Sequential screening to predict symptomatic pulmonary thromboembolism after gynecologic surgery in Nara, Japan. 1

• 資料種別: 博士論文
• ISSN: 0020-7292
• タイトル: Sequential screening to predict symptomatic pulmonary thromboembolism after gynecologic surgery in Nara, Japan.
• 巻次・部編番号: 132 1
• 著者・編者: Haruta, Shoji; Kawaguchi, Ryuji; Hirai, Toshiko; Kobayashi, Hiroshi
• 著者標目: Haruta, Shoji; Kawaguchi, Ryuji; Hirai, Toshiko; Kobayashi, Hiroshi
• 出版事項: Elsevier
• 出版年月日等: 2016-01; 132 1
• 出版年（W3CDTF）: 2016-01
• 並列タイトル等: 婦人科手術術後の症候性肺血栓塞栓症予防スクリーニングの有用性についての検討
• タイトル（掲載誌）: International journal of gynaecology and obstetrics
• 授与機関名: 奈良県立医科大学
• 授与年月日: 2016-03-15
• 授与年月日（W3CDTF）: 2016-03-15
• 報告番号: 乙第1375号
• 学位: 博士（医学）
• 博論授与番号: 乙第1375号
• 本文の言語コード: eng
• 件名標目: D-dimer; Deep vein thrombosis; Gynecologic surgery; Pulmonary thromboembolism; Sequential screening; Ultrasonography
• 対象利用者: 一般
• 一般注記: type:Thesis; OBJECTIVE: To evaluate a sequential screening method's efficacy in predicting symptomatic pulmonary thromboembolism (PTE) after gynecologic surgery. METHODS: A prospective study employing a two-stage screening process was conducted among consecutive asymptomatic adults who underwent outpatient evaluation for gynecologic surgery at Nara Medical University Hospital, Japan, between April 1, 2004, and December 31, 2013. Patients with a preoperative plasma D-dimer level greater than or equal to 1.0μg/mL underwent compression ultrasonography of the lower extremities. The primary outcome measure was postoperative detection of symptomatic PTE. RESULTS: Overall, 1729 patients were included. The mean D-dimer level was 1.7±3.3μg/mL. Compression ultrasonography was conducted among 470 (27.1%) patients with positive D-dimer test results; symptomatic deep vein thrombosis (DVT) was preoperatively detected among 94 (20.0%) of them. Patients with DVT (n=94) had higher D-dimer levels than patients (n=1635) without (7.8±12.8μg/mL vs 1.1±1.8μg/mL; P<0.001). Despite anticoagulant therapy, symptomatic PTE was detected postoperatively among two of these 94 patients. Symptomatic PTE was also detected among four of 376 patients with positive D-dimer test results but no evidence of DVT by ultrasonography. No clinical onset of postoperative PTE was observed among 1259 patients with D-dimer levels below the cut-off value. CONCLUSION: The PROVEN screening strategy (Preoperative surveillance using a sequential strategy) was ineffective at predicting postoperative symptomatic PTE.; 博士（医学）・乙第1375号・平成28年3月15日; Copyright © 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.; identifier:International journal of gynaecology and obstetrics Vol.132 No.1 p.42-45; identifier:00207292; identifier:http://ginmu.naramed-u.ac.jp/dspace/handle/10564/3199; identifier:International journal of gynaecology and obstetrics, 132(1): 42-45
• DOI: info:doi/10.1016/j.ijgo.2015.06.048; https://doi.org/info:doi/10.1016/j.ijgo.2015.06.048
• 国立国会図書館永続的識別子: info:ndljp/pid/9969038; https://dl.ndl.go.jp/pid/9969038
• コレクション（共通）: 障害者向け資料
• コレクション（障害者向け資料：レベル1）: テキストデータ
• コレクション（個別）: 国立国会図書館デジタルコレクション > デジタル化資料 > 博士論文; https://dl.ndl.go.jp/collections/A00014
• 収集根拠: 博士論文（自動収集）
• 受理日（W3CDTF）: 2016-05-01T16:38:40+09:00
• 記録形式（IMT）: application/pdf
• オンライン閲覧公開範囲: 国立国会図書館内限定公開
• デジタル化資料送信: 図書館・個人送信対象外
• 遠隔複写可否（NDL）: 可
• 関連情報（URI）: http://www.ijgo.org/article/S0020-7292(15)00598-6/abstract
• 掲載誌（URI）: http://hdl.handle.net/10564/3199
• 連携機関・データベース: 国立国会図書館 : 国立国会図書館デジタルコレクション; https://dl.ndl.go.jp

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