{"created":"2023-05-25T05:26:08.486419+00:00","id":4824,"links":{},"metadata":{"_buckets":{"deposit":"b7e6f712-9af2-4c67-8fc3-433a7f9fc82b"},"_deposit":{"created_by":17,"id":"4824","owners":[17],"pid":{"revision_id":0,"type":"depid","value":"4824"},"status":"published"},"_oai":{"id":"oai:yamagata.repo.nii.ac.jp:00004824","sets":["29:31:176:177"]},"author_link":["14661","14663","14664","14672","14669","14668","14674","14670","14673","14675","14666","14676","14667","14662","14671"],"item_3_alternative_title_18":{"attribute_name":"その他の言語のタイトル","attribute_value_mlt":[{"subitem_alternative_title":"Actual condition of subarachnoid hemorrhage with ruptured cerebral aneurysm in Yamagata prefecture"}]},"item_3_alternative_title_19":{"attribute_name":"タイトル（ヨミ）","attribute_value_mlt":[{"subitem_alternative_title":"ヤマガタケン ニ オケル ハレツ ノウ ドウミャクリュウ ニ ヨル クモマクカ シュッケツ ノ ジッタイ"}]},"item_3_biblio_info_6":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2020-02-15","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"1","bibliographicPageEnd":"37","bibliographicPageStart":"25","bibliographicVolumeNumber":"38","bibliographic_titles":[{"bibliographic_title":"山形大学紀要. 医学 : 山形医学 "},{"bibliographic_title":"Bulletin of the Yamagata University. Medical science : Yamagata medical journal ","bibliographic_titleLang":"en"}]}]},"item_3_description_42":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"subitem_description":"論文(Article) ","subitem_description_type":"Other"}]},"item_3_description_5":{"attribute_name":"内容記述","attribute_value_mlt":[{"subitem_description":"緒言：くも膜下出血（SAH）は依然として死亡率が高く、さらに発症年齢の高齢化により治療成績の悪化が問題となっている。山形県では平成10年より山形県対脳卒中治療研究会が設立され、急性期脳卒中症例が網羅的に登録されている。本研究の目的はこれらデータから今後のSAHの治療成績の向上のため、SAHの実態と予後不良因子を明らかにすることである。\n対象と方法：1998年から15年間登録されたSAHの4460例（男性1460例、女性2996例、不明４例、平均年齢66.0±14.5歳）のうち出血源検索を行えた3566例の破裂脳動脈瘤によるものと重症で出血源が検索されなかった748例を加え、4314例を対象とした。５年毎に前、中、後期の３群に分け、患者背景、重症度、治療法、治療成績を検討し、経年的変化及び予後不良因子を解析した。\n結果：年間平均発症数は前期311.4、中期313.6、後期267.0例/年で平均年齢は前期64.9±13.6、中期66.3 ±14.9、後期66.9±15.0歳と有意に高齢化していた（p<0.05）。年間発症数は二峰性を呈し、50－60歳と75－80歳にピークを認めた。SAHの治療成績は、前期に比べ後期で予後不良例が増加していたが、前期の年齢構成で年齢調整を行うと同等であった。後期では80歳以上の高齢者の割合が増加していた。治療法別には、クリッピングは予後不良例がやや増加傾向、血管内治療は後期で特に80歳以上の予後不良例の減少を認めた。多重ロジスティック回帰分析では有意な予後不良因子は発症時の重症度（JCS）と年齢であった。\n結論：SAHの治療成績は後期で予後不良例が増加していたが、発症時の重症度が高く予後不良な高齢者の割合の増加が要因であることが明らかとなり、高齢者や重症例に対する治療適応、選択の再検討がくも膜下出血の治療成績向上に必要な問題点であると考えられている。","subitem_description_type":"Other"}]},"item_3_full_name_2":{"attribute_name":"著者(ヨミ)","attribute_value_mlt":[{"nameIdentifiers":[{"nameIdentifier":"14667","nameIdentifierScheme":"WEKO"}],"names":[{"name":"ワタナベ, シゲキ"}]},{"nameIdentifiers":[{"nameIdentifier":"14668","nameIdentifierScheme":"WEKO"}],"names":[{"name":"コクボ, ヤスアキ"}]},{"nameIdentifiers":[{"nameIdentifier":"14674","nameIdentifierScheme":"WEKO"}],"names":[{"name":"コンドウ, レイ"}]},{"nameIdentifiers":[{"nameIdentifier":"14675","nameIdentifierScheme":"WEKO"}],"names":[{"name":"カヤマ, タカマサ"}]},{"nameIdentifiers":[{"nameIdentifier":"14676","nameIdentifierScheme":"WEKO"}],"names":[{"name":"ソノダ, ユキヒコ"}]}]},"item_3_full_name_3":{"attribute_name":"著者別名","attribute_value_mlt":[{"nameIdentifiers":[{"nameIdentifier":"14669","nameIdentifierScheme":"WEKO"}],"names":[{"name":"Watanabe, Shigeki "}]},{"nameIdentifiers":[{"nameIdentifier":"14670","nameIdentifierScheme":"WEKO"}],"names":[{"name":"Kokubo, Yasuaki "}]},{"nameIdentifiers":[{"nameIdentifier":"14671","nameIdentifierScheme":"WEKO"}],"names":[{"name":"Kondo, Rei "}]},{"nameIdentifiers":[{"nameIdentifier":"14672","nameIdentifierScheme":"WEKO"}],"names":[{"name":"Kayama, Takamasa"}]},{"nameIdentifiers":[{"nameIdentifier":"14673","nameIdentifierScheme":"WEKO"}],"names":[{"name":"Sonoda, Yukihiko "}]}]},"item_3_identifier_registration":{"attribute_name":"ID登録","attribute_value_mlt":[{"subitem_identifier_reg_text":"10.15022/00004780","subitem_identifier_reg_type":"JaLC"}]},"item_3_publisher_32":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"山形大学"}]},"item_3_source_id_7":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"0288-030X","subitem_source_identifier_type":"ISSN"}]},"item_3_source_id_9":{"attribute_name":"書誌レコードID","attribute_value_mlt":[{"subitem_source_identifier":"AN00067279 ","subitem_source_identifier_type":"NCID"}]},"item_3_text_33":{"attribute_name":"出版者（ヨミ）","attribute_value_mlt":[{"subitem_text_value":"ヤマガタ ダイガク"}]},"item_3_text_34":{"attribute_name":"別言語の出版者","attribute_value_mlt":[{"subitem_text_value":"Yamagata University"}]},"item_3_text_43":{"attribute_name":"資源タイプ・ローカル","attribute_value_mlt":[{"subitem_text_value":"紀要論文 "}]},"item_3_text_44":{"attribute_name":"資源タイプ・NII","attribute_value_mlt":[{"subitem_text_value":"Departmental Bulletin Paper "}]},"item_3_text_45":{"attribute_name":"資源タイプ・DCMI","attribute_value_mlt":[{"subitem_text_value":"text "}]},"item_3_text_46":{"attribute_name":"資源タイプ・ローカル表示コード","attribute_value_mlt":[{"subitem_text_value":"2"}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"渡辺, 茂樹"}],"nameIdentifiers":[{"nameIdentifier":"14661","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"小久保, 安昭"}],"nameIdentifiers":[{"nameIdentifier":"14662","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"近藤　, 礼"}],"nameIdentifiers":[{"nameIdentifier":"14663","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"嘉山, 孝正"}],"nameIdentifiers":[{"nameIdentifier":"14664","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"園田, 順彦"}],"nameIdentifiers":[{"nameIdentifier":"14666","nameIdentifierScheme":"WEKO"}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2020-02-12"}],"displaytype":"detail","filename":"kiyoum-38-1-25to37.pdf","filesize":[{"value":"868.0 kB"}],"format":"application/pdf","licensetype":"license_note","mimetype":"application/pdf","url":{"label":"kiyoum-38-1-25to37","url":"https://yamagata.repo.nii.ac.jp/record/4824/files/kiyoum-38-1-25to37.pdf"},"version_id":"41cb1f0e-55d3-47c8-b88e-b3948f2e0279"}]},"item_keyword":{"attribute_name":"キーワード","attribute_value_mlt":[{"subitem_subject":"クモ膜下出血、脳動脈瘤、クリッピング、コイル塞栓、高齢社会","subitem_subject_scheme":"Other"},{"subitem_subject":"subarachnoid hemorrhage, cerebral aneurysm, clipping, coil embolization, aged society","subitem_subject_language":"en","subitem_subject_scheme":"Other"}]},"item_language":{"attribute_name":"言語","attribute_value_mlt":[{"subitem_language":"jpn"}]},"item_resource_type":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"resourcetype":"departmental bulletin paper","resourceuri":"http://purl.org/coar/resource_type/c_6501"}]},"item_title":"山形県における破裂脳動脈瘤によるくも膜下出血の実態","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"山形県における破裂脳動脈瘤によるくも膜下出血の実態"}]},"item_type_id":"3","owner":"17","path":["177"],"pubdate":{"attribute_name":"公開日","attribute_value":"2020-02-18"},"publish_date":"2020-02-18","publish_status":"0","recid":"4824","relation_version_is_last":true,"title":["山形県における破裂脳動脈瘤によるくも膜下出血の実態"],"weko_creator_id":"17","weko_shared_id":-1},"updated":"2023-05-25T06:19:33.491697+00:00"}