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'abstract_inverted_index': {'近年,増加傾向にある気管支喘息発作による発作死患者の病態を知る目的で,気管支喘息により来院時心肺停止状態であった患者26人(心肺停止群)を,重症気管支喘息のため人工呼吸管理を必要とした患者25人(対照群)と比較し,背景因子や臨床経過,病態生理などの差異について検討した。両群間で性比,年齢,通院治療歴,大発作入院歴,24時間以内の緩解発作の既往などの背景因子に差は認められなかった。来院までの経過は,心肺停止群では通報時12人(46.2%)が意識清明であったにもかかわらず,救急隊現場到着時20人(76.9%)の患者が心肺停止状態となっていた。一方対照群では,来院時22人(88.0%)に意識障害を認めたが,全例血圧は維持されていた。気管内挿管時の動脈血ガス所見では,心肺停止群は高度の混合性アシドーシスであったのに対し,対照群は呼吸性アシドーシスのみであった。症状出現から人工呼吸開始までの時間および治療開始後,気管内挿管時のPaCO2が半減するまでの時間は,心肺停止群でそれぞれ106±31min,': [0], '132±34minで,対照群の322±62min,': [1], '591±173minに比べ,ともに有意に短時間であった(p<0.01)。また症状出現から人工呼吸開始までの時間の分布も,心肺停止群は1時間以内が17人(65.4%)を占めていたが,対照群は1時間以上が17人(68.0%)占めていた。以上より心肺停止群は症状出現後急速に増悪し,きわめて短時間のうちに心肺停止に陥っているが,治療開始後の換気の改善もきわめて速い。心肺停止となる気管支喘息発作は,病態生理学的に発症機序が異なることが考えられ,わが国において急速に心肺停止に至る気管支喘息発作患者を減少させるためには,発症機序の解明とともに病院に来院するまでの対策が重要と考えられる。': [2]}, 'cited_by_api_url': 'https://api.openalex.org/works?filter=cites:W2008074384', 'counts_by_year': [{'year': 2020, 'cited_by_count': 1}], 'updated_date': '2024-08-15T05:29:54.307641', 'created_date': '2016-06-24'}