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タイトル: トロンボモデュリン製剤を中心とした集学的治療が著効したf-TUL後の敗血症性ショックの1例
その他のタイトル: Septic Shock Following Flexible Transurethral Lithotripsy Showing Favourable Response after Multidisciplinary Treatment Mainly Composed of Recombinant Thrombomodulin : A Case Report
著者: 加藤, 春雄  KAKEN_name
柴田, 康博  KAKEN_name
鈴木, 智美  KAKEN_name
伊藤, 一人  KAKEN_name
鈴木, 和浩  KAKEN_name
著者名の別形: Kato, Haruo
Shibata, Yasuhiro
Suzuki, Tomomi
Ito, Kazuto
Suzuki, Kazuhiro
キーワード: f-TUL
Septic shock
Doripenem
Thrombomodulin
Procarcitonin
発行日: Sep-2012
出版者: 泌尿器科紀要刊行会
誌名: 泌尿器科紀要
巻: 58
号: 9
開始ページ: 499
終了ページ: 502
抄録: We herein present a case of a 65-year-old woman who developed severe septic shock following flexible transurethral lithotripsy (f-TUL) showing favourable response after treatment with doripenem and recombinant thrombomodulin (rTM). The patient underwent f-TUL for nephrolithiasis of the left kidney. Preoperative urine culture indicated the presence of a mucoid strain of E. coli that was susceptible to cefazolin ; therefore, the antibiotic cefazolin was administered as a preventive measure. The operation was completed without any specific intraoperative complications. On the day following the operation, blood pressure decreased and clouding of consciousness was observed. Hematological examination showed high levels of procalcitonin, a decrease in platelet count, and high levels of fibrin degradation products (FDP), indicative of severe septic shock and disseminated intravascular coagulation (DIC). The patient was immediately shifted to the intensive care unit (ICU), and multidisciplinary treatment consisting of doripenem (3 g/day) and rTM (380 U/kg) was administered. The medical treatment was successful ; the patient recovered from DIC at an early stage and was able to leave the hospital within 10 days after the operation. The risk of complications is expected to increase with the spread of f-TUL, and prompt action must be taken.
著作権等: 許諾条件により本文は2013-10-01に公開
URI: http://hdl.handle.net/2433/160116
PubMed ID: 23070390
出現コレクション:Vol.58 No.9

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