帝王切開術前の深部静脈血栓症に対するD-dimerのカットオフ値およびD-dimerと帝王切開術中出血量の関与についての検討

• 資料種別: 博士論文
• タイトル: 帝王切開術前の深部静脈血栓症に対するD-dimerのカットオフ値およびD-dimerと帝王切開術中出血量の関与についての検討
• 著者・編者: 折田, 有史
• 著者標目: 折田, 有史 オリタ, ユウジ
• 出版事項: Kurume University School of Medicine
• 並列タイトル等: The optimal cutoff level of D-dimer during pregnancy to exclude deep vein thrombosis, and the association between D-dimer and postpartum hemorrhage in Cesarean section patients
• 授与機関名: 鹿児島大学
• 授与年月日: 2019-10-02
• 報告番号: 甲総研第533号
• 学位: 博士(医学); Doctor of Philosophy in Medical Science
• 本文の言語コード: eng
• 件名標目: D-dimer; deep vein thrombosis; cutoff level; singleton; twin pregnancies; postpartum hemorrhage
• 対象利用者: 一般
• 一般注記: 博士論文全文, 博士論文要旨, 最終試験結果の要旨, 論文審査の要旨; Objective: The main purpose was to clarify the optimal D-dimer cutoff level during pregnancy to exclude deep vein thrombosis (DVT) prior to Cesarean section. The secondary purpose was to determine whether D-dimer can predict severe postpartum hemorrhage (PPH) in Cesarean section patients. Methods: Two hundred and seventy eight elective Cesarean section cases were enrolled. Clinical factors and blood parameters at 34-37 weeks of gestation were analyzed. To detect DVT, lower extremities veins were examined using color Doppler ultrasonography in cases with D-dimer level ＞＿ 1.5 μg/mL. In addition, postpartum blood loss amounts during Cesarean section were recorded. Results: Five DVT cases occurred in 250 singleton pregnancies, and 2 DVT cases occurred in 28 twin pregnancies. The overall incidence of DVT was 2.5%. The D-dimer level was higher in DVT cases than in non-DVT cases (3.84±1.97 vs. 2.31±1.48 μg/mL, P<0.01). The optimal D-dimer cutoff level was 2.6 μg/mL with a negative predictive value of 99.5%, and sensitivity of 85.7%. PPH during Cesarean section was positively correlated with D-dimer level in all pregnancies. However, this relationship disappeared after excluding twin pregnancies. Conclusion: A D-dimer level < 2.6 μg/mL at 34-37 weeks of gestation has the potential to exclude DVT. D-dimer can be an independent predictor for severe PPH for all Cesarean section cases, including twin pregnancies. YUJI ORITA, TOMONORI HAMADA, SHINICHI TOGAMI, TSUTOMU DOUCHI, HIROAKI KOBAYASHI The Optimal Cutoff Level of D-Dimer during Pregnancy to Exclude Deep Vein Thrombosis, and the Association between D-Dimer and Postpartum Hemorrhage in Cesarean Section Patients The Kurume Medical Journal (2019) 66(2) 107-114 https://doi.org/10.2739/kurumemedj.MS662003
• 記録形式（IMT）: application/pdf
• オンライン閲覧公開範囲: インターネット公開
• 連携機関・データベース: 国立情報学研究所 : 学術機関リポジトリデータベース（IRDB）（機関リポジトリ）; https://irdb.nii.ac.jp
• 提供元機関・データベース: 鹿児島大学 : 鹿児島大学リポジトリ

目次

Result_Orita_Yuji_isk_533 other

Comments_Orita_Yuji_isk_533 other

Diss_折田_有史_ISK533_2019 fulltext

Abstract_折田_有史_4512800161_2019 abstract