵外科,胃腸外科,食道外科) 全体では17名 (33%) に達した.平均手術時間は,心臓血管外科5.4時間,肝胆膵外科5.0時間,胃腸外科4.5時間であった.また,患者の栄養状態および術後の身体装着物による体動制限も褥瘡発生の一因と考えられた.褥瘡対策チームの関わりが奏効した消化器外科術後症例を呈示した.75歳,男性,下部胆管癌に対し,膵頭十二指腸切除術施行後に仙骨部に5×3.6cm,NPUAPステージIII,DesiGN 12点の褥瘡が発生し褥瘡外来に紹介された.圧切替型エアーマットレスの使用,ずれ防止,栄養状態を改善することにより約1ヶ月で治癒した.今後は,癌終末期の患者や術後の褥瘡発生率の高い診療科には,体圧分散マットレスなどの予防環境を特に徹底したい.また,手術時間が4時間以上となることが予測される患者では,術中の体圧分散に留意していく必要がある., In these 15 months, a total of 144 patients visited the outpatient clinic of pressure ulcers in Akita University Hospital. Among these 144 patients, 93 were non-surgical patients and 51 were patients who had undergone surgery beforehand. Of 93 non-surgical patients, 17(18%) belonged to the Department of Respiratory Organs, and as many as 29(31%) belonged to the Department of Digestive Organs and Department of Gastroenterological Surgery (hepato-pancreato-biliary surgery, gastro-intestinal surgery, esophageal surgery). Of 51 patients whose pressure ulcers developed postoperatively, 12(24%) belonged to Department of Cardiovascular Surgery, and as many as 17(33%) belonged to the Department of Gastroenterological Surgery. The mean operative time was 5.4 hours for patients of Department of Cardiovascular Surgery, 5.0 hours for patients of Department of Hepato-Pancreato-Biliary Surgery, 4.5 hours for patients of Department of Gastrointestinal Surgery. The risk factors for postoperative pressure ulcers include the malnutrition and patients' disability to function due to body restriction by various drainage tubes etc. A case of 75 y/o male who suffered from lower bile duct cancer and underwent pancreatoduodenectomy was presented. Deep pressure ulcer (5×3.6cm in size, NPUAP stage III, DesiGN 12 points) developed postoperatively at the sacral area and he was referred to the outpatient clinic of pressure ulcers. The pressuredispersing mattress was adopted, the rub was prevented and nutritional condition was improved, then the pressure ulcer was cured within almost 1 month. A pressure-dispersing mattress should be prepared sufficiently for the Departments that take care of patients with cancer in the terminal stage and for the Departments with high incidence of postoperative pressure ulcers. Furthermore, for patients whose operative time might exceed 4 hours, pressure dispersion during operation should be intended.},
 pages = {129--137},
 title = {秋田大学医学部附属病院における褥瘡外来の現状と治療・ケアの実際},
 volume = {12},
 year = {2004}
}