潰よう性大腸炎死亡例の検討

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  • Analysis of Mortality in Patients with Ulcerative Colitis.

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Seven (1.0%) out of 680 patients with ulcerative colitis treated at Yokohama City Hospital died between Aug. 1993 and Feb 2001. They were 5 males and 2 females with a mean age of 44.7 years. Three died from colonic malignant diseases (2 colonic cancers, 1 carcinoid) and 4 died from postoperative complications. The patients that died from malignant disease had not received surveillance colonoscopy, and they died from liver metastasis and/or peritoneal dissemination. Four patients that died from postoperative complications had severe colitis. The postoperative mortality of severe colitis (9.8%, 4/41) was significantly higher than that of operated from the other reasons (0%, 0/190). The amount of prednisolone given within 1 month prior to surgery in the mortality group (1608±710mg) was significantly higher than that in the survived group (451 ±600mg). The cause of death was finally MOF. To reduce mortality, it is important to extend surveillance colonoscopy for the long standing patients and to avoid excess use of steroids preoperatively.

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