{"id":1528,"date":"2018-07-18T15:11:55","date_gmt":"2018-07-18T06:11:55","guid":{"rendered":"http:\/\/www.hcfm.jp\/journal\/?p=1528"},"modified":"2018-07-18T15:19:57","modified_gmt":"2018-07-18T06:19:57","slug":"%e6%80%a5%e6%80%a7%e8%99%ab%e5%9e%82%e7%82%8e%e3%81%ae%e8%a8%ba%e6%96%ad%e3%81%a8%e3%83%9e%e3%83%8d%e3%82%b8%e3%83%a1%e3%83%b3%e3%83%88","status":"publish","type":"post","link":"https:\/\/www.hcfm.jp\/journal\/?p=1528","title":{"rendered":"\u6025\u6027\u866b\u5782\u708e\u306e\u8a3a\u65ad\u3068\u30de\u30cd\u30b8\u30e1\u30f3\u30c8"},"content":{"rendered":"<p>\uff0d\u6587\u732e\u540d\uff0d<br \/>\nMatthew J. Snyder. Acute Appendicitis: Efficient Diagnosis and Management. AAFP. 2018; 98(1): 25-33.<\/p>\n<p>\uff0d\u8981\u7d04\uff0d<br \/>\n\u6025\u6027\u866b\u5782\u708e\u306f\u3001\u6210\u4eba\u3068\u5c0f\u5150\u306e\u6025\u6027\u8179\u75db\u75c7\u306e\u6700\u3082\u4e00\u822c\u7684\u306a\u539f\u56e0\u306e\u4e00\u3064\u3067\u3042\u308a\u3001\u751f\u6daf\u30ea\u30b9\u30af\u306f\u7537\u6027\u30678.6%\u3001\u5973\u6027\u30676.7%\u3067\u3042\u308b\u3002\u307e\u305f\u3001\u598a\u5a20\u4e2d\u306e\u5973\u6027\u306b\u304a\u3044\u3066\u306f\u3001\u7523\u79d1\u624b\u8853\u4ee5\u5916\u3067\u306e\u7dca\u6025\u624b\u8853\u3068\u3057\u3066\u6700\u3082\u591a\u3044\u3002\u75c5\u6b74\u30fb\u8eab\u4f53\u6240\u898b\u30fb\u691c\u67fb\u6240\u898b\u306e\u7d50\u679c\u306f\u8a3a\u65ad\u306e\u4e00\u52a9\u3068\u306a\u308b\u3002\u53f3\u4e0b\u8179\u90e8\u75db(LR+ 7.3-8.5)\u3001\u7b4b\u6027\u9632\u5fa1(LR+ 3.8)\u3001\u53f3\u4e0b\u8179\u90e8\u306b\u653e\u6563\u3059\u308b\u3078\u305d\u5468\u56f2\u306e\u75db\u307f(LR+ 3.2)\u306f\u6210\u4eba\u306e\u6025\u6027\u866b\u5782\u708e\u3092\u8003\u3048\u308b\u5146\u5019\u3067\u3042\u308b\u3002\u307e\u305f\u3001\u8178\u8815\u52d5\u97f3\u306e\u6e1b\u5f31\u30fb\u6d88\u5931(LR+ 3.1)\u3001psaos sign(LR+ 3.2)\u3001obturator sign(LR+ 3.5)\u3001Rovsing\u5146\u5019(LR+ 3.5)\u306f\u5c0f\u5150\u306e\u6025\u6027\u866b\u5782\u708e\u3092\u8003\u3048\u308b\u5146\u5019\u3067\u3042\u308b\u3002<br \/>\nAlvarado score(\u3082\u3063\u3068\u3082\u7814\u7a76\u304c\u306a\u3055\u308c\u3066\u3044\u308b\u30b9\u30b3\u30a2\u30fb\u6210\u4eba\u3068\u5c0f\u5150\u306e\u4e21\u65b9\u3067\u4f7f\u7528\u53ef\u80fd)\u3001Pediatric Appendicitis score(\u5c0f\u5150\u306b\u7279\u5316\u3057\u305f\u30b9\u30b3\u30a2)\u3001Appendicitis Inflammatory Response score(\u65b0\u3057\u3044\u30b9\u30b3\u30a2)\u306f\u60a3\u8005\u3092\u4f4e\u30ea\u30b9\u30af\u30fb\u4e2d\u30ea\u30b9\u30af\u30fb\u9ad8\u30ea\u30b9\u30af\u306b\u5206\u3051\u308b\u3053\u3068\u304c\u3067\u304d\u3001\u8fc5\u901f\u306a\u8a3a\u65ad\u306b\u3082\u5f79\u7acb\u3064\u3002<\/p>\n<p><a href=\"https:\/\/www.hcfm.jp\/journal\/wp-content\/uploads\/2018\/07\/20180718JC\uff08\u4f50\u91ce\uff09\uff11.png\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.hcfm.jp\/journal\/wp-content\/uploads\/2018\/07\/20180718JC\uff08\u4f50\u91ce\uff09\uff11.png\" alt=\"20180718JC\uff08\u4f50\u91ce\uff09\uff11\" width=\"692\" height=\"417\" class=\"alignleft size-full wp-image-1535\" \/><\/a><\/p>\n<p>\u753b\u50cf\u691c\u67fb\u306e\u7b2c\u4e00\u9078\u629e\u306b\u306f\u8179\u90e8\u30a8\u30b3\u30fc\u304c\u63a8\u5968\u3055\u308c\u308b\u3002\u2192\u3069\u3046\u3067\u3059\u304b\uff1f<br \/>\n\uff08\u80a5\u6e80\u60a3\u8005\u306e\u5834\u5408\u306fCT\u304c\u63a8\u5968\u3055\u308c\u3066\u3044\u308b\uff09<\/p>\n<p><a href=\"https:\/\/www.hcfm.jp\/journal\/wp-content\/uploads\/2018\/07\/20180718JC\uff08\u4f50\u91ce\uff09\uff12.png\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.hcfm.jp\/journal\/wp-content\/uploads\/2018\/07\/20180718JC\uff08\u4f50\u91ce\uff09\uff12.png\" alt=\"20180718JC\uff08\u4f50\u91ce\uff09\uff12\" width=\"691\" height=\"686\" class=\"alignleft size-full wp-image-1536\" \/><\/a><\/p>\n<p>\u958b\u8179\u3082\u3057\u304f\u306f\u8179\u8154\u93e1\u4e0b\u306e\u866b\u5782\u5207\u9664\u8853\u304c\u6a19\u6e96\u6cbb\u7642\u6cd5\u3067\u3042\u308b\u3002\u3057\u304b\u3057\u4e00\u90e8\u306e\u60a3\u8005\u306b\u306f\u7d4c\u9759\u8108\u7684\u306a\u6297\u751f\u5264\u6295\u4e0e\u304c\u7b2c\u4e00\u9078\u629e\u3068\u306a\u308b\u3002\u30aa\u30d4\u30aa\u30a4\u30c9\u3001NSAIDs\u3001\u30a2\u30bb\u30c8\u30a2\u30df\u30ce\u30d5\u30a7\u30f3\u3092\u7528\u3044\u305f\u75bc\u75db\u7ba1\u7406\u304c\u512a\u5148\u3055\u308c\u308b\u3079\u304d\u3067\u3042\u308a\u3001\u6cbb\u7642\u4ecb\u5165\u306e\u9045\u308c\u3084\u4e0d\u8981\u306a\u51e6\u7f6e\u3092\u62db\u304f\u7d50\u679c\u306b\u306f\u306a\u3089\u306a\u3044\u3002\uff08Alvarado\u30b9\u30b3\u30a2\u306f\u5909\u308f\u3089\u306a\u3044\uff09<br \/>\n\u8178\u7ba1\u7a7f\u5b54\u306f17-32%\u306e\u60a3\u8005\u3067\u307f\u3089\u308c\u3001\u6557\u8840\u75c7\u3092\u5f15\u304d\u8d77\u3053\u3059\u3002\u5916\u79d1\u7684\u51e6\u7f6e\u524d\u306e\u75c7\u72b6\u306e\u9577\u3055\u304c\u30ea\u30b9\u30af\u3068\u306a\u308b\u3002\u4e2d\u30ea\u30b9\u30af\u301c\u9ad8\u30ea\u30b9\u30af\u306e\u60a3\u8005\u3067\u306f\u3001\u7a7f\u5b54 \u306e\u7f79\u60a3\u7387\u3084\u6b7b\u4ea1\u7387\u3092\u6e1b\u3089\u3059\u305f\u3081\u306b\u3001\u65e9\u6025\u306a\u5916\u79d1\u7684\u4ecb\u5165\u304c\u5fc5\u8981\u3067\u3042\u308b\u3002<\/p>\n<p>\u3010\u958b\u50ac\u65e5\u3011\u5e73\u6210\uff13\uff10\u5e74\uff17\u6708\uff11\uff18\u65e5\uff08\u6c34\uff09<\/p>\n","protected":false},"excerpt":{"rendered":"<p>\uff0d\u6587\u732e\u540d\uff0d Matthew J. Snyder. Acute Appendicitis: Efficient Diagnosis and Management. AAFP. 2018; 98(1): 25-33. \uff0d\u8981\u7d04 &hellip; <a href=\"https:\/\/www.hcfm.jp\/journal\/?p=1528\" class=\"more-link\">\u7d9a\u304d\u3092\u8aad\u3080 <span class=\"screen-reader-text\">\u6025\u6027\u866b\u5782\u708e\u306e\u8a3a\u65ad\u3068\u30de\u30cd\u30b8\u30e1\u30f3\u30c8<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[17],"tags":[],"class_list":["post-1528","post","type-post","status-publish","format-standard","hentry","category-17"],"_links":{"self":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/1528","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=1528"}],"version-history":[{"count":5,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/1528\/revisions"}],"predecessor-version":[{"id":1537,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/1528\/revisions\/1537"}],"wp:attachment":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1528"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=1528"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=1528"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}