{"created":"2023-06-19T11:20:31.131024+00:00","id":561,"links":{},"metadata":{"_buckets":{"deposit":"b8c536cc-c6e4-4b9f-8ef9-8ecbde034d42"},"_deposit":{"created_by":3,"id":"561","owners":[3],"pid":{"revision_id":0,"type":"depid","value":"561"},"status":"published"},"_oai":{"id":"oai:asahikawa-med.repo.nii.ac.jp:00000561","sets":["7","7:23"]},"author_link":["1055","1056","1057","1058","1059","1060","1061","1062","1063"],"item_5_biblio_info_21":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2005-07-01","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"7","bibliographicPageEnd":"435","bibliographicPageStart":"431","bibliographicVolumeNumber":"45","bibliographic_titles":[{"bibliographic_title":"脈管学"}]}]},"item_5_description_33":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"過去5年間に手術を施行した下肢閉塞性動脈硬化症(ASO)235例のうち,鼠径靱帯以下の末梢動脈血行再建を要した165例202肢を対象に,虚血性足病変の治療における問題点を検討した.71例はFontaine III度またはIV度の重症虚血肢であった.非糖尿病群は膝下膝窩動脈へのバイパス42%,足関節領域へのバイパス6%であった.糖尿病群は膝窩動脈へのバイパスは比較的少なく,足関節領域へのバイパスは50%を占めた.肢趾切断は,非糖尿病群9%,糖尿病群39%と糖尿病群が有意に多かった.下腿以上の大切断を要したのは,糖尿病群の4例であった.糖尿病合併下肢AS0に伴う足部病変は,潰瘍や壊死部分に感染を伴っていることが多く,切断端の創治癒には感染の制御が非常に重要であり,最近ではシャワー浴等の大量の流水による洗浄を基本としている.2003年から足部切断創の処置にvacuum-assisted 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