{"id":7061,"date":"2023-01-04T17:58:24","date_gmt":"2023-01-04T08:58:24","guid":{"rendered":"https:\/\/wp.meccari.jp\/?p=7061"},"modified":"2023-12-25T12:16:04","modified_gmt":"2023-12-25T03:16:04","slug":"menu_46","status":"publish","type":"post","link":"https:\/\/wp.meccari.jp\/eigocafe\/menu_46\/","title":{"rendered":"Menu 46\u3000\u80f8\u6c34\u3068\u80f8\u90e8\u30ec\u30f3\u30c8\u30b2\u30f3\u691c\u67fb\u306b\u95a2\u3059\u308b\u82f1\u8a9e\u8868\u73fe"},"content":{"rendered":"

\"\"<\/p>\r\n\r\n

\u3053\u3093\u306b\u3061\u306f\u3002\u300c\u533b\u5b66\u82f1\u8a9e\u30ab\u30d5\u30a7<\/strong><\/span>\u300d\u306b\u3088\u3046\u3053\u305d\uff01<\/span><\/p>\r\n

\u3053\u3053\u306f\u300c\u30b3\u30fc\u30d2\u30fc1\u676f\u5206\u300d\u306e\u6642\u9593\u3067\u3001\u533b\u5b66\u82f1\u8a9e\u306b\u307e\u3064\u308f\u308b\u8a71\u3092\u6c17\u8efd\u306b\u697d\u3057\u3093\u3067\u3044\u305f\u3060\u304f\u30b3\u30fc\u30ca\u30fc\u3067\u3059\u3002<\/span><\/p>\r\n

\u672c\u65e5\u306e\u30c6\u30fc\u30de\u306f\u300c\u80f8\u6c34\u3068\u80f8\u90e8\u30ec\u30f3\u30c8\u30b2\u30f3\u691c\u67fb<\/strong><\/span>\u300d\u3067\u3059\u3002<\/span><\/p>\r\n

\u300c\u80f8\u6c34<\/strong>\u300d\u306f\u60a3\u8005\u3055\u3093\u304c\u8a34\u3048\u308b\u300c\u75c7\u72b6\u300d\u3067\u306f\u306a\u304f\u3001\u691c\u67fb\u3067\u5224\u5b9a\u3067\u304d\u308b\u300c\u75c5\u614b<\/strong>\u300d\u3067\u3042\u308a\u3001\u533b\u5b66\u6559\u80b2\u30e2\u30c7\u30eb\u30fb\u30b3\u30a2\u30fb\u30ab\u30ea\u30ad\u30e5\u30e9\u30e0\u306b\u3042\u308b\u7fd2\u5f97\u3059\u3079\u304d37\u306e\u75c7\u5019\u306e\u4e00\u3064\u3068\u3057\u3066\u5b9a\u3081\u3089\u308c\u3066\u3044\u307e\u3059\u3002\u305d\u3057\u3066\u305d\u306e\u8a3a\u65ad\u306b\u306f\u300c\u80f8\u90e8\u30ec\u30f3\u30c8\u30b2\u30f3\u691c\u67fb<\/strong>\u300d\u304c\u6709\u7528\u3067\u3059\u304c\u3001\u305d\u306e\u8aad\u5f71\u306f\u82f1\u8a9e\u570f\u3067\u306e\u81e8\u5e8a\u5b9f\u7fd2\u3067\u306f\u5fc5\u9808\u3068\u306a\u308a\u307e\u3059\u3002<\/span><\/p>\r\n

\u305d\u3053\u3067\u4eca\u6708\u306f\u3001\u80f8\u6c34\u306e\u9451\u5225<\/strong>\u3068\u80f8\u90e8\u30ec\u30f3\u30c8\u30b2\u30f3\u691c\u67fb\u306e\u8aad\u5f71<\/strong>\u306b\u95a2\u3059\u308b\u82f1\u8a9e\u8868\u73fe\u3092\u3054\u7d39\u4ecb\u3057\u307e\u3059\u3002<\/span><\/p>\r\n

Light\u2019s Criteria \u3063\u3066\u4f55\uff1f<\/strong><\/span><\/span>
\r\n\u307e\u305a\u306f\u300c\u80f8\u6c34<\/strong>\u300d\u306e\u82f1\u8a9e\u8868\u73fe\u304b\u3089\u898b\u3066\u3044\u304d\u307e\u3057\u3087\u3046\u3002<\/span><\/p>\r\n

\u300c\u80f8\u6c34<\/strong>\u300d\u306f\u82f1\u8a9e\u3067\u306f pleural effusion<\/strong><\/span> \u3068\u306a\u308a\u307e\u3059\u3002\u7686\u3055\u3093\u3054\u5b58\u77e5\u306e\u901a\u308a\u3001\u80ba\u306f\u300c\u80f8\u819c<\/strong>\u300dpleura<\/strong> \u306b\u8986\u308f\u308c\u3066\u3044\u307e\u3059\u3002\u305d\u3057\u3066\u3053\u306e pleura \u306f\u3001\u5916\u5074\u306e\u300c\u58c1\u5074\u80f8\u819c<\/strong>\u300dparietal pleura<\/strong><\/span> \u3068\u5185\u5074\u306e\u300c\u81d3\u5074\u80f8\u819c<\/strong>\u300dvisceral pleura<\/strong><\/span> \u306b\u3088\u308b2\u5c64\u69cb\u9020\u3068\u306a\u3063\u3066\u3044\u307e\u3059\u3002\u305d\u3057\u3066\u3053\u306e parietal pleura \u3068 visceral pleura \u306b\u56f2\u307e\u308c\u305f\u7a7a\u9593\u3092\u300c\u80f8\u819c\u8154<\/strong>\u300d pleural space<\/strong><\/span> \u3068\u8a00\u3044\u307e\u3059\u304c\u3001\u3053\u306e pleural space \u306b\u7570\u5e38\u306b\u6c34\u5206\u304c\u300c\u6d41\u51fa<\/strong>\u300deffusion<\/strong> \u3057\u305f\u72b6\u614b\u3092\u300c\u80f8\u6c34<\/strong>\u300dpleural effusion<\/strong><\/span> \u3068\u547c\u3073\u307e\u3059\u3002\u540c\u3058\u3088\u3046\u306b\u300c\u8179\u8154<\/strong>\u300dperitoneal cavity<\/strong> \u306b\u7570\u5e38\u306b\u6c34\u5206\u304c\u6d41\u51fa\u3057\u305f\u72b6\u614b\u304c\u300c\u8179\u6c34<\/strong>\u300d\u3067\u3042\u308a\u3001\u82f1\u8a9e\u3067\u306f peritoneal effusion \u3068\u3082\u547c\u3076\u306e\u3067\u3059\u304c\u3001\u81e8\u5e8a\u73fe\u5834\u3067\u306f ascites<\/strong><\/span> \u3068\u3044\u3046\u8868\u73fe\u306e\u65b9\u304c\u4f7f\u308f\u308c\u3066\u3044\u307e\u3059\u3002<\/span><\/p>\r\n

\u3053\u306e pleural effusion \u306e\u75c5\u614b\u751f\u7406\u3092\u8003\u3048\u308b\u969b\u306b\u306f\u3001\u300c\u6d6e\u816b<\/strong>\u300dedema<\/strong> \u3068\u540c\u3058\u3088\u3046\u306b\u4e0b\u8a18\u306e4\u3064\u306e\u8981\u7d20\u3092\u8003\u3048\u307e\u3059\u3002<\/span><\/p>\r\n

\u300c\u9759\u6c34\u5727\u306e\u4e0a\u6607<\/strong>\u300dincreased hydrostatic pressure<\/strong> \u306b\u3088\u308b\u80f8\u6c34<\/span>
\r\n\u300c\u81a0\u8cea\u6d78\u900f\u5727\u306e\u4f4e\u4e0b<\/strong>\u300ddecreased osmotic pressure<\/strong> \u306b\u3088\u308b\u80f8\u6c34<\/span>
\r\n\u300c\u6bdb\u7d30\u8840\u7ba1\u900f\u904e\u6027\u306e\u4ea2\u9032<\/strong>\u300dincreased capillary permeability<\/strong> \u306b\u3088\u308b\u80f8\u6c34<\/span>
\r\n\u300c\u30ea\u30f3\u30d1\u7ba1\u306e\u9589\u585e<\/strong>\u300dlymphatic obstruction<\/strong> \u306b\u3088\u308b\u80f8\u6c34<\/span><\/p>\r\n

\u3053\u306e\u3046\u3061\u300c\u9759\u6c34\u5727\u306e\u4e0a\u6607\u300d\u3068\u300c\u81a0\u8cea\u6d78\u900f\u5727\u306e\u4f4e\u4e0b\u300d\u306b\u3088\u308b\u80f8\u6c34\u3067\u306f\u3001\u30bf\u30f3\u30d1\u30af\u8cea\u306e\u542b\u6709\u7387\u304c\u4f4e\u3044\u300c\u6f0f\u51fa\u6db2<\/strong>\uff08\u308d\u3046\u3057\u3085\u3064\u3048\u304d<\/strong>\uff09\u300dtransudate<\/strong><\/span>\/transudative effusion<\/strong> \u3068\u306a\u308a\u3001\u300c\u6bdb\u7d30\u8840\u7ba1\u900f\u904e\u6027\u306e\u4ea2\u9032<\/strong>\u300d\u3068\u300c\u30ea\u30f3\u30d1\u7ba1\u306e\u9589\u585e<\/strong>\u300d\u306b\u3088\u308b\u80f8\u6c34\u3067\u306f\u3001\u30bf\u30f3\u30d1\u30af\u8cea\u306e\u542b\u6709\u7387\u304c\u9ad8\u3044\u300c\u6ef2\u51fa\u6db2<\/strong>\uff08\u3057\u3093\u3057\u3085\u3064\u3048\u304d<\/strong>\uff09\u300dexudate<\/strong><\/span>\/exudative effusion<\/strong> \u3068\u306a\u308a\u307e\u3059\u3002<\/span><\/p>\r\n

\u3053\u306e transudate \u3068 exudate \u3092\u9451\u5225\u3059\u308b\u624b\u6bb5\u3068\u3057\u3066\u3001\u80f8\u819c\u8154\u306b\u91dd\u3092\u633f\u5165\u3057\u3066\u80f8\u6c34\u3092\u63a1\u53d6\u3059\u308b\u300c\u80f8\u8154\u7a7f\u523a<\/strong>\u300dthoracentesis<\/strong><\/span> \u304c\u3042\u308a\u307e\u3059\u3002\u3053\u306e –centesis<\/strong> \u306f\u300c\u7a7f\u523a<\/strong>\u300d\u3068\u3044\u3046\u610f\u5473\u3067\u3059\u306e\u3067\u3001\u3053\u306e thoracentesis \u4ee5\u5916\u306b\u3082\u300c\u7f8a\u6c34\u7a7f\u523a<\/strong>\u300damniocentesis<\/strong> \u3084\u300c\u8179\u8154\u7a7f\u523a<\/strong>\u300dparacentesis<\/strong> \u306e\u3088\u3046\u306b\u4f7f\u308f\u308c\u307e\u3059\u3002<\/span><\/p>\r\n

thoracentesis \u306b\u304a\u3044\u3066\u542b\u6709 protein<\/strong> \u304c pleural effusion\/serum \u30670.5\u4ee5\u4e0b\u3067\u3042\u308c\u3070 transudate<\/strong> \u3068\u306a\u308a\u30010.5\u3088\u308a\u3082\u5927\u304d\u304f\u306a\u308c\u3070 exudate<\/strong> \u3068\u306a\u308a\u307e\u3059\u3002\u307e\u305f\u542b\u6709 LDH<\/strong> \u304c pleural effusion\/serum \u30670.6\u4ee5\u4e0b\u3067\u3042\u308c\u3070 transudate<\/strong> \u3068\u306a\u308a\u30010.6\u3088\u308a\u3082\u5927\u304d\u304f\u306a\u308c\u3070 exudate<\/strong> \u3068\u306a\u308a\u307e\u3059\u3002\u3053\u306e\u3088\u3046\u306b thoracentesis \u306b\u304a\u3044\u3066
\r\npleural effusion \u306b\u542b\u6709\u3059\u308b protein \u3068 LDH \u3092\u4f7f\u3063\u3066 transudate \u3068 exudate \u306b\u5206\u985e\u3059\u308b\u57fa\u6e96\u3092 Light\u2019s Criteria<\/strong><\/span> \u3068\u547c\u3073\u307e\u3059\u3002<\/span><\/p>\r\n

\u3053\u306e\u3088\u3046\u306b Light\u2019s Criteria<\/strong> \u3092\u7528\u3044\u3066\u3001\u305d\u306e pleural effusion \u304c transudate \u306a\u306e\u304b exudate \u306a\u306e\u304b\u3092\u5224\u5b9a\u3057\u3066\u3044\u304d\u307e\u3059\u3002\u4e0b\u8a18\u306b\u305d\u306e\u4ee3\u8868\u7684\u306a\u9451\u5225\u75be\u60a3\u3092\u6319\u3052\u3066\u304a\u304d\u307e\u3059\u3002\uff08\u300c\u80ba\u585e\u6813\u75c7\u300dpulmonary embolism \u306f transudate \u3068 exudate \u306e\u4e21\u65b9\u3092\u5f15\u304d\u8d77\u3053\u3059\u53ef\u80fd\u6027\u304c\u3042\u308a\u307e\u3059\u3002\uff09<\/span><\/p>\r\n

\u300c\u6f0f\u51fa\u6db2<\/strong>\u300dtransudate<\/strong><\/span> \u306e\u539f\u56e0<\/strong><\/span>
\r\n\u3000<\/em> \u2022\u3000<\/em> <\/strong>\u300c\u3046\u3063\u8840\u6027\u5fc3\u4e0d\u5168\u300dcongestive heart failure<\/span>
\r\n\u3000<\/em> \u2022\u3000<\/em> <\/strong>\u300c\u809d\u786c\u5909\u300dliver cirrhosis<\/span>
\r\n\u3000<\/em> \u2022\u3000<\/em> <\/strong>\u300c\u30cd\u30d5\u30ed\u30fc\u30bc\u75c7\u5019\u7fa4\u300dnephrotic syndrome<\/span>
\r\n\u3000<\/em> \u2022\u3000<\/em> <\/strong>\u300c\u80ba\u585e\u6813\u75c7\u300dpulmonary embolism<\/span><\/p>\r\n

\u300c\u6ef2\u51fa\u6db2<\/strong>\u300dexudate<\/strong><\/span> \u306e\u539f\u56e0<\/strong><\/span>
\r\n\u3000<\/em> \u2022\u3000<\/em> <\/strong>\u300c\u80ba\u708e\u300dpneumonia<\/span>
\r\n\u3000<\/em> \u2022\u3000<\/em> <\/strong>\u300c\u7d50\u6838\u300dtuberculosis<\/span>
\r\n\u3000<\/em> \u2022\u3000<\/em> <\/strong>\u300c\u80ba\u304c\u3093\u300dlung cancer<\/span>
\r\n\u3000<\/em> \u2022\u3000<\/em> <\/strong>\u300c\u81b5\u708e\u300dpancreatitis<\/span>
\r\n\u3000<\/em> \u2022\u3000<\/em> <\/strong>\u300c\u95a2\u7bc0\u30ea\u30a6\u30de\u30c1\u300drheumatoid arthritis<\/span>
\r\n\u3000<\/em> \u2022\u3000<\/em> <\/strong>\u300c\u5168\u8eab\u6027\u30a8\u30ea\u30c6\u30de\u30c8\u30fc\u30c7\u30b9\u300dsystematic lupus erythematosus<\/span>
\r\n\u3000<\/em> \u2022\u3000<\/em> <\/strong>\u300c\u80ba\u585e\u6813\u75c7\u300dpulmonary embolism<\/span><\/p>\r\n

pleurisy\u3063\u3066\u4f55\u306e\u3053\u3068\uff1f<\/strong><\/span><\/span>
\r\n\u3067\u306f\u6b21\u306b\u3001 pleural effusion \u304c\u3042\u308b\u5834\u5408\u306e signs<\/strong> & symptoms<\/strong> \u3092\u898b\u3066\u3044\u304d\u307e\u3057\u3087\u3046\u3002\u3061\u306a\u307f\u306b signs<\/strong> \u3068\u306f\u7686\u3055\u3093\u304c\u89b3\u5bdf\u3059\u308b\u5ba2\u89b3\u7684\u306a\u60c5\u5831\u3067\u3042\u308a\u3001\u65e5\u672c\u8a9e\u3067\u306f\u300c\u5146\u5019<\/strong>\u300d\u3068\u306a\u308a\u307e\u3059\u3002\u305d\u3057\u3066 symptoms<\/strong> \u3068\u306f\u60a3\u8005\u3055\u3093\u304c\u8a34\u3048\u308b\u4e3b\u89b3\u7684\u306a\u60c5\u5831\u3067\u3042\u308a\u3001\u65e5\u672c\u8a9e\u3067\u306f\u300c\u75c7\u72b6<\/strong>\u300d\u3068\u306a\u308a\u307e\u3059\u3002\u901a\u5e38\u306f\u533b\u7642\u9762\u63a5\u3067 symptoms \u3092\u5f97\u3066\u304b\u3089\u8eab\u4f53\u8a3a\u5bdf\u306b\u3066 signs \u3092\u5f97\u308b\u308f\u3051\u3067\u3059\u304b\u3089\u3001\u8a9e\u9806\u3068\u3057\u3066\u306f symptoms & signs \u3068\u306a\u308b\u3068\u601d\u3044\u304c\u3061\u3067\u3059\u304c\u3001\u82f1\u8a9e\u3067\u306f\u5fc5\u305a signs & symptoms<\/strong> \u3068\u3044\u3046\u8a9e\u9806\u306b\u306a\u308b\u306e\u3067\u3054\u6ce8\u610f\u3092\u3002<\/span><\/p>\r\n

pleural effusion \u304c\u3042\u308b\u5834\u5408\u3001\u4e0a\u8a18\u3067\u793a\u3057\u305f\u539f\u56e0\u75be\u60a3\u306b\u3088\u3063\u3066\u69d8\u3005\u306a symptoms \u304c\u51fa\u3066\u304d\u307e\u3059\u304c\u3001\u5171\u901a\u3057\u3066\u3042\u308b\u306e\u304c\u300c\u606f\u5207\u308c<\/strong>\u300dshortness of breath (SOB)<\/strong><\/span> \u3067\u3059\u3002\u305d\u3057\u3066\u3053\u306e\u533b\u5b66\u82f1\u8a9e\u306f\u300c\u547c\u5438\u56f0\u96e3<\/strong>\u300ddyspnea<\/strong><\/span> \u3068\u306a\u308a\u307e\u3059\u3002<\/span><\/p>\r\n

\u307e\u305f\u300c\u80f8\u819c\u708e<\/strong>\u300d\u3068\u3044\u3046\u610f\u5473\u306e pleurisy<\/strong><\/span> \u3067\u3059\u304c\u3001\u3053\u308c\u306f\u81e8\u5e8a\u7684\u306b\u306f a sharp chest pain that worsens with deep inspiration<\/strong>\u300c\u6df1\u3044\u547c\u5438\u3067\u5f15\u304d\u8d77\u3053\u3055\u308c\u308b\u92ed\u3044\u80f8\u75db<\/strong>\u300d\u306e\u3088\u3046\u306b symptom \u3068\u3057\u3066\u4f7f\u308f\u308c\u308b\u3053\u3068\u304c\u4e00\u822c\u7684\u3067\u3001pleuritic chest pain<\/strong><\/span> \u3068\u3082\u547c\u3070\u308c\u307e\u3059\u3002<\/span><\/p>\r\n

\u305d\u3057\u3066 pleural effusion \u306b\u3088\u3063\u3066\u5f15\u304d\u8d77\u3053\u3055\u308c\u308b sign \u3068\u3057\u3066\u306f\u3001\u300c\u80f8\u819c\u6469\u64e6\u97f3<\/strong>\u300dpleural friction rub<\/strong><\/span> \u304c\u3042\u308a\u307e\u3059\u3002\u3053\u308c\u306f inspiration<\/strong> & expiration<\/strong> \u306e\u4e21\u65b9\u3067\u8074\u53d6\u3055\u308c\u308b low-pitched<\/strong> grating<\/strong><\/span> sounds<\/strong> \u3067\u3059\u3002\u3053\u306e grating<\/strong> \u3068\u306f\u300c\u64e6\u308a\u5408\u308f\u305b\u308b<\/strong>\u300d\u300c\u304d\u3057\u3080<\/strong>\u300d\u3068\u3044\u3046\u3088\u3046\u306a\u30a4\u30e1\u30fc\u30b8\u306e\u5f62\u5bb9\u8a5e\u3067\u3001\u4ed6\u306b\u3082 creaking<\/strong><\/span> \u306a\u3069\u3068\u3082\u8868\u73fe\u3055\u308c\u307e\u3059\u3002<\/span><\/p>\r\n

lucency \u3068opacity \u3063\u3066\u4f55\u306e\u3053\u3068\uff1f<\/strong><\/span><\/span>
\r\n\u3067\u306f\u3001\u3053\u3053\u304b\u3089 pleural effusion \u306e\u8a3a\u65ad\u306b\u3082\u6709\u7528\u306a\u300c\u80f8\u90e8\u30ec\u30f3\u30c8\u30b2\u30f3\u691c\u67fb<\/strong>\u300d\u306b\u95a2\u3059\u308b\u82f1\u8a9e\u8868\u73fe\u3092\u898b\u3066\u3044\u304d\u307e\u3057\u3087\u3046\u3002<\/span><\/p>\r\n

\u305d\u3082\u305d\u3082\u300c\u80f8\u90e8\u30ec\u30f3\u30c8\u30b2\u30f3\u691c\u67fb<\/strong>\u300d\u306f\u82f1\u8a9e\u3067\u4f55\u3068\u3044\u3046\u306e\u3067\u3057\u3087\u3046\uff1f<\/span><\/p>\r\n

\u82f1\u8a9e\u570f\u306e\u81e8\u5e8a\u73fe\u5834\u3067\u306f\u4e00\u822c\u7684\u306b chest X-ray<\/strong><\/span> \u3068\u547c\u3073\u3001\u3053\u306e\u7565\u8a9e\u3067\u3042\u308b CXR<\/strong><\/span> \u3082\u3088\u304f\u4f7f\u308f\u308c\u3066\u3044\u307e\u3059\u3002\u305f\u3060\u53b3\u5bc6\u306b\u3044\u3046\u3068 chest radiography<\/strong> \u3068\u3044\u3046\u306e\u304c\u691c\u67fb\u306e\u540d\u79f0<\/strong>\u3067\u3042\u308a\u3001\u3053\u306e\u691c\u67fb\u3067\u5f97\u3089\u308c\u308b\u753b\u50cf<\/strong>\u3092 chest radiograph<\/strong> \u3068\u547c\u3073\u307e\u3059\u3002\u307e\u305f\u3053\u306e chest radiograph \u304c\u5199\u3063\u3066\u3044\u308b\u5199\u771f\u305d\u306e\u3082\u306e<\/strong>\u3092 chest film<\/strong> \u3084 chest X-ray film<\/strong> \u3068\u547c\u3073\u307e\u3059\u3002\u3069\u308c\u3082\u7d1b\u3089\u308f\u3057\u3044\u306e\u3067\u6574\u7406\u3057\u3066\u899a\u3048\u3066\u304a\u304d\u307e\u3057\u3087\u3046\u3002<\/span><\/p>\r\n

\u3055\u3066\u3053\u306e chest X-ray \u306b\u304a\u3044\u3066\u306f\u3001\u5bc6\u5ea6\u306e\u5c0f\u3055\u3044\u7d44\u7e54<\/strong>\u306f\u653e\u5c04\u7dda\u306e\u900f\u904e\u6027\u304c\u9ad8\u3044<\/strong>\u305f\u3081\u306b\u9ed2\u304f<\/strong>\u5199\u308a\u307e\u3059\u3002\u3053\u306e\u3088\u3046\u306b low density \u306e\u7d44\u7e54\u304c\u6301\u3064\u300c\u900f\u904e\u6027<\/strong>\uff08\u9ed2\u304f\u5199\u308b\u5ea6\u5408<\/strong>\uff09\u300d\u306e\u3053\u3068\u3092 lucency<\/strong><\/span> \u3068\u547c\u3073\u307e\u3059\u3002<\/span><\/p>\r\n

\u9006\u306b\u5bc6\u5ea6\u306e\u9ad8\u3044\u7d44\u7e54<\/strong>\u306f\u653e\u5c04\u7dda\u306e\u900f\u904e\u6027\u304c\u4f4e\u3044<\/strong>\u305f\u3081\u306b chest X-ray \u306b\u304a\u3044\u3066\u306f\u767d\u304f<\/strong>\u5199\u308a\u307e\u3059\u3002\u3053\u306e\u3088\u3046\u306b high density \u306e\u7d44\u7e54\u304c\u6301\u3064\u300c\u4e0d\u900f\u904e\u6027<\/strong>\uff08\u767d\u304f\u5199\u308b\u5ea6\u5408<\/strong>\uff09\u300d\u306e\u3053\u3068\u3092 opacity<\/strong><\/span> \u3068\u547c\u3073\u307e\u3059\u3002\u305d\u3057\u3066 chest X-ray \u306b\u5199\u308b\u7570\u5e38\u306a\u5f71<\/strong>\u306e\u3053\u3068\u3092 shadow<\/strong><\/span> \u3068\u547c\u3073\u3001\u4e00\u822c\u7684\u306b\u306f\u3053\u306e opacity \u304c\u9ad8\u307e\u308b\u3053\u3068\u3092 opacification<\/strong><\/span> \u3084 shadowing<\/strong><\/span> \u306a\u3069\u3068\u547c\u3073\u307e\u3059\u3002<\/span><\/p>\r\n

\u201cRIP\u201d \u3063\u3066\u4f55\u306e\u3053\u3068\uff1f\u77e5\u3063\u3066\u304a\u304d\u305f\u3044 systematic approach<\/strong><\/span><\/span>
\r\n\u6b21\u306b chest X-ray \u3092\u8aad\u5f71\u3059\u308b\u969b\u306e\u624b\u9806\u306b\u3064\u3044\u3066\u898b\u3066\u3044\u304d\u307e\u3057\u3087\u3046\u3002<\/span><\/p>\r\n

\u65e5\u672c\u306e\u533b\u5e2b\u56fd\u5bb6\u8a66\u9a13\u3067\u3082\u7c73\u56fd\u306e USMLE \u3067\u3082 snapshot diagnosis<\/strong>\u300c\u30d1\u30c3\u3068\u898b\u3066\u3067\u304d\u308b\u8a3a\u65ad<\/strong>\u300d\u3092\u793a\u3059 chest X-ray \u3082\u3042\u308a\u307e\u3059\u304c\u3001\u304d\u3061\u3093\u3068\u624b\u9806\u3092\u8e0f\u3093\u3067 chest X-ray interpretation<\/strong>\u300c\u80f8\u90e8\u30ec\u30f3\u30c8\u30b2\u30f3\u5199\u771f\u306e\u8aad\u5f71<\/strong>\u300d\u3092\u3059\u308b\u3053\u3068\u304c\u91cd\u8981\u3067\u3059\u3002\u82f1\u8a9e\u3067\u306f\u300c\u7686\u304c\u77e5\u3063\u3066\u3044\u308b\u3051\u308c\u3069\u3082\u8ab0\u3082\u8a71\u3057\u305f\u304c\u3089\u306a\u3044\u8a71\u984c<\/strong>\u300d\u3068\u3044\u3046\u610f\u5473\u3067 elephant in the room<\/strong> \u3068\u3044\u3046\u8868\u73fe\u304c\u3042\u308a\u307e\u3059\u304c\u3001chest X-ray \u306e\u3088\u3046\u306a\u753b\u50cf\u691c\u67fb\u3067\u3082\u300c\u8ab0\u3082\u304c\u6700\u521d\u306b\u6c17\u3065\u304f\u660e\u3089\u304b\u306a\u7570\u5e38\u6240\u898b<\/strong>\u300d\u3068\u3044\u3046\u610f\u5473\u3067 \u201celephant<\/strong>\u201d \u3068\u3044\u3046\u8868\u73fe\u304c\u4f7f\u308f\u308c\u308b\u3053\u3068\u304c\u3042\u308a\u307e\u3059\u3002\u3057\u304b\u3057\u3053\u306e\u3088\u3046\u306a \u201celephant<\/strong>\u201d \u306b\u3070\u304b\u308a\u76ee\u3092\u596a\u308f\u308c\u3066\u3044\u308b\u3068\u3001\u4ed6\u306e\u5927\u5207\u306a\u6240\u898b\u3092\u898b\u843d\u3068\u3059\u3053\u3068\u306b\u3082\u7e4b\u304c\u308a\u307e\u3059\u3002\u305d\u306e\u3088\u3046\u306a\u3053\u3068\u3092\u9632\u3050\u305f\u3081\u306b\u3082 systematic approach \u304c\u5fc5\u8981\u306b\u306a\u308b\u306e\u3067\u3059\u3002<\/span><\/p>\r\n

\u82f1\u8a9e\u570f\u3067\u306f\u5b9f\u306b\u69d8\u3005\u306a chest X-ray systematic approaches \u304c\u7d39\u4ecb\u3055\u308c\u3066\u3044\u307e\u3059\u304c\u3001\u3053\u3053\u3067\u306f\u3053\u3061\u3089<\/strong><\/span><\/a>\u306e\u52d5\u753b\u306b\u6cbf\u3063\u3066\u3001\u4e0b\u8a18\u306e\u3088\u3046\u306a
\r\nsystematic approach \u3092\u3054\u7d39\u4ecb\u3057\u307e\u3059\u3002<\/span><\/p>\r\n

1.\u00a0\u00a0Confirm Details<\/strong><\/span>
\r\n2.\u00a0\u00a0\u201cRIP\u201d<\/strong><\/span>
\r\n3.\u00a0\u00a0\u201cABCDE\u201d<\/strong><\/span><\/p>\r\n

\u3067\u306f\u3053\u306e\u5185\u5bb9\u3092\u4e00\u3064\u305a\u3064\u898b\u3066\u3044\u304d\u307e\u3057\u3087\u3046\u3002<\/span><\/p>\r\n

1.\u00a0\u00a0Confirm Details: Patient Name, Film Date, and Orientation<\/strong><\/span><\/p>\r\n

\u6700\u521d\u306b\u78ba\u8a8d\u3059\u308b\u306e\u304c Patient Name<\/strong><\/span>\u3001\u3064\u307e\u308a\u60a3\u8005\u3055\u3093\u306e full name<\/strong> \u3067\u3059\u3002\u6b21\u306b chest X-ray \u304c\u64ae\u3089\u308c\u305f Film Date<\/strong><\/span>\u3001\u305d\u3057\u3066 posterior-anterior (PA)<\/strong><\/span> \u304b anterior-posterior (AP)<\/strong><\/span> \u306e\u3069\u3061\u3089\u306e Orientation<\/strong><\/span> \u3067\u64ae\u3089\u308c\u305f\u3082\u306e\u304b\u3092\u78ba\u8a8d\u3057\u307e\u3059\u3002<\/span><\/p>\r\n

2.\u00a0\u00a0\u201cRIP\u201d: R<\/span>otation, I<\/span>nspiration, and P<\/span>enetration<\/strong><\/span><\/p>\r\n

\u6b21\u306b chest X-ray \u306e quality \u3092\u78ba\u8a8d\u3057\u307e\u3059\u3002\u305d\u306e\u5185\u5bb9\u3068\u3057\u3066 Halloween \u3067\u3082\u3059\u3063\u304b\u308a\u6709\u540d\u306b\u306a\u3063\u305f \u201crest in peace\u201d \u3092\u8868\u3059 \u201cRIP<\/strong>\u201d \u3067\u8868\u3055\u308c\u308b\uff13\u9805\u76ee\u3092\u4f7f\u3044\u307e\u3059\u3002<\/span><\/p>\r\n

\u307e\u305a\u306f Rotation<\/strong><\/span> \u3067\u3059\u3002\u3053\u308c\u306f\u60a3\u8005\u3055\u3093\u304c\u53f3\u5411\u304d\u3067\u3082\u5de6\u5411\u304d\u3067\u3082\u306a\u304f\u3001\u6b63\u9762\u3092\u5411\u3044\u3066\u3044\u308b\u304b<\/strong>\u3092\u8868\u3057\u307e\u3059\u3002\u690e\u9aa8\u306e\u68d8\u7a81\u8d77 spinose process<\/strong> \u304c\u5de6\u53f3\u306e\u9396\u9aa8 clavicles<\/strong> \u306e\u3061\u3087\u3046\u3069\u771f\u3093\u4e2d\u306b\u4f4d\u7f6e\u3057\u3066\u3044\u308b\u304b\u304c\u78ba\u8a8d\u3067\u304d\u308c\u3070\u3001\u6b63\u9762\u3092\u5411\u3044\u3066\u3044\u308b\u3068\u5224\u65ad\u3057\u307e\u3059\u3002<\/span><\/p>\r\n

\u6b21\u306b Inspiration<\/strong><\/span> \u3067\u3059\u3002\u3053\u308c\u306f\u60a3\u8005\u3055\u3093\u304c\u5341\u5206\u306b\u5438\u6c17\u3057\u3066\u3044\u308b\u304b<\/strong>\u3092\u8868\u3057\u307e\u3059\u3002\u524d\u90e8\u306e\u808b\u9aa8 anterior ribs<\/strong> \u304c 5-7\u672c<\/strong>\u898b\u3048\u308c\u3070\u3001\u5341\u5206\u306a\u5438\u6c17\u304c\u3042\u308b\u3068\u5224\u65ad\u3057\u307e\u3059\u3002<\/span><\/p>\r\n

\u6700\u5f8c\u304c Projection<\/strong><\/span> \u3067\u3059\u3002\u3053\u308c\u306f\u653e\u5c04\u7dda\u91cf\u304c\u9069\u5207\u3067\u3042\u3063\u305f\u304b\u3092\u8868\u3057\u307e\u3059\u3002\u5fc3\u81d3\u306e\u5f8c\u306b\u690e\u9aa8\u304c\u78ba\u8a8d<\/strong>\u3067\u304d\u308c\u3070\u3001\u9069\u5207\u306a\u653e\u5c04\u7dda\u91cf\u3067\u3042\u308b\u3068\u5224\u65ad\u3057\u307e\u3059\u3002<\/span><\/p>\r\n

3.\u00a0\u00a0\u201cABCDE\u201d: A<\/span>irway, B<\/span>ones, C<\/span>irculation, D<\/span>iaphragm, and E<\/span>xtra<\/strong><\/span><\/p>\r\n

\u3053\u3053\u304b\u3089\u304c\u8aad\u5f71\u672c\u756a\u3067\u3059\u3002\u3057\u304b\u3057\u305d\u306e\u9806\u756a\u306f \u201cABCDE<\/strong><\/span>\u201d \u3067\u899a\u3048\u308b\u3068\u5fd8\u308c\u306b\u304f\u3044\u3067\u3057\u3087\u3046\u3002<\/span><\/p>\r\n

Airway<\/strong><\/span> \u3067\u306f trachea\/bronchi\/lungs \u3092\u898b\u3066\u3044\u304d\u307e\u3059\u3002\u3053\u306e\u3046\u3061 lungs \u306f chest X-ray \u3067\u306f upper\/middle\/lower zone \u3068\u3044\u3046\u3088\u3046\u306b zone \u3068\u3044\u3046\u533a\u5206\u3092\u4f7f\u3044\u307e\u3059\u3002\u3053\u306e zone \u306f\u89e3\u5256\u5b66\u7684\u306a lobe \u3068\u306f\u7570\u306a\u308b\u306e\u3067\u6ce8\u610f\u3057\u3066\u304f\u3060\u3055\u3044\u3002<\/span><\/p>\r\n

Bones<\/strong><\/span> \u3067\u306f ribs\/clavicles\/humerus\/spine \u3092\u898b\u3066\u3044\u304d\u307e\u3059\u3002\u3053\u308c\u3089\u306b fracture\/dislocation\/arthritis\/metastasis \u306a\u3069\u304c\u3042\u308b\u304b\u3069\u3046\u304b\u3092\u78ba\u8a8d\u3057\u307e\u3059\u3002<\/span><\/p>\r\n

Circulation<\/strong><\/span> \u3067\u306f\u300c\u5fc3\u80f8\u90ed\u6bd4<\/strong>\u300d\u3067\u3042\u308b cardiothoracic ratio<\/strong> \u3068\u300c\u7e26\u9694\u306e\u8f2a\u90ed<\/strong>\u300d mediastinal contours<\/strong> \u3092\u78ba\u8a8d\u3057\u307e\u3059\u3002\u3053\u306e cardiothoracic ratio \u304c 50% \u3092\u8d85\u3048\u308b\u5834\u5408\u3001\u300c\u5fc3\u80a5\u5927<\/strong>\u300dcardiomegaly<\/strong> \u3068\u306a\u308a\u307e\u3059\u3002<\/span><\/p>\r\n

Diaphragm<\/strong><\/span> \u3067\u306f\u300c\u808b\u9aa8\u6a2a\u9694\u819c\u89d2<\/strong>\u300d\u3067\u3042\u308b costophrenic angle<\/strong> \u3092\u78ba\u8a8d\u3057\u307e\u3059\u3002\u65e5\u672c\u3067\u306f\u3053\u306e costophrenic angle \u3092 CP angle \u3068\u7565\u3057\u3066\u547c\u3073\u307e\u3059\u304c\u3001\u82f1\u8a9e\u570f\u3067\u306f\u3053\u306e CP angle\u3068\u3044\u3046\u7565\u8a9e\u306f\u307b\u3068\u3093\u3069\u4f7f\u308f\u308c\u307e\u305b\u3093<\/strong>\u3002\u307e\u305f\u3053\u306e costophrenic angle \u306e\u89d2\u5ea6\u304c\u4e0d\u660e\u77ad\u306b\u306a\u308b\u3053\u3068\u3092\u65e5\u672c\u3067\u306f dull \u3068\u3044\u3046\u5f62\u5bb9\u8a5e\u3067\u8868\u73fe\u3059\u308b\u65b9\u304c\u591a\u3044\u306e\u3067\u3059\u304c\u3001\u3053\u308c\u3082\u304a\u52e7\u3081\u3067\u304d\u307e\u305b\u3093\u3002\u92ed\u89d2\u306f\u82f1\u8a9e\u3067\u306f sharp angle \u3068\u306a\u308a\u307e\u3059\u3002\u3053\u306e\u53cd\u610f\u8a9e\u3068\u3057\u3066 dull \u304c\u4f7f\u308f\u308c\u3066\u3044\u308b\u306e\u3060\u3068\u601d\u3044\u307e\u3059\u304c\u3001\u3053\u306e costophrenic angle \u304c\u4e0d\u660e\u77ad\u306b\u306a\u308b\u3053\u3068\u3092\u82f1\u8a9e\u3067\u306f blunting<\/strong><\/span> of a costophrenic angle \u306e\u3088\u3046\u306b\u8868\u73fe\u3059\u308b\u306e\u3067\u6ce8\u610f\u3057\u3066\u304f\u3060\u3055\u3044\u3002<\/span><\/p>\r\n

Extra<\/strong><\/span> features \u3067\u306f\u4e0a\u8a18\u3067\u78ba\u8a8d\u3057\u305f\u9805\u76ee\u4ee5\u5916\u306e\u5168\u3066\u304c\u542b\u307e\u308c\u307e\u3059\u3002\u5177\u4f53\u7684\u306b\u306f soft tissue \u3084 medical equipment \u306a\u3069\u304c\u542b\u307e\u308c\u307e\u3059\u3002<\/span><\/p>\r\n

\u4e0a\u8a18\u306e\u9805\u76ee\u306f\u6570\u3042\u308b systematic approaches \u306e\u4e2d\u3067\u3082\u6bd4\u8f03\u7684\u899a\u3048\u3084\u3059\u3044\u3082\u306e\u3060\u3068\u601d\u3044\u307e\u3059\u3002\u8208\u5473\u3092\u6301\u3063\u305f\u65b9\u306f\u662f\u975e\u3053\u306e\u3084\u308a\u65b9\u3092\u81ea\u5206\u306a\u308a\u306b\u53d6\u308a\u5165\u308c\u3066\u307f\u3066\u304f\u3060\u3055\u3044\u3002<\/span><\/p>\r\n

\u3055\u3066\u3001\u305d\u308d\u305d\u308d\u30ab\u30c3\u30d7\u306e\u30b3\u30fc\u30d2\u30fc\u3082\u6b8b\u308a\u308f\u305a\u304b\u3067\u3059\u3002<\/span><\/p>\r\n

\u6700\u5f8c\u306b\u6b63\u5e38\u306a chest X-ray<\/strong> \u3092\u81e8\u5e8a\u73fe\u5834\u3067\u3069\u306e\u3088\u3046\u306b\u30d7\u30ec\u30bc\u30f3\u30c6\u30fc\u30b7\u30e7\u30f3\u3059\u308c\u3070\u826f\u3044\u304b\u3092\u3054\u7d39\u4ecb\u3057\u307e\u3059\u3002<\/span><\/p>\r\n

1.\u00a0\u00a0Confirm Details<\/strong><\/span><\/span>
\r\n\u3000<\/em>\u2022\u3000<\/em>This is a plain chest radiograph of Mr. John Smith taken on December 20 in 2022, at 14:32.<\/span>
\r\n\u3000<\/em>\u2022\u3000<\/em>It is a PA image, and I note the side marker is correct.<\/span><\/p>\r\n

2.\u00a0\u00a0\u201cRIP\u201d<\/strong><\/span><\/span>
\r\n\u3000<\/em>\u2022\u3000<\/em>The medial aspect of each clavicle is equidistant from the spinous processes.<\/span>
\r\n\u3000<\/em>\u2022\u3000<\/em>The 7 anterior ribs are visible.<\/span>
\r\n\u3000<\/em>\u2022\u3000<\/em>The spine is visible behind the heart.<\/span>
\r\n\u3000<\/em>\u2022\u3000<\/em>The image is of adequate quality.<\/span><\/p>\r\n

3.\u00a0\u00a0\u201cABCDE\u201d<\/strong><\/span><\/span>
\r\n\u3000<\/em>\u2022\u3000<\/em>I cannot see any abnormality at first glance. but looking at the image systematically\u2026<\/span><\/p>\r\n

Airway<\/strong><\/span><\/span>
\r\n\u3000<\/em>\u2022\u3000<\/em>The trachea is central.<\/span>
\r\n\u3000<\/em>\u2022\u3000<\/em>The hilar structures are normal.<\/span>
\r\n\u3000<\/em>\u2022\u3000<\/em>The upper, middle, and lower zones of the lungs are symmetrical and clear.<\/span><\/p>\r\n

Bones<\/strong><\/span><\/span>
\r\n\u3000<\/em>\u2022\u3000<\/em>No abnormalities are seen in the bones.<\/span><\/p>\r\n

Circulation<\/strong><\/span><\/span>
\r\n\u3000<\/em>\u2022\u3000<\/em>Cardiothoracic ratio and mediastinal contours are normal.<\/span><\/p>\r\n

Diaphragm<\/strong><\/span><\/span>
\r\n\u3000<\/em>\u2022\u3000<\/em>Costophrenic angles are well-defined.<\/span><\/p>\r\n

Extra features<\/strong><\/span><\/span>
\r\n\u3000<\/em>\u2022\u3000<\/em>No abnormalities are seen in the soft tissues.<\/span><\/p>\r\n

Summary<\/strong><\/span><\/span>
\r\n\u3000<\/em>\u2022\u3000<\/em>In summary, this X-ray is unremarkable for pathology.<\/span><\/p>\r\n

\u3067\u306f\u3001\u307e\u305f\u306e\u3054\u6765\u5e97\u3092\u304a\u5f85\u3061\u3057\u3066\u304a\u308a\u307e\u3059\u3002<\/span><\/p>\r\n


\r\n\u300cDr. \u62bc\u5473\u306e\u533b\u5b66\u82f1\u8a9e\u30ab\u30d5\u30a7\u300d\u3067\u306f\u7686\u3055\u3093\u304b\u3089\u6271\u3063\u3066\u6b32\u3057\u3044\u30c8\u30d4\u30c3\u30af\u3092\u52df\u96c6\u3044\u305f\u3057\u307e\u3059\u3002\u3053\u3061\u3089\u306e\u30ea\u30f3\u30af<\/strong><\/span><\/a>\u304b\u3089\u3053\u306e\u30ab\u30d5\u30a7\u3067\u6271\u3063\u3066\u6b32\u3057\u3044\u3068\u601d\u3046\u533b\u5b66\u82f1\u8a9e\u306e\u30c8\u30d4\u30c3\u30af\u3092\u3054\u81ea\u7531\u306b\u8a18\u8f09\u304f\u3060\u3055\u3044\u3002<\/span><\/p>\r\n

\u56fd\u969b\u533b\u7642\u798f\u7949\u5927\u5b66\u533b\u5b66\u90e8 \u533b\u5b66\u6559\u80b2\u7d71\u62ec\u30bb\u30f3\u30bf\u30fc \u51c6\u6559\u6388\u3000\u62bc\u5473 \u8cb4\u4e4b<\/p>\r\n","protected":false},"excerpt":{"rendered":"\u3053\u3093\u306b\u3061\u306f\u3002\u300c\u533b\u5b66\u82f1\u8a9e\u30ab\u30d5\u30a7\u300d\u306b\u3088\u3046\u3053\u305d\uff01 \u3053\u3053\u306f\u300c\u30b3\u30fc\u30d2\u30fc1\u676f\u5206\u300d\u306e\u6642\u9593\u3067\u3001\u533b\u5b66\u82f1\u8a9e\u306b\u307e\u3064\u308f\u308b\u8a71\u3092\u6c17\u8efd\u306b\u697d\u3057\u3093\u3067\u3044\u305f\u3060\u304f\u30b3\u30fc\u30ca\u30fc\u3067\u3059\u3002 \u672c\u65e5\u306e\u30c6\u30fc\u30de\u306f\u300c\u80f8\u6c34\u3068\u80f8\u90e8\u30ec\u30f3\u30c8\u30b2\u30f3\u691c\u67fb\u300d\u3067\u3059\u3002 \u300c\u80f8\u6c34\u300d\u306f\u60a3\u8005\u3055\u3093\u304c\u8a34\u3048\u308b\u300c\u75c7\u72b6","protected":false},"author":1,"featured_media":6873,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"onecolumn-960.php","format":"standard","meta":{"_acf_changed":false,"_jin_ogp_image_url":"","_jin_last_featured_id":0,"footnotes":""},"categories":[63],"tags":[],"class_list":["post-7061","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-eigocafe"],"acf":[],"_links":{"self":[{"href":"https:\/\/wp.meccari.jp\/api\/wp\/v2\/posts\/7061","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/wp.meccari.jp\/api\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/wp.meccari.jp\/api\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/wp.meccari.jp\/api\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/wp.meccari.jp\/api\/wp\/v2\/comments?post=7061"}],"version-history":[{"count":1,"href":"https:\/\/wp.meccari.jp\/api\/wp\/v2\/posts\/7061\/revisions"}],"predecessor-version":[{"id":7075,"href":"https:\/\/wp.meccari.jp\/api\/wp\/v2\/posts\/7061\/revisions\/7075"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/wp.meccari.jp\/api\/wp\/v2\/media\/6873"}],"wp:attachment":[{"href":"https:\/\/wp.meccari.jp\/api\/wp\/v2\/media?parent=7061"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/wp.meccari.jp\/api\/wp\/v2\/categories?post=7061"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/wp.meccari.jp\/api\/wp\/v2\/tags?post=7061"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}