藪中 幸一^{1, 2}, 飯坂 真司², 山本 匠³, 真田 弘美²

Koichi YABUNAKA^{1, 2}, Shinji IIZAKA², Takumi YAMAMOTO³, Hiromi SANADA²

¹葛城病院超音波室, ²東京大学大学院医学系研究科老年看護学／創傷看護学分野, ³東京大学医学部附属病院形成外科学

¹Department of Ultrasound, Katsuragi Hospital, ²Department of Gerontological Nursing/Wound Care Management, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, ³Department of Plastic and Reconstructive Surgery, The University of Tokyo Hospital

キーワード : pressure ulcer, ultrasonography, deep tissue injury, early detection

これまでの褥瘡診断は視診・触診による外診をもとになされてきた．しかし，近年，外診では一見すると浅い褥瘡にみえるが，既に深部まで組織が障害されている状態で，深部から表層にかけて急激に悪化する深部組織損傷（deep tissue injury: DTI）が注目され，早期診断による治療と看護ケアが求められる．そこで，その正確性を高めるために超音波検査（ultrasonography: US）の併用が期待されている．USは非侵襲的で簡便かつリアルタイムな検査であり，褥瘡の診断や評価における有用性を示す研究も増加している．そこで，本稿ではこれから褥瘡USを行う術者に必要とされる基本的な検査手順とUS画像診断について述べる．そして，褥瘡USが臨床の現場で広く普及することを期待する．

The diagnosis of pressure ulcer (PU) has been based on a physical examination consisting of inspection and palpation. Recently, a new type of etiology of PU has been emerging, referred to as a deep tissue injury (DTI). A DTI is difficult to evaluate by the usual inspection because invisible deep tissue damage is already present despite an intact or shallow skin appearance, rapidly deteriorating into an advanced stage. Ultrasonography (US) is a noninvasive, easy-to-use, and real-time technology that will be helpful for early detection of DTI and accurate diagnosis or evaluation of PU status and healing. The efficacy of US for PU assessment has been reported in previous reports. This review briefly introduces the basic diagnostic techniques and procedures of US for PU assessment. It is expected that US will be widely disseminated in the clinical field of PU management.