{"created":"2024-07-17T02:29:35.570994+00:00","id":2000428,"links":{},"metadata":{"_buckets":{"deposit":"65a5baa9-940b-4ea3-9d90-6deb05bf7d15"},"_deposit":{"created_by":50,"id":"2000428","owner":"50","owners":[50],"pid":{"revision_id":0,"type":"depid","value":"2000428"},"status":"published"},"_oai":{"id":"oai:kagawa-u.repo.nii.ac.jp:02000428","sets":["2:1720746067615:1720751912376"]},"author_link":["1983","2818","1832","4269"],"control_number":"2000428","item_10001_biblio_info_7":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2010-09-01","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"1","bibliographicPageEnd":"22","bibliographicPageStart":"19","bibliographicVolumeNumber":"12","bibliographic_titles":[{"bibliographic_title":"香川産科婦人科雑誌","bibliographic_titleLang":"ja"},{"bibliographic_title":"Kagawa journal of obstetrics and gynecology : official journal of the Kagawa Society of Obstetrics and Gynecology","bibliographic_titleLang":"en"}]}]},"item_10001_description_5":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"当科における子宮外妊娠数はH15,16,17年の3年間まで年間10件以下であったが、H18年より増加し、年間20件を超えるようになった。症例の増加に伴い、腹腔鏡手術を積極的に施行し、またH20年より、産婦人科診療ガイドラインも参考に、治療法の選択基準を設けて薬物療法（メソトレキセート全身投与）も導入している。当科では方法が簡便なsingle dose法でおこない、H20,21年では計18例で薬物療法を施行した。薬物療法を施行した全例において緊急手術となることなく、手術を回避することができた。治療開始前の平均血清hCG値は985IU/Lであり、投与回数は2回投与した症例が最も多く、9例（50%）であった。当科ではガイドラインで容認されているhCG値（5,000IU/L以下を許容、3,000IU/L以下を推奨）よりも比較的低値（当科では平均1,000IU/L以下）で行っており、かなり慎重に症例を選んでいる印象であった。血清hCG定量と経膣超音波検査との組み合わせで手術療法のみでなく、薬物療法による手術回避できる症例が増える分、患者側の治療選択肢が増え、医療者側の負担も軽減した。今後、メソトレキセートの子宮外妊娠への保険適応がえられ、症例の蓄積がされていけば、わが国における子宮外妊娠治療が大きく変化する可能性があると思われる。","subitem_description_language":"ja","subitem_description_type":"Abstract"}]},"item_10001_heading_23":{"attribute_name":"見出し","attribute_value_mlt":[{"subitem_heading_banner_headline":"臨床","subitem_heading_language":"ja"},{"subitem_heading_banner_headline":"[Clinical 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