濱中 恵子¹, 米村 重則², 豊崎 光代¹, 家戸 美帆¹, 奥田 佳那子¹, 宇城 研悟¹, 桜井 正樹², 長島 光治¹

Keiko HAMANAKA¹, Shigenori YONEMURA², Mitsuyo TOYOSAKI¹, Miho KATO¹, Kanako OKUDA¹, Kengo USHIRO¹, Masaki SAKURAI², Kouji NAGASHIMA¹

¹松阪市民病院検査科, ²松阪市民病院泌尿器科

¹Department of Laboratory, Matsusaka City Hospital, ²Department of Urology, Matsusaka City Hospital

キーワード : ultrasonography, deep venous thrombosis, D-dimer, urologic surgery

目的：泌尿器科周術期における下肢静脈超音波検査とDダイマーの有用性について，深部静脈血栓症の有無をもとに検討した．対象および方法：2005年1月‐2006年3月までに当院泌尿器科で手術を受け，術前術後に下肢静脈超音波検査とDダイマーの測定を行った56症例を対象とした．手術の内訳は開腹手術17症例，経尿道的手術39症例である．下肢静脈超音波検査の観察部位は外腸骨静脈，総大腿静脈，浅大腿静脈，膝下静脈，後脛骨静脈，腓骨静脈，ヒラメ静脈とした．結果：術前術後で深部静脈血栓症が発見された症例は1例も認められなかった．しかし術後に測定したDダイマーは経尿道的手術39例すべて陰性であったのに対して，開腹手術は17例中6例でDダイマーが陽性であった．結語：Dダイマーの測定を実施するのであれば，経尿道的手術ではルーチンでの下肢静脈超音波検査は必要でないと考えられた．

Purpose: Venous ultrasonography and measurement of D-dimers were performed to evaluate their efficacies in the diagnosis of deep venous thrombosis in patients undergoing routine urologic surgery. Materials and Methods: The subjects in this study were 56 patients who underwent urologic surgery at our hospital between January 2005 and March 2006. We performed ultrasonographic examination and measurement of D-dimers before and after the surgery. Thirty-nine of the 56 patients underwent transurethral surgery, and seventeen underwent open urologic surgery. We carried out ultrasonographic examination for the detection of deep venous thrombosis from the bilateral iliac veins to the calf muscle veins. Results and discussion: None of the patients had any evidence of deep venous thrombosis either before or after the operations. As for the D-dimer levels, there were no transurethral surgery patients who had D-dimer levels in the positive range; however, six of the 17 patients who underwent open urological surgery showed D-dimer levels in the positive range. Conclusion: In cases undergoing transurethral surgery, routine venous ultrasonography may not be needed if serum D-dimer concentrations can be measured after the operation.