大腸穿孔症例に対するエンドトキシン吸着療法の検討

The aim of this retrospective study was to investigate the therapeutic results of Polymyxin Bimmobilized Direct Hemoperfusion（PMX-DHP）for colorectal perforation. The study subjects were 40 patients with colorectal perforation surgically treated from 1993 through 2004, of whom 18 underwent PMX-DHP after operation（P group）and 22 underwent operations only（N group）. Although there was no significant difference between the two groups in the overall mortality rate, the mortality rate for ARDS was significantly lower in the P group than in the N group. There was a statistically significant correlation between the P/F ratio and the time interval from the disease onset（r=－0.590, p=0.0009<0.001）. The time lag from disease onset to operation and the length of PMX-DHP period were significantly longer in the death group than in the survivor group. We anticipate that PMX-DHP for colorectal perforation proves effective in reducing deaths from ARDS. For an effective facilitation of PMX-DHP, the procedure should be started as soon as possible from the onset of the disease.

四国医学雑誌 : http://www.med.tokushima-u.ac.jp/article/0012780.html