非侵襲的陽圧換気（NIV）を用いて緩和ケアを行った肺がん合併間質性肺炎の1例

【緒言】終末期に非侵襲的陽圧換気（NIV）を継続した状態でさまざまな活動が可能であった症例を経験したため報告する．【症例】57歳，男性．気腫合併間質性肺線維症の診断で外来経過観察中に肺がんと臨床診断され在宅酸素療法，NIVを導入されていたが，安静時呼吸困難が増悪し入院した．日中もNIVが必要となり，いったん食事摂取を中止され，緩和病棟へ転棟した．緩和ケア病棟でNIV継続した状態で食事摂取を再開し，入浴も行えた．ボランティアによる民謡鑑賞も行えた．合併症は移動時の低酸素血症，呼吸困難のみで，皮膚に発赤，潰瘍形成はみられなかった．【結語】NIVは終末期の活動を行う際に有用なデバイスの1つである可能...

Full description

Saved in:
Bibliographic Details
Published inPalliative Care Research Vol. 10; no. 1; pp. 519 - 523
Main Authors 川浦, 幸光, 村上, 眞也, 武田, 仁浩, 松沼, 亮, 早稲田, 優子, 笠原, 寿郎
Format Journal Article
LanguageJapanese
Published 日本緩和医療学会 2015
Subjects
緩和ケア
肺がん
間質性肺炎
非侵襲的陽圧換気
Online AccessGet full text
ISSN1880-5302
DOI10.2512/jspm.10.519

Cover

Abstract 【緒言】終末期に非侵襲的陽圧換気（NIV）を継続した状態でさまざまな活動が可能であった症例を経験したため報告する．【症例】57歳，男性．気腫合併間質性肺線維症の診断で外来経過観察中に肺がんと臨床診断され在宅酸素療法，NIVを導入されていたが，安静時呼吸困難が増悪し入院した．日中もNIVが必要となり，いったん食事摂取を中止され，緩和病棟へ転棟した．緩和ケア病棟でNIV継続した状態で食事摂取を再開し，入浴も行えた．ボランティアによる民謡鑑賞も行えた．合併症は移動時の低酸素血症，呼吸困難のみで，皮膚に発赤，潰瘍形成はみられなかった．【結語】NIVは終末期の活動を行う際に有用なデバイスの1つである可能性がある．
AbstractList 【緒言】終末期に非侵襲的陽圧換気（NIV）を継続した状態でさまざまな活動が可能であった症例を経験したため報告する．【症例】57歳，男性．気腫合併間質性肺線維症の診断で外来経過観察中に肺がんと臨床診断され在宅酸素療法，NIVを導入されていたが，安静時呼吸困難が増悪し入院した．日中もNIVが必要となり，いったん食事摂取を中止され，緩和病棟へ転棟した．緩和ケア病棟でNIV継続した状態で食事摂取を再開し，入浴も行えた．ボランティアによる民謡鑑賞も行えた．合併症は移動時の低酸素血症，呼吸困難のみで，皮膚に発赤，潰瘍形成はみられなかった．【結語】NIVは終末期の活動を行う際に有用なデバイスの1つである可能性がある．
Author 早稲田, 優子
笠原, 寿郎
松沼, 亮
川浦, 幸光
村上, 眞也
武田, 仁浩
Author_xml – sequence: 1
  fullname: 川浦, 幸光
  organization: 小松市民病院　外科
– sequence: 1
  fullname: 村上, 眞也
  organization: 小松市民病院　外科
– sequence: 1
  fullname: 武田, 仁浩
  organization: 小松市民病院　呼吸器内科
– sequence: 1
  fullname: 松沼, 亮
  organization: 小松市民病院　呼吸器内科
– sequence: 1
  fullname: 早稲田, 優子
  organization: Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna
– sequence: 1
  fullname: 笠原, 寿郎
  organization: 金沢大学附属病院　呼吸器内科
BookMark eNo9kEtLAlEAhS9RkJmrfsfYfY0zswlCeghSm2o73BlnykFNZty0awYXRlKhUfSmoqwW0QMJQv0zV51x5V9opGhzDuc7cBZnCowXtgsGADMIxrGI8KzlFPPxMIhIGQMRJMtQEAnEkyDmOFkNQkxlSimOAGtwdd3tNIOHD_-8PDhr9y4b_cOL_tvpsFVZSW0MW3vcq_nHT9wtc_fR_3ru1arce-feXciD2yp377l7E3jf3A15vXdU6babg5N68PnS322E3PcOuPuKup39aTBhspxjxP48CtYXF9aSy0J6dSmVnE8LFpJkJigi0U2EFU0xINahRE1FpljTWUJBLGOIRFIUU0I4k2CMICJjktFFiWJMNZMxDEkUzP3uWk6JbRpq0c7mmb2jMruU1XOGOvpGRVBFIwkP-i_0LWarFiM_KfeG4A
ContentType Journal Article
Copyright 2015 日本緩和医療学会
Copyright_xml – notice: 2015 日本緩和医療学会
DOI 10.2512/jspm.10.519
DatabaseTitleList
DeliveryMethod fulltext_linktorsrc
Discipline Medicine
EISSN 1880-5302
EndPage 523
ExternalDocumentID article_jspm_10_1_10_519_article_char_ja
GroupedDBID 123
2WC
ALMA_UNASSIGNED_HOLDINGS
CS3
JSF
JSH
KQ8
OK1
RJT
RZJ
X7L
ID FETCH-LOGICAL-j178a-953cf129b9e02c074f9842bca691ade53799f712d6aa313823dc574224bfaa203
IngestDate Wed Sep 03 06:25:09 EDT 2025
IsDoiOpenAccess true
IsOpenAccess true
IsPeerReviewed false
IsScholarly false
Issue 1
Language Japanese
LinkModel OpenURL
MergedId FETCHMERGED-LOGICAL-j178a-953cf129b9e02c074f9842bca691ade53799f712d6aa313823dc574224bfaa203
OpenAccessLink https://www.jstage.jst.go.jp/article/jspm/10/1/10_519/_article/-char/ja
PageCount 5
ParticipantIDs jstage_primary_article_jspm_10_1_10_519_article_char_ja
PublicationCentury 2000
PublicationDate 2015
PublicationDateYYYYMMDD 2015-01-01
PublicationDate_xml – year: 2015
  text: 2015
PublicationDecade 2010
PublicationTitle Palliative Care Research
PublicationTitleAlternate Palliat Care Res
PublicationYear 2015
Publisher 日本緩和医療学会
Publisher_xml – name: 日本緩和医療学会
References 2) 有田健一，三戸晶子，梶原俊毅，他．過去20年間における肺線維症・間質性肺炎終末期の緩和医療に関する検討．日胸臨2010;69:353-61
12) Keenan SP, Sinuff T, Cook DJ, et al. Does noninvasive positive pressure ventilation improve outcome in acute hypoxemic respiratory failure? A systematic review. Crit Care Med 2004;32:2516-23.
6) Abernethy AP, McDonald CF, Frith PA, et al. Effect of palliative oxygen versus medical(room)air in relief of breathlessness in patients with refractory dyspnea:a doubleblind randomized controlled trial. Lancet 2010;376:784-93.
15) Simonds AK, Elliott MW. Outcome of domiciliary nasal intermittent positive pressure ventilation in restrictive and obstructive disorders. Thorax 1995;50:604-9.
19) 鈴木晃代，加藤里美，安西由美子，他．急性呼吸不全症例における非侵襲的陽圧換気法施行時の合併症―看護師用チェックリストによる検討．日呼吸管理会誌2004;14:302-5
9) Sullivan CE, lssa FG, Barthon-Jones M, et al. Reversal of obstructive sleep apnoea by continuous positive airway pressure applied through nares. Lancet 1981;1:862-5.
10) Masip J, Roque M, Sanchez B, et al. Noninvasive ventilation in acute cardiogenic pulmonary edema:systematic review and meta-analysis. JAMA 2005;294:3124-30.
20) De Keulenaer BL, De Backer A, Schepens DR, et al. Abdominal compartment syndrome related to noninvasive ventilation. Intensive Care Med 2003;29:1177-81.
1) Hollen PJ, Gralla RJ, Kris MG, et al. Normative data and trends in quality of life from the Lung Cancer Symptom Scale(LCSS). Support Care Cancer 1999;7:140-8.
3) Jennings AL, Davies AN, Higgins JP, et al. A systematic review of the use of opioids in the management of dyspnoea. Thorax 2002;57:939-44.
18) Foglio C, Vitacca M, Quadri A, et al. Acute exacerbations in severe COLD patients. Treatment using positive pressure ventilation by nasal mask. Chest 1992;101:1533-8.
4) Mazzocato C, Buclin T, Rapin CH. The effects of morphine on dyspnea and ventilatory function in elderly patients with advanced cancer:a randomized double-blind controlled trial. Ann Oncol 1999;10:1511-4.
5) Bruera E, Stoutz ND, Velasco-Leiva A, et al. Effect of oxygen on dyspnoea in hypoxaemic terminal cancer patients. Lancet 1993;342:13-4.
7) Nava S, Ferrer M, Esquinas A, et al. Palliative use of non-invasive ventilation in end-of-life patients with solid tumours:a randomised feasibility trial. Lancet Oncol 2013;14:219-27.
16) Curtis JR, Cook DJ, Sinuff T, et al. The SCCM Palliative NPPV Task Force. Noninvasive positive pressure ventilation in critical and palliative care settings:understanding the goals of therapy. Crit Care Med 2007;35:932-9.
17) Kacmarek RM. Should Noninvasive Ventilation Be Used With the Do-Not-Intubate Patient? Respir Care 2009;54:223-31.
8) 町田和子．NPPVトラブルへの対応―リーク・顔面潰瘍・不快感などに対する対応策．日胸臨2005;64:S196-204
14) Leger P, Bedicam JM, Cornette A, et al. Nasal intermittent positive pressure ventilation. Long-term follow-up in patients with severe chronic respiratory insufficiency. Chest 1994;105:100-5.
13) Agarwal R, Aggarwal AN, Gupta D, et al. Role of noninvasive positive-pressure ventilation in postextubation respiratory failure:a meta-analysis. Respir Care 2007;52:1472-9.
11) Gray A, Goodacre S, Newby DE, et al. Noninvasive Ventilation in Acute Cardiogenic Pulmonary Edema. N Engl J Med 2008;359:142-51.
References_xml – reference: 1) Hollen PJ, Gralla RJ, Kris MG, et al. Normative data and trends in quality of life from the Lung Cancer Symptom Scale(LCSS). Support Care Cancer 1999;7:140-8.
– reference: 14) Leger P, Bedicam JM, Cornette A, et al. Nasal intermittent positive pressure ventilation. Long-term follow-up in patients with severe chronic respiratory insufficiency. Chest 1994;105:100-5.
– reference: 16) Curtis JR, Cook DJ, Sinuff T, et al. The SCCM Palliative NPPV Task Force. Noninvasive positive pressure ventilation in critical and palliative care settings:understanding the goals of therapy. Crit Care Med 2007;35:932-9.
– reference: 18) Foglio C, Vitacca M, Quadri A, et al. Acute exacerbations in severe COLD patients. Treatment using positive pressure ventilation by nasal mask. Chest 1992;101:1533-8.
– reference: 8) 町田和子．NPPVトラブルへの対応―リーク・顔面潰瘍・不快感などに対する対応策．日胸臨2005;64:S196-204．
– reference: 9) Sullivan CE, lssa FG, Barthon-Jones M, et al. Reversal of obstructive sleep apnoea by continuous positive airway pressure applied through nares. Lancet 1981;1:862-5.
– reference: 3) Jennings AL, Davies AN, Higgins JP, et al. A systematic review of the use of opioids in the management of dyspnoea. Thorax 2002;57:939-44.
– reference: 4) Mazzocato C, Buclin T, Rapin CH. The effects of morphine on dyspnea and ventilatory function in elderly patients with advanced cancer:a randomized double-blind controlled trial. Ann Oncol 1999;10:1511-4.
– reference: 6) Abernethy AP, McDonald CF, Frith PA, et al. Effect of palliative oxygen versus medical(room)air in relief of breathlessness in patients with refractory dyspnea:a doubleblind randomized controlled trial. Lancet 2010;376:784-93.
– reference: 11) Gray A, Goodacre S, Newby DE, et al. Noninvasive Ventilation in Acute Cardiogenic Pulmonary Edema. N Engl J Med 2008;359:142-51.
– reference: 17) Kacmarek RM. Should Noninvasive Ventilation Be Used With the Do-Not-Intubate Patient? Respir Care 2009;54:223-31.
– reference: 2) 有田健一，三戸晶子，梶原俊毅，他．過去20年間における肺線維症・間質性肺炎終末期の緩和医療に関する検討．日胸臨2010;69:353-61．
– reference: 19) 鈴木晃代，加藤里美，安西由美子，他．急性呼吸不全症例における非侵襲的陽圧換気法施行時の合併症―看護師用チェックリストによる検討．日呼吸管理会誌2004;14:302-5．
– reference: 20) De Keulenaer BL, De Backer A, Schepens DR, et al. Abdominal compartment syndrome related to noninvasive ventilation. Intensive Care Med 2003;29:1177-81.
– reference: 5) Bruera E, Stoutz ND, Velasco-Leiva A, et al. Effect of oxygen on dyspnoea in hypoxaemic terminal cancer patients. Lancet 1993;342:13-4.
– reference: 13) Agarwal R, Aggarwal AN, Gupta D, et al. Role of noninvasive positive-pressure ventilation in postextubation respiratory failure:a meta-analysis. Respir Care 2007;52:1472-9.
– reference: 10) Masip J, Roque M, Sanchez B, et al. Noninvasive ventilation in acute cardiogenic pulmonary edema:systematic review and meta-analysis. JAMA 2005;294:3124-30.
– reference: 12) Keenan SP, Sinuff T, Cook DJ, et al. Does noninvasive positive pressure ventilation improve outcome in acute hypoxemic respiratory failure? A systematic review. Crit Care Med 2004;32:2516-23.
– reference: 15) Simonds AK, Elliott MW. Outcome of domiciliary nasal intermittent positive pressure ventilation in restrictive and obstructive disorders. Thorax 1995;50:604-9.
– reference: 7) Nava S, Ferrer M, Esquinas A, et al. Palliative use of non-invasive ventilation in end-of-life patients with solid tumours:a randomised feasibility trial. Lancet Oncol 2013;14:219-27.
SSID ssib002484442
ssj0050005
Score 1.6206799
Snippet ...
SourceID jstage
SourceType Publisher
StartPage 519
SubjectTerms 緩和ケア
肺がん
間質性肺炎
非侵襲的陽圧換気
Title 非侵襲的陽圧換気（NIV）を用いて緩和ケアを行った肺がん合併間質性肺炎の1例
URI https://www.jstage.jst.go.jp/article/jspm/10/1/10_519/_article/-char/ja
Volume 10
hasFullText 1
inHoldings 1
isFullTextHit
isPrint
ispartofPNX Palliative Care Research, 2015, Vol.10(1), pp.519-523
link http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnR3LahRBcIgRxIv4xDc5WMeNM9Mz093Hmd1ZghJRSCC3ZR67hwVj0OTiyV1yiBhUElF8o6JRD-KDIEiSn5kku_GSX7CqZ2adxBxiYGlqq6uruqq6p6uG7h5Nu8BFELPY5KUolJig1O2wFDo2K8WM7vpuBFxX93QPX3GGRq1LY_ZY377fhV1LU5PhYHR7x3Mle_Eq4tCvdEr2PzzbY4oIhNG_WKKHsdyVj8GXICsgffAt8HzwbPAFuDZ4JvgcpAvCUjQSvAr4NsgyuBx8B0QVpEeAp4NETBW8MgiByWAOS_AZCBNkysoCVyiMoXgqwHWoyuPgSsXcBFHOWnlGBrhmgQ_2zchpsDnLAFmlKmrl5iJyPpIpzjr2TelYUTqiRo6qEuAxcF2lka5U6_HhBAg_l-UbmY2EV4zHrwb0ukltn6KTWL2NiPk4JOmoIBqZbGWTyjgmFRZtKggQ-JN_6R3lkVQadsZN6TmZPvMT9r5apHcrmSXRyOgORY-QR_3OpG7nj3pQjUmeyuldVLL4Dic9v6rmm2rFaWAQgGOgvJPjbCpRLPVEkvUQk_XNIkEyuyk2XcLwiVyib0FtWeP0f-ZyumDZ2YKVxj52evZ7-7JKMTAtq7cmrg_i316bLfeUZ7OgRlQ1Si2pQNJaXkHHCGtNzGX2m5wbtP328rVi6issy-pd_Ubf6bDT87Qk_WJBNsaKTcyc8l2XKhAcOawdyjK4ATeVd0TrawZHtQPD2R6VY1pz4-Wr1ZXF7vvvnWfTG0-X114srD94vv71yebSDM6vzaW7SXuu8-hj0ppOWh86Pz-tzc0m7W9J-y3iu29mk9a7pPW62_6VtBA_v_ZwZnV5cePxfPfH5_U7C4jvtO8nrS_G6sq949po1R8pD5WyL5qUmgY-FWmvRNTACDuUdd2MMHpvSGGZYRQ40gjius24lA1umLETBIxuB2VxZHMLw-ywEQSmzk5o_eM3xusntQE7RHInYkwEkRWLIAwwU2roethgmJFF_JTGUyvVJtJra2q7ddDpPbc8ox2k0Z2-oTyr9U_enKqfw5h9MjyvnP0H3K_QlQ
linkProvider Colorado Alliance of Research Libraries
openUrl ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=%E9%9D%9E%E4%BE%B5%E8%A5%B2%E7%9A%84%E9%99%BD%E5%9C%A7%E6%8F%9B%E6%B0%97%EF%BC%88NIV%EF%BC%89%E3%82%92%E7%94%A8%E3%81%84%E3%81%A6%E7%B7%A9%E5%92%8C%E3%82%B1%E3%82%A2%E3%82%92%E8%A1%8C%E3%81%A3%E3%81%9F%E8%82%BA%E3%81%8C%E3%82%93%E5%90%88%E4%BD%B5%E9%96%93%E8%B3%AA%E6%80%A7%E8%82%BA%E7%82%8E%E3%81%AE1%E4%BE%8B&rft.jtitle=Palliative+Care+Research&rft.au=%E5%B7%9D%E6%B5%A6%2C+%E5%B9%B8%E5%85%89&rft.au=%E6%9D%91%E4%B8%8A%2C+%E7%9C%9E%E4%B9%9F&rft.au=%E6%AD%A6%E7%94%B0%2C+%E4%BB%81%E6%B5%A9&rft.au=%E6%9D%BE%E6%B2%BC%2C+%E4%BA%AE&rft.date=2015&rft.pub=%E6%97%A5%E6%9C%AC%E7%B7%A9%E5%92%8C%E5%8C%BB%E7%99%82%E5%AD%A6%E4%BC%9A&rft.eissn=1880-5302&rft.volume=10&rft.issue=1&rft.spage=519&rft.epage=523&rft_id=info:doi/10.2512%2Fjspm.10.519&rft.externalDocID=article_jspm_10_1_10_519_article_char_ja