痔核の時間的進行経過の検討
痔核の脱出症状の時間的進行経過と，発育進展に影響するリスク因子を明らかにする目的で，手術症例計200例を対象にアンケート調査を行った．脱出程度はGoligher分類に準拠して，II度をIIa（脱出したと初めて感じた時期）・IIb（排便時ほとんど毎回脱出すると感じた時期）に細分類し，1年＝1cm間隔のVAS（Visual Analog Scale）を用い病期間隔を計測した．II-III，III-IV，IIa-IIb，IIb-IIIの中央値（年）はそれぞれ5，1，3，0.2で，全期間とも7割以上が10年未満であった．患者因子別（性別，便の硬度，機能性便秘の有無，便秘スコア，食物繊維摂取の多寡，職業...
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| Published in | 日本大腸肛門病学会雑誌 Vol. 69; no. 2; pp. 59 - 65 |
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| Main Authors | , , , , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
日本大腸肛門病学会
2016
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0047-1801 1882-9619 |
| DOI | 10.3862/jcoloproctology.69.59 |
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| Abstract | 痔核の脱出症状の時間的進行経過と，発育進展に影響するリスク因子を明らかにする目的で，手術症例計200例を対象にアンケート調査を行った．脱出程度はGoligher分類に準拠して，II度をIIa（脱出したと初めて感じた時期）・IIb（排便時ほとんど毎回脱出すると感じた時期）に細分類し，1年＝1cm間隔のVAS（Visual Analog Scale）を用い病期間隔を計測した．II-III，III-IV，IIa-IIb，IIb-IIIの中央値（年）はそれぞれ5，1，3，0.2で，全期間とも7割以上が10年未満であった．患者因子別（性別，便の硬度，機能性便秘の有無，便秘スコア，食物繊維摂取の多寡，職業，痔核肉眼形態）に脱出症状の病期間隔を検討した結果，進行を速める因子は便秘スコア7点以上であり，II-IIIとIIa-IIb期間で有意に病期間隔が短かった（P＝0.04）．便秘スコア高値は痔核進行を速める可能性が示唆された． |
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| AbstractList | 痔核の脱出症状の時間的進行経過と，発育進展に影響するリスク因子を明らかにする目的で，手術症例計200例を対象にアンケート調査を行った．脱出程度はGoligher分類に準拠して，II度をIIa（脱出したと初めて感じた時期）・IIb（排便時ほとんど毎回脱出すると感じた時期）に細分類し，1年＝1cm間隔のVAS（Visual Analog Scale）を用い病期間隔を計測した．II-III，III-IV，IIa-IIb，IIb-IIIの中央値（年）はそれぞれ5，1，3，0.2で，全期間とも7割以上が10年未満であった．患者因子別（性別，便の硬度，機能性便秘の有無，便秘スコア，食物繊維摂取の多寡，職業，痔核肉眼形態）に脱出症状の病期間隔を検討した結果，進行を速める因子は便秘スコア7点以上であり，II-IIIとIIa-IIb期間で有意に病期間隔が短かった（P＝0.04）．便秘スコア高値は痔核進行を速める可能性が示唆された． |
| Author | 新井, 健広 森, 康治 北山, 大祐 松尾, 恵五 川西, 輝貴 藤解, 邦生 望月, 暁 鵜瀞, 条 岡田, 滋 |
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| References | 12) 鬼束惇哉:痔核-特にその病因について. 治療 51:2081-2089, 1969 15) Burkit DP: Varicose veins, deep vein thrombosis, and haemorrhoids: epidemiology and suggested aetiology. Br Med J 2:556-561, 1972 17) Acheson RM: Haemorrhoids in the adult male ; a small epidemiological study. Guys Hosp Rep 109:184-195, 1960 11) Graham-Stewart CW: What causes hemorrhoids? A new theory of etiology. Dis Colon Rectum 6:333-344, 1963 4) Agachan F, Chen T, Pfeifer J, et al: A constipation scoring system to simplify evaluation and management of constipated patients. Dis Colon Rectum 39:681-685, 1996 13) Gazet JC, Redding W, Rickett JW: The prevalence of haemorrhoids. A preliminary survey. Proc R Soc Med 63 (Suppl):78-80, 1970 5) 松尾恵五, 辻仲康伸:痔核の病態, 診断, 分類. 外科 71:1391-1395, 2009 14) Prasad GC, Prakash V, Tandon AK, et al: Studies on etiopathogenesis of hemorrhoids. Am J Proctol 27:33-41, 1976 10) Johannsson HO, Graf W, Pahlman L: Bowel habits in hemorrhoid patients and normal subjects. Am J Gastroenterol 100:401-406, 2005 7) Rivadeneira DE, Steele SR, Ternent C, et al: Practice Parameters for the management of hemorrhoids (revised 2010). Dis Colon Rectum 54:1059-1064, 2011 16) Alonso-Coello P, Guyatt G, Heels-Ansdell D, et al: Laxatives for the treatment of hemorrhoids. Cochrane Database Syst Rev CD004649, 2005 2) O'Donnell LJ, Virjee J, Heaton KW: Detection of pseudodiarrhea by simple clinical assessment of intestinal transit rate. Br J Med 300:439-440, 1990 8) 日本大腸肛門病学会:肛門疾患（痔核・痔瘻・裂肛）診療ガイドライン. 南江堂, 東京, 2014 9) Johanson JF, Sonnenberg A: The prevalence of hemorrhoids and chronic constipation. An epidemiologic study. Gastroenterology 98:380-386, 1990 3) Longstreth GF, Thompson WG, Chey WD, et al: Functional bowel disorders. Gastroenterol 130:1480-1491, 2006 1) Goligher JC: Surgery of the Anus Rectum and Colon. 5th ed. Bailliere Tindall, London, 1984, p98-102 6) Altomare DF, Roveran A, Pecorella G, et al: The treatment of hemorrhoids: guidelines of the Italian Society of ColoRectal Surgery. Tech Coloproctol 10:181-186, 2006 |
| References_xml | – reference: 11) Graham-Stewart CW: What causes hemorrhoids? A new theory of etiology. Dis Colon Rectum 6:333-344, 1963 – reference: 3) Longstreth GF, Thompson WG, Chey WD, et al: Functional bowel disorders. Gastroenterol 130:1480-1491, 2006 – reference: 13) Gazet JC, Redding W, Rickett JW: The prevalence of haemorrhoids. A preliminary survey. Proc R Soc Med 63 (Suppl):78-80, 1970 – reference: 8) 日本大腸肛門病学会:肛門疾患（痔核・痔瘻・裂肛）診療ガイドライン. 南江堂, 東京, 2014 – reference: 6) Altomare DF, Roveran A, Pecorella G, et al: The treatment of hemorrhoids: guidelines of the Italian Society of ColoRectal Surgery. Tech Coloproctol 10:181-186, 2006 – reference: 17) Acheson RM: Haemorrhoids in the adult male ; a small epidemiological study. Guys Hosp Rep 109:184-195, 1960 – reference: 10) Johannsson HO, Graf W, Pahlman L: Bowel habits in hemorrhoid patients and normal subjects. Am J Gastroenterol 100:401-406, 2005 – reference: 5) 松尾恵五, 辻仲康伸:痔核の病態, 診断, 分類. 外科 71:1391-1395, 2009 – reference: 16) Alonso-Coello P, Guyatt G, Heels-Ansdell D, et al: Laxatives for the treatment of hemorrhoids. Cochrane Database Syst Rev CD004649, 2005 – reference: 7) Rivadeneira DE, Steele SR, Ternent C, et al: Practice Parameters for the management of hemorrhoids (revised 2010). Dis Colon Rectum 54:1059-1064, 2011 – reference: 9) Johanson JF, Sonnenberg A: The prevalence of hemorrhoids and chronic constipation. An epidemiologic study. Gastroenterology 98:380-386, 1990 – reference: 2) O'Donnell LJ, Virjee J, Heaton KW: Detection of pseudodiarrhea by simple clinical assessment of intestinal transit rate. Br J Med 300:439-440, 1990 – reference: 12) 鬼束惇哉:痔核-特にその病因について. 治療 51:2081-2089, 1969 – reference: 14) Prasad GC, Prakash V, Tandon AK, et al: Studies on etiopathogenesis of hemorrhoids. Am J Proctol 27:33-41, 1976 – reference: 1) Goligher JC: Surgery of the Anus Rectum and Colon. 5th ed. Bailliere Tindall, London, 1984, p98-102 – reference: 15) Burkit DP: Varicose veins, deep vein thrombosis, and haemorrhoids: epidemiology and suggested aetiology. Br Med J 2:556-561, 1972 – reference: 4) Agachan F, Chen T, Pfeifer J, et al: A constipation scoring system to simplify evaluation and management of constipated patients. Dis Colon Rectum 39:681-685, 1996 |
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| Title | 痔核の時間的進行経過の検討 |
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