{"created":"2023-06-19T11:23:14.496218+00:00","id":3737,"links":{},"metadata":{"_buckets":{"deposit":"53f710d8-9e73-4223-9875-6a7f685d1057"},"_deposit":{"created_by":3,"id":"3737","owners":[3],"pid":{"revision_id":0,"type":"depid","value":"3737"},"status":"published"},"_oai":{"id":"oai:asahikawa-med.repo.nii.ac.jp:00003737","sets":["7","7:23"]},"author_link":["11042","11043","11044","11045","11046","11047","11048","11049","11050","11051"],"item_5_biblio_info_21":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2009-05-01","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"5","bibliographicPageEnd":"632","bibliographicPageStart":"630","bibliographicVolumeNumber":"30","bibliographic_titles":[{"bibliographic_title":"Therapeutic Research"}]}]},"item_5_description_33":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"43歳白人男。患者は呼吸困難を主訴とした。5年前から妻に夜間の鼾、無呼吸を指摘されていた。体重は推定200kg以上の高度肥満で、機器の耐久性の問題から肺動脈造影、肺血流シンチは施行できなかった。だが、造影CTは施行でき、画質は不明瞭であったものの、両側主肺動脈分岐部に造影欠損が認められた。また、末梢肺動脈にかけても欠損がみられたが、下肢静脈エコーでは両下肢ともプローベによる圧迫後にヒラメ静脈の虚脱を認めなかった。以上より、本症例は下肢静脈の血栓で、ならびに高度肥満による深部静脈血栓症に引き続いた肺血栓塞栓症と診断された。治療として血栓溶解療法としてmonteplase 320万単位を静注し、抗凝固療法としてはヘパリンを使用した。更に第4病日目からはワルファリンを開始し、PT-INRが有効域に達した後にヘパリンを中止した。一方、高度睡眠時無呼吸症候群と判断し、検査翌日からnasal CPAPを開始したところ、第31病日目の胸部造影CTでは肺動脈にみられた造影欠損は消失し、経過は良好で第40病日目に患者は退院となった。","subitem_description_language":"ja","subitem_description_type":"Abstract"}]},"item_5_description_36":{"attribute_name":"注記","attribute_value_mlt":[{"subitem_description":"雑誌掲載版","subitem_description_type":"Other"}]},"item_5_description_37":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"subitem_description":"text","subitem_description_type":"Other"}]},"item_5_description_41":{"attribute_name":"フォーマット","attribute_value_mlt":[{"subitem_description":"application/pdf","subitem_description_type":"Other"}]},"item_5_source_id_22":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"0289-8020","subitem_source_identifier_type":"PISSN"}]},"item_5_text_44":{"attribute_name":"ID(XooNIps)","attribute_value_mlt":[{"subitem_text_value":"2009308502"}]},"item_5_text_54":{"attribute_name":"閲覧数(XooNIps)","attribute_value_mlt":[{"subitem_text_value":"826"}]},"item_5_text_55":{"attribute_name":"ダウンロード数(XooNIps)","attribute_value_mlt":[{"subitem_text_value":"374"}]},"item_5_text_7":{"attribute_name":"著者 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