大腸穿孔症例に対する好中球エラスターゼ阻害薬の使用経験

概要

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In six patients who were found to have acute lung injury after emergency surgery for large intestine perforation, we used a selective neutrophil elastase inhibitor (sivelestat sodium hydrate) immediately after operation. Favorable outcomes were achieved in these patients. To describe our experiences of using the drug and its effects, here we present a representative case from these six large intestine perforation cases. Sivelestat was given during postoperative ventilation, and the decreased ratio of PaO_2/FiO_2 noted after surgery improved over time following administration of the drug. Although one patient died from multi-organ failure on the day of operation, the remaining five patients were extubated. Two patients had three failed organs : one died on the day of operation and the other died on the 81st day of hospitalization. The remaining four patients improved and were discharged from the hospital. Our experiences have shown that a neutrophil elastase inhibitor may be effective in the treatment of acute lung injury after surgery for large intestine perforation. However, further investigation is necessary to determine dosage and administration of the drug as well as available concomitant therapies in patients with multiple organ disorders.
東京女子医科大学の論文