{"id":4824,"date":"2023-04-08T19:53:58","date_gmt":"2023-04-08T10:53:58","guid":{"rendered":"https:\/\/imedica.jp\/?p=4824"},"modified":"2025-11-16T09:58:13","modified_gmt":"2025-11-16T00:58:13","slug":"%e3%80%90%e8%a8%ba%e7%99%82tips%e3%80%91%e5%a3%8a%e6%ad%bb%e6%80%a7%e8%bb%9f%e9%83%a8%e7%b5%84%e7%b9%94%e6%84%9f%e6%9f%93%e7%97%87%ef%bc%88necrotizing-soft-tissue-infection-nsti%ef%bc%89","status":"publish","type":"post","link":"https:\/\/imedica.jp\/en\/nsti-early-diagnosis-management\/","title":{"rendered":"\u3010\u8a3a\u7642Tips\u3011\u58ca\u6b7b\u6027\u8edf\u90e8\u7d44\u7e54\u611f\u67d3\u75c7\uff08NSTI\uff09\u306e\u65e9\u671f\u8a3a\u65ad\u3068\u521d\u671f\u5bfe\u5fdc\uff1a\u533b\u7642\u8005\u304c\u7d76\u5bfe\u306b\u898b\u9003\u3057\u3066\u306f\u3044\u3051\u306a\u3044\u201c3\u3064\u306e\u8d64\u65d7\u201d"},"content":{"rendered":"<div id=\"ez-toc-container\" class=\"ez-toc-v2_0_76 counter-hierarchy ez-toc-counter ez-toc-grey ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">Table of Contents<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Toggle Table of Content\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewbox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #999;color:#999\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewbox=\"0 0 24 24\" version=\"1.2\" baseprofile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1' ><li class='ez-toc-page-1 ez-toc-heading-level-4'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/imedica.jp\/en\/nsti-early-diagnosis-management\/#%E5%AE%9A%E7%BE%A9\" >\u5b9a\u7fa9<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-4'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/imedica.jp\/en\/nsti-early-diagnosis-management\/#%E7%96%AB%E5%AD%A6\" >\u75ab\u5b66<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-4'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/imedica.jp\/en\/nsti-early-diagnosis-management\/#%E5%88%86%E9%A1%9E\" >\u5206\u985e<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-4'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/imedica.jp\/en\/nsti-early-diagnosis-management\/#%E7%97%85%E6%85%8B\" >\u75c5\u614b<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-4'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/imedica.jp\/en\/nsti-early-diagnosis-management\/#%E8%87%A8%E5%BA%8A%E6%89%80%E8%A6%8B\" >\u81e8\u5e8a\u6240\u898b<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-4'><a class=\"ez-toc-link ez-toc-heading-6\" href=\"https:\/\/imedica.jp\/en\/nsti-early-diagnosis-management\/#%E6%97%A9%E6%9C%9F%E8%A8%BA%E6%96%AD%E3%81%AE%E3%83%9D%E3%82%A4%E3%83%B3%E3%83%88\" >\u65e9\u671f\u8a3a\u65ad\u306e\u30dd\u30a4\u30f3\u30c8<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-4'><a class=\"ez-toc-link ez-toc-heading-7\" href=\"https:\/\/imedica.jp\/en\/nsti-early-diagnosis-management\/#%E7%94%BB%E5%83%8F%E8%A8%BA%E6%96%AD\" >\u753b\u50cf\u8a3a\u65ad<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-4'><a class=\"ez-toc-link ez-toc-heading-8\" href=\"https:\/\/imedica.jp\/en\/nsti-early-diagnosis-management\/#%E8%A8%BA%E6%96%AD%E8%A3%9C%E5%8A%A9%E3%83%84%E3%83%BC%E3%83%AB%EF%BC%9ALRINEC%EF%BC%88%E3%83%A9%E3%82%A4%E3%83%8D%E3%83%83%E3%82%AF%EF%BC%89%E3%82%B9%E3%82%B3%E3%82%A2\" >\u8a3a\u65ad\u88dc\u52a9\u30c4\u30fc\u30eb\uff1aLRINEC\uff08\u30e9\u30a4\u30cd\u30c3\u30af\uff09\u30b9\u30b3\u30a2<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-4'><a class=\"ez-toc-link ez-toc-heading-9\" href=\"https:\/\/imedica.jp\/en\/nsti-early-diagnosis-management\/#%E8%A8%BA%E6%96%AD%E3%81%AE%E6%B1%BA%E3%82%81%E6%89%8B%EF%BC%9A%E8%A9%A6%E9%A8%93%E5%88%87%E9%96%8B%E3%81%A8finger_test\" >\u8a3a\u65ad\u306e\u6c7a\u3081\u624b\uff1a\u8a66\u9a13\u5207\u958b\u3068finger test<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-4'><a class=\"ez-toc-link ez-toc-heading-10\" href=\"https:\/\/imedica.jp\/en\/nsti-early-diagnosis-management\/#%E5%A4%96%E7%A7%91%E7%9A%84%E6%B2%BB%E7%99%82\" >\u5916\u79d1\u7684\u6cbb\u7642<\/a><\/li><\/ul><\/nav><\/div>\n<h4 class=\"st-matome\"><span class=\"ez-toc-section\" id=\"%E5%AE%9A%E7%BE%A9\"><\/span><strong>\u5b9a\u7fa9<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h4>\n<ul>\n<li><span class=\"bmarker\">\u58ca\u6b7b\u6027\u8edf\u90e8\u7d44\u7e54\u611f\u67d3\u75c7\uff08necrotizing soft tissue infection: \u4ee5\u4e0b\u3001NSTI\uff09<\/span>\u306f\u3001\u8edf\u90e8\u7d44\u7e54\uff08\u76ae\u819a\u3001\u76ae\u4e0b\u7d44\u7e54\u3001\u6d45\u7b4b\u819c\u3001\u6df1\u7b4b\u819c\u3001\u7b4b\u8089\uff09\u306e\u3044\u305a\u308c\u304b\u306e\u90e8\u4f4d\u304b\u3089\u6025\u901f\u304b\u3064\u5e83\u7bc4\u56f2\u306b\u7d44\u7e54\u58ca\u6b7b\u304c\u5e83\u304c\u308a\u3001\u81d3\u5668\u969c\u5bb3\u3092\u304d\u305f\u3059\u611f\u67d3\u75c7\u306e\u7dcf\u79f0\u3067\u3042\u308b\u3002<\/li>\n<li>\u4ee5\u524d\u306f\u6d45\u7b4b\u819c\u3092\u611f\u67d3\u306e\u4e3b\u5ea7\u3068\u3059\u308b\u3082\u306e\u3092\u58ca\u6b7b\u6027\u7b4b\u819c\u708e\u3068\u547c\u3093\u3067\u3044\u305f\u304c\u3001\u8fd1\u5e74\u306f<span class=\"bmarker\">\u58ca\u6b7b\u6027\u7b4b\u819c\u708e\u3082\u542b\u3081\u305f\u5305\u62ec\u7684\u306a\u6982\u5ff5\u3068\u3057\u3066NSTI\u3068\u547c\u3076<\/span>\u3053\u3068\u304c\u591a\u3044\u3002<\/li>\n<\/ul>\n<p><script type=\"text\/javascript\">(function(b,c,f,g,a,d,e){b.MoshimoAffiliateObject=a;b[a]=b[a]||function(){arguments.currentScript=c.currentScript||c.scripts[c.scripts.length-2];(b[a].q=b[a].q||[]).push(arguments)};c.getElementById(a)||(d=c.createElement(f),d.src=g,d.id=a,e=c.getElementsByTagName(\"body\")[0],e.appendChild(d))})(window,document,\"script\",\"\/\/dn.msmstatic.com\/site\/cardlink\/bundle.js?20220329\",\"msmaflink\");msmaflink({\"n\":\"\uff1c\uff11\u4eba\u533b\u9577\u30de\u30cb\u30e5\u30a2\u30eb\u30b7\u30ea\u30fc\u30ba\uff1e\u624b\u5916\u50b7\u3078\u306e\u5bfe\u5fdc(PEPARS(\u30da\u30d1\u30fc\u30ba) No.192(2022\u5e7412\u6708\u53f7))\",\"b\":\"\u5168\u65e5\u672c\u75c5\u9662\u51fa\u7248\u4f1a\",\"t\":\"\",\"d\":\"https:\\\/\\\/m.media-amazon.com\",\"c_p\":\"\\\/images\\\/I\",\"p\":[\"\\\/41-QMWufVFL._SL500_.jpg\",\"\\\/41g06Fse93L._SL500_.jpg\",\"\\\/41iA2+zJhNL._SL500_.jpg\",\"\\\/41UwITPNddL._SL500_.jpg\",\"\\\/41Z9dHvTkdL._SL500_.jpg\",\"\\\/41JiY9QRmpL._SL500_.jpg\",\"\\\/41M1ui9E7rL._SL500_.jpg\",\"\\\/4141diRqaoL._SL500_.jpg\",\"\\\/41EPZIvP9pL._SL500_.jpg\"],\"u\":{\"u\":\"https:\\\/\\\/www.amazon.co.jp\\\/dp\\\/4865193928\",\"t\":\"amazon\",\"r_v\":\"\"},\"v\":\"2.1\",\"b_l\":[{\"id\":1,\"u_tx\":\"Amazon\u3067\u898b\u308b\",\"u_bc\":\"#f79256\",\"u_url\":\"https:\\\/\\\/www.amazon.co.jp\\\/dp\\\/4865193928\",\"a_id\":2658335,\"p_id\":170,\"pl_id\":27060,\"pc_id\":185,\"s_n\":\"amazon\",\"u_so\":1},{\"id\":2,\"u_tx\":\"\u697d\u5929\u5e02\u5834\u3067\u898b\u308b\",\"u_bc\":\"#f76956\",\"u_url\":\"https:\\\/\\\/search.rakuten.co.jp\\\/search\\\/mall\\\/%EF%BC%9C%EF%BC%91%E4%BA%BA%E5%8C%BB%E9%95%B7%E3%83%9E%E3%83%8B%E3%83%A5%E3%82%A2%E3%83%AB%E3%82%B7%E3%83%AA%E3%83%BC%E3%82%BA%EF%BC%9E%E6%89%8B%E5%A4%96%E5%82%B7%E3%81%B8%E3%81%AE%E5%AF%BE%E5%BF%9C(PEPARS(%E3%83%9A%E3%83%91%E3%83%BC%E3%82%BA)%20No.192(2022%E5%B9%B412%E6%9C%88%E5%8F%B7))\\\/\",\"a_id\":2658337,\"p_id\":54,\"pl_id\":27059,\"pc_id\":54,\"s_n\":\"rakuten\",\"u_so\":2},{\"id\":3,\"u_tx\":\"Yahoo!\u30b7\u30e7\u30c3\u30d4\u30f3\u30b0\u3067\u898b\u308b\",\"u_bc\":\"#66a7ff\",\"u_url\":\"https:\\\/\\\/shopping.yahoo.co.jp\\\/search?first=1\\u0026p=%EF%BC%9C%EF%BC%91%E4%BA%BA%E5%8C%BB%E9%95%B7%E3%83%9E%E3%83%8B%E3%83%A5%E3%82%A2%E3%83%AB%E3%82%B7%E3%83%AA%E3%83%BC%E3%82%BA%EF%BC%9E%E6%89%8B%E5%A4%96%E5%82%B7%E3%81%B8%E3%81%AE%E5%AF%BE%E5%BF%9C(PEPARS(%E3%83%9A%E3%83%91%E3%83%BC%E3%82%BA)%20No.192(2022%E5%B9%B412%E6%9C%88%E5%8F%B7))\",\"a_id\":2658339,\"p_id\":1225,\"pl_id\":27061,\"pc_id\":1925,\"s_n\":\"yahoo\",\"u_so\":3}],\"eid\":\"uu5C7\",\"s\":\"s\"});<\/script><\/p>\n<div id=\"msmaflink-uu5C7\">link<\/div>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<h4 class=\"st-matome\"><span class=\"ez-toc-section\" id=\"%E7%96%AB%E5%AD%A6\"><\/span><strong>\u75ab\u5b66<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h4>\n<ul>\n<li>10\u4e07\u4eba\u3042\u305f\u308a4\u4eba<sup>(1)<\/sup>\u3068\u7f79\u60a3\u7387\u306f\u4f4e\u3044\u3082\u306e\u306e\u3001<span class=\"bmarker\">\u6b7b\u4ea1\u7387\u306f16\u301c24\uff05<\/span><sup>(2)<\/sup>\u3068\u9ad8\u3044\u81f4\u6b7b\u7684\u75be\u60a3\u3067\u3042\u308b\u3002<\/li>\n<\/ul>\n<p style=\"padding-left: 40px;\"><span style=\"font-size: 70%;\">(1) Ellis Simonsen SM, et al. Cellulitis incidence in a defined population. Epidemiol Infect 2006;134:293-299.<\/span><\/p>\n<p style=\"padding-left: 40px;\"><span style=\"font-size: 70%;\">(2) Anaya DA, et al. Necrotizing soft-tissue infection: Diagnosis and management. Clin Infect Dis 2007;44:705-710.<\/span><\/p>\n<p>&nbsp;<\/p>\n<h4 class=\"st-matome\"><span class=\"ez-toc-section\" id=\"%E5%88%86%E9%A1%9E\"><\/span><strong>\u5206\u985e<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h4>\n<ul>\n<li>NSTI\u306f\u8d77\u56e0\u83cc\u5225\u306e\u5206\u985e\u306b\u3088\u308a\u3001<span class=\"bmarker\">Type 1<\/span>\u3068<span class=\"bmarker\">Type 2<\/span>\u306b\u5206\u985e\u3055\u308c\u308b\uff08\u5b9f\u969b\u306b\u306f<em>Vibrio<\/em> spp.\u306a\u3069\u306e\u6d77\u95a2\u9023\u306e\u30b0\u30e9\u30e0\u9670\u6027\u687f\u83cc\u306b\u3088\u308bType 3\u3001\u5916\u50b7\u304c\u539f\u56e0\u3068\u306a\u308b\u771f\u83cc\u306b\u3088\u308bType 4\u3082\u3042\u308b\u304c\u3001\u983b\u5ea6\u304c\u4f4e\u3044\u305f\u3081\u3053\u3053\u3067\u306f\u7701\u304f\uff09<sup>(3)<\/sup>\u3002<\/li>\n<li><span class=\"bmarker\">Type 1<\/span>\u306f\u3001\u597d\u6c17\u6027\u83cc\u3068\u5acc\u6c17\u6027\u83cc\u306e\u8907\u6570\u83cc\u306b\u3088\u308b<span class=\"bmarker\">\u6df7\u5408\u611f\u67d3<\/span>\u304c\u539f\u56e0\u3067\u3042\u308a\u3001<span class=\"bmarker\">\u9ad8\u9f62\u8005\u3084\u57fa\u790e\u75be\u60a3\u304c\u3042\u308b\u60a3\u8005\u306b\u597d\u767a<\/span>\u3059\u308b\u3002\u75c5\u72b6\u306f\u7de9\u5f90\u306b\u9032\u884c\u3057\u3001\u6bd4\u8f03\u7684\u4e88\u5f8c\u306f\u3088\u304f\u3001\u6b7b\u4ea1\u7387\u306f\u57fa\u790e\u75be\u60a3\u306b\u4f9d\u5b58\u3059\u308b\u3002<\/li>\n<li><span class=\"bmarker\">Type 2<\/span>\u306f\u3001<span class=\"bmarker\">A\u7fa4\u6eb6\u8840\u6027\u30ec\u30f3\u30b5\u7403\u83cc\u3084\u9ec4\u8272\u30d6\u30c9\u30a6\u7403\u83cc<\/span>\u306a\u3069\u76ae\u819a\u3084\u6c17\u9053\u306e\u5358\u4e00\u83cc\u306b\u3088\u308b\u611f\u67d3\u304c\u539f\u56e0\u3067\u3042\u308a\u3001\u5e74\u9f62\u3084\u57fa\u790e\u75be\u60a3\u306f\u95a2\u4fc2\u306a\u304f<span class=\"bmarker\">\u5065\u5e38\u8005\u306b\u3082\u751f\u3058\u308b<\/span>\u3002<\/li>\n<\/ul>\n<p style=\"padding-left: 40px;\"><span style=\"font-size: 70%;\">(3) Bonne SL, et al. Evaluation and management of necrotizing soft tissue infections. Infect Dis Clin North Am 2017;31:497-511<\/span><\/p>\n<p><img decoding=\"async\" class=\"alignnone size-large wp-image-4825\" src=\"https:\/\/imedica.jp\/wp-content\/uploads\/2023\/04\/NSTI-type-classification-1024x576.jpeg\" alt=\"\" width=\"920\" height=\"518\" srcset=\"https:\/\/imedica.jp\/wp-content\/uploads\/2023\/04\/NSTI-type-classification-1024x576.jpeg 1024w, https:\/\/imedica.jp\/wp-content\/uploads\/2023\/04\/NSTI-type-classification-300x169.jpeg 300w, https:\/\/imedica.jp\/wp-content\/uploads\/2023\/04\/NSTI-type-classification-768x432.jpeg 768w, https:\/\/imedica.jp\/wp-content\/uploads\/2023\/04\/NSTI-type-classification-1536x864.jpeg 1536w, https:\/\/imedica.jp\/wp-content\/uploads\/2023\/04\/NSTI-type-classification.jpeg 1920w\" sizes=\"(max-width: 920px) 100vw, 920px\" \/><\/p>\n<p>&nbsp;<\/p>\n<h4 class=\"st-matome\"><span class=\"ez-toc-section\" id=\"%E7%97%85%E6%85%8B\"><\/span><strong>\u75c5\u614b<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h4>\n<ul>\n<li>\u75c5\u614b\u306e\u30e1\u30ab\u30cb\u30ba\u30e0\u3068\u3057\u3066\u306f\u3001\u307e\u305a\u8edf\u90e8\u306b\u4fb5\u5165\u3057\u305f\u83cc\u304c<span class=\"bmarker\">\u6bd2\u7d20<\/span>\u3092\u7523\u751f\u3057<span class=\"bmarker\">\u672b\u68a2\u8840\u7ba1\u304c\u9589\u585e<\/span>\u3059\u308b\u3053\u3068\u3067\u865a\u8840\u3068\u58ca\u6b7b\u304c\u9032\u884c\u3059\u308b\u3002<\/li>\n<li>\u3055\u3089\u306b\u58ca\u6b7b\u74b0\u5883\u3067\u7d30\u83cc\u304c\u5897\u6b96\u3059\u308b\u3053\u3068\u3067\u611f\u67d3\u304c\u6025\u901f\u306b\u5468\u56f2\u306b\u9032\u5c55\u3059\u308b\u6a5f\u5e8f\u304c\u8003\u3048\u3089\u308c\u3066\u3044\u308b\u3002<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<h4 class=\"st-matome\"><span class=\"ez-toc-section\" id=\"%E8%87%A8%E5%BA%8A%E6%89%80%E8%A6%8B\"><\/span><strong>\u81e8\u5e8a\u6240\u898b<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h4>\n<ul>\n<li>\u81e8\u5e8a\u6240\u898b: <span class=\"bmarker\">stage 1\uff08\u65e9\u671f\uff09<\/span>\u3066\u3099\u306f\u3001\u767a\u8d64\u3001\u71b1\u611f\u3001\u816b\u8139\u3068\u3068\u3082\u306b\u76ae\u819a\u6240\u898b\u3092\u8d8a\u3048\u305f\u5727\u75db\u3001<span class=\"bmarker\">stage 2\uff08\u4e2d\u671f\uff09<\/span>\u3066\u3099\u306f\u3001\u6c34\u75b1\u5f62\u6210\u3001\u76ae\u819a\u306e\u6ce2\u52d5\u30fb\u786c\u7d50\u3001 <span class=\"bmarker\">stage 3\uff08\u6669\u671f\uff09<\/span>\u3066\u3099\u306f\u3001\u8840\u6027\u30fb\u6c34\u75b1\u5f62\u6210\u3001\u63e1\u96ea\u611f\u3001\u76ae\u819a\u77e5\u899a\u4f4e\u4e0b\u3001\u76ae\u819a\u58ca\u6b7b\u3092\u8a8d\u3081\u308b<sup>(4)<\/sup>\u3002<\/li>\n<\/ul>\n<p style=\"padding-left: 40px;\"><span style=\"font-size: 70%;\">(4) Wang YS, et al. Staging of necrotizing fasciitis based on the evolving cutaneous features. Int J Dermatol 2007;46:1036\u20121041.<\/span><\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<h4 class=\"st-matome\"><span class=\"ez-toc-section\" id=\"%E6%97%A9%E6%9C%9F%E8%A8%BA%E6%96%AD%E3%81%AE%E3%83%9D%E3%82%A4%E3%83%B3%E3%83%88\"><\/span><strong>\u65e9\u671f\u8a3a\u65ad\u306e\u30dd\u30a4\u30f3\u30c8<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h4>\n<ul>\n<li>NSTI\u306f\u6642\u9593\u5358\u4f4d\u3067\u7d44\u7e54\u969c\u5bb3\u304c\u9032\u884c\u3059\u308b\u305f\u3081\u3001\u3067\u304d\u308b\u3060\u3051\u65e9\u3044\u6bb5\u968e\u3067\u8a3a\u65ad\u3059\u308b\u3053\u3068\u304c\u6c42\u3081\u3089\u308c\u308b\u3002<\/li>\n<li>NSTI\u3092\u7a4d\u6975\u7684\u306b\u7591\u3046\u7279\u5fb4\u7684\u306a\u6240\u898b\u3068\u3057\u3066\u306f\u3001<span class=\"bmarker\">\u2460 \u7d05\u6591\u306e\u5883\u754c\u304b\u3099\u4e0d\u660e\u77ad\u3067\u3042\u308b\u3053\u3068<\/span>\uff08\u8868\u5728\u6027\u611f\u67d3\u75c7\u3067\u306f\u7d05\u6591\u306e\u5883\u754c\u306f\u660e\u77ad\u3067\u3042\u308b\uff09\u3001<span class=\"bmarker\">\u2461 \u7d05\u6591\u306e\u7bc4\u56f2\u3092\u8d8a\u3048\u305f\u5727\u75db<\/span>\u3001<span class=\"bmarker\">\u2462 \u76ae\u819a\u6240\u898b\u304b\u3089\u8003\u3048\u3089\u308c\u308b\u3088\u308a\u3082\u306f\u308b\u304b\u306b\u5f37\u304f\u75db\u304c\u308b\u3053\u3068<\/span>\u3001\u304b\u3099\u3042\u3051\u3099\u3089\u308c\u308b\u3002NSTI\u306f\u3001\u8edf\u90e8\u7d44\u7e54\u306e\u306a\u304b\u3067\u3082\u8840\u6d41\u304c\u4e0d\u826f\u306a\u7b4b\u819c\u3092\u4e3b\u5ea7\u306b\u3057\u3066\u611f\u67d3\u304c\u5e83\u304c\u308b\u305f\u3081\u3001\u521d\u671f\u306b\u306f\u8868\u5c64\u306e\u7d44\u7e54\uff08\u76ae\u819a\u3084\u76ae\u4e0b\u7d44\u7e54\uff09\u306b\u306f\u6240\u898b\u304c\u3067\u3065\u3089\u3044\u305f\u3081\u306b\u4e0a\u8a18\u306e\u3088\u3046\u306a\u73fe\u8c61\u304c\u751f\u3058\u308b\u3002<\/li>\n<li>\u4e00\u822c\u5916\u6765\u306e\u8a3a\u7642\u533b\u306f\u2460\u2461\u2462\u3092\u898b\u9003\u3055\u306a\u3044\u3088\u3046\u306b\u3057\u3001\u3053\u308c\u3089\u3092\u8a8d\u3081\u308b\u3088\u3046\u3067\u3042\u308c\u3070\u5373\u5ea7\u306b\u9ad8\u6b21\u533b\u7642\u6a5f\u95a2\u306b\u6551\u6025\u642c\u9001\u3092\u304a\u3053\u306a\u3046\u3002<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<h4 class=\"st-matome\"><span class=\"ez-toc-section\" id=\"%E7%94%BB%E5%83%8F%E8%A8%BA%E6%96%AD\"><\/span><strong>\u753b\u50cf\u8a3a\u65ad<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h4>\n<ul>\n<li>NSTI\u306e\u8a3a\u65ad\u306e\u305f\u3081\u306e\u753b\u50cf\u8a3a\u65ad\u306f\u3001\u30a8\u30b3\u30fc\u3001CT\u3001MRI\u306e\u6709\u7528\u6027\u304c\u305d\u308c\u305e\u308c\u5831\u544a\u3055\u308c\u3066\u3044\u308b\u3082\u306e\u306e\u3001\u6709\u7528\u6027\u306b\u95a2\u3059\u308b\u8a55\u4fa1\u306f\u4e00\u5b9a\u3057\u3066\u3044\u306a\u3044\u3002<\/li>\n<li>\u6d77\u5916\u304b\u3089\u306e\u5831\u544a\u3067\u306f\u3001\u300cNSTI\u306f\u6025\u901f\u9032\u884c\u6027\u306e\u305f\u3081\u753b\u50cf\u64ae\u5f71\u3092\u3059\u308b\u3053\u3068\u3067\u6cbb\u7642\u4ecb\u5165\u304c\u9045\u308c\u3066\u306f\u306a\u3089\u306a\u3044\u300d\u3068\u3059\u308b\u610f\u898b\u304c\u591a\u3044\u3002\u4e00\u65b9\u65e5\u672c\u3067\u306fCT\u304c\u6bd4\u8f03\u7684\u8fc5\u901f\u306b\u64ae\u5f71\u3067\u304d\u308b\u3053\u3068\u3082\u3042\u308a\u3001\u308f\u308c\u308f\u308c\u306e\u65bd\u8a2d\u3067\u306f\u5168\u4f8b\u3067CT\u64ae\u5f71\u3092\u3057\u3066\u304b\u3089\u624b\u8853\u3092\u304a\u3053\u306a\u3063\u3066\u3044\u308b\u3002CT\u3067\u306f\u30ac\u30b9\u50cf\u306e\u6709\u7121\u3084\u7b4b\u819c\u306e\u80a5\u539a\u3084\u6db2\u4f53\u8caf\u7559\u306e\u7bc4\u56f2\u3092\u78ba\u8a8d\u3059\u308b\u3053\u3068\u304c\u53ef\u80fd\u3067\u3042\u308a\u3001\u5916\u79d1\u7684\u4ecb\u5165\u3092\u304a\u3053\u306a\u3046\u7bc4\u56f2\u3092\u4e88\u6e2c\u3059\u308b\u3046\u3048\u3067\u6709\u7528\u3067\u3042\u308b\u3068\u8003\u3048\u3066\u3044\u308b\u3002<\/li>\n<li>\u307e\u305f2018\u5e74\u306bMartinez M \u3089\u306f\u3001NSTI\u306e\u8a3a\u65ad\u306b\u9020\u5f71CT\u304c\u6709\u7528\uff08\u611f\u5ea6100\uff05\u3001\u7279\u7570\u5ea698\uff05\uff09\u3067\u3042\u308b\u3068\u5831\u544a\u3057\u3066\u3044\u308b<sup>(5)<\/sup>\u3002<\/li>\n<\/ul>\n<p style=\"padding-left: 40px;\"><span style=\"font-size: 70%;\">(5) Martinez M, et al. The role of computed tomography in the diagnosis of necrotizing soft tissue infections. World J Surg 2018;42:82\u201387.<\/span><\/p>\n<ul>\n<li>NSTI\u306e\u753b\u50cf\u8a3a\u65ad\u306e\u6709\u7528\u6027\u306b\u95a2\u3057\u3066\u306f\u66f4\u306a\u308b\u306e\u30a8\u30d3\u30c7\u30f3\u30b9\u306e\u78ba\u7acb\u304c\u6c42\u3081\u3089\u308c\u308b\u6bb5\u968e\u3067\u3042\u308b\u3002<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<h4 class=\"st-matome\"><span class=\"ez-toc-section\" id=\"%E8%A8%BA%E6%96%AD%E8%A3%9C%E5%8A%A9%E3%83%84%E3%83%BC%E3%83%AB%EF%BC%9ALRINEC%EF%BC%88%E3%83%A9%E3%82%A4%E3%83%8D%E3%83%83%E3%82%AF%EF%BC%89%E3%82%B9%E3%82%B3%E3%82%A2\"><\/span><strong>\u8a3a\u65ad\u88dc\u52a9\u30c4\u30fc\u30eb\uff1aLRINEC\uff08\u30e9\u30a4\u30cd\u30c3\u30af\uff09\u30b9\u30b3\u30a2<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h4>\n<ul>\n<li>\u8840\u6db2\u751f\u5316\u5b66\u691c\u67fb\u30c7\u30fc\u30bf\u3092\u4f7f\u7528\u3057\u305f\u8a3a\u65ad\u88dc\u52a9\u30c4\u30fc\u30eb\u3068\u3057\u3066<a href=\"https:\/\/imedica.jp\/en\/lrinec-score%ef%bc%88%e3%83%a9%e3%82%a4%e3%83%8d%e3%83%83%e3%82%af%e3%82%b9%e3%82%b3%e3%82%a2%ef%bc%89\/\"><span class=\"bmarker\">Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC)\u30b9\u30b3\u30a2<\/span><\/a>\u304c\u3042\u308b<sup>(6)<\/sup>\u30026\u3064\u306e\u72ec\u7acb\u3057\u305f\u691c\u67fb\u30c7\u30fc\u30bf\uff08<span class=\"bmarker\">CRP<\/span>\u3001<span class=\"bmarker\">WBC<\/span>\u3001<span class=\"bmarker\">Hb<\/span>\u3001<span class=\"bmarker\">\u8840\u6e05Na<\/span>\u3001<span class=\"bmarker\">\u8840\u6e05Cre<\/span>\u3001<span class=\"bmarker\">\u8840\u7cd6<\/span>\uff09\u3092\u30b9\u30b3\u30a2\u5316\u3057\u3001NSTI\u306e\u53ef\u80fd\u6027\u3092\u5224\u65ad\u3059\u308b\u6307\u6a19\u3068\u3057\u3066\u7528\u3044\u308b\u3002<\/li>\n<li>LRINEC\u30b9\u30b3\u30a2\u304c6\u70b9\u4ee5\u4e0a\u3067\u3042\u308c\u3070\u3001\u967d\u6027\u4e88\u6e2c\u5024\u304c92\uff05\u3001\u9670\u6027\u4e88\u6e2c\u5024\u304c96\uff05\u3067NSTI\u306e\u53ef\u80fd\u6027\u304c\u9ad8\u3044\u3068\u5224\u5b9a\u3055\u308c\u308b\u3002<\/li>\n<li>\u4e00\u65b9\u3067\u3001LRINEC\u30b9\u30b3\u30a2\u304c0\u70b9\u3067\u3042\u3063\u305fNSTI\u3082\u5831\u544a\u3055\u308c\u3066\u304a\u308a<sup>(7)<\/sup>\u3001\u63a1\u8840\u30c7\u30fc\u30bf\u306b\u5909\u5316\u304c\u3067\u3066\u3044\u306a\u3044\u65e9\u671f\u306eNSTI\u306e\u8a3a\u65ad\u3084\u9664\u5916\u306b\u306f\u9650\u754c\u304c\u3042\u308b\u3068\u3044\u308f\u308c\u3066\u3044\u308b\u3002<\/li>\n<\/ul>\n<p style=\"padding-left: 40px;\"><span style=\"font-size: 70%;\">(6) Wong CH, et al. The Laboratory risk indicator for necrotizing fasciitis) score: a tool for distinguishing necrotizing fasciitis from other soft tissue infections. Crit Care Med 2004;32:1535-1541.<\/span><\/p>\n<p style=\"padding-left: 40px;\"><span style=\"font-size: 70%;\">(7) Wilson MP, et al. A Case of Necrotizing Fasciitis with a LRINEC Score of Zero : Clinical Suspicion Should Trump Scoring Systems. J Emerg Med 2013;44:928-931.<\/span><\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<h4 class=\"st-matome\"><span class=\"ez-toc-section\" id=\"%E8%A8%BA%E6%96%AD%E3%81%AE%E6%B1%BA%E3%82%81%E6%89%8B%EF%BC%9A%E8%A9%A6%E9%A8%93%E5%88%87%E9%96%8B%E3%81%A8finger_test\"><\/span><strong>\u8a3a\u65ad\u306e\u6c7a\u3081\u624b\uff1a\u8a66\u9a13\u5207\u958b\u3068finger test<br \/>\n<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h4>\n<ul>\n<li>\u4e0a\u8a18\u304b\u3089\u308f\u304b\u308b\u3088\u3046\u306bNSTI\u306e\u65e9\u671f\u8a3a\u65ad\u306f\u975e\u5e38\u306b\u96e3\u3057\u3044\u3002<\/li>\n<li>\u8a3a\u65ad\u306e\u6c7a\u3081\u624b\u3068\u3057\u3066\u6700\u3082\u4fe1\u983c\u6027\u304c\u9ad8\u3044\u306e\u306f\u3001<span class=\"bmarker\">\u8a66\u9a13\u5207\u958b<\/span>\u3068<span class=\"bmarker\">finger test<\/span>\u3067\u3042\u308b\u3002<\/li>\n<li>\u5916\u6765\u3084\u30d9\u30c3\u30c9\u30b5\u30a4\u30c9\u3067\u5c40\u6240\u9ebb\u9154\u4e0b\u306b\u6570cm\u306e\u76ae\u819a\u5207\u958b\u3092\u3057\u3001<span class=\"bmarker\">\u60aa\u81ed\u3092\u4f34\u3046\u6fc1\u3063\u305f\u6db2\u4f53\u306e\u6392\u51fa\uff08dishwater brown fluid\uff09<\/span>\u3092\u8a8d\u3081\u3001<span class=\"bmarker\">\u6307\u3067\u76ae\u4e0b\uff08\u6d45\u7b4b\u819c\u30ec\u30d9\u30eb\uff09\u3092\u62b5\u6297\u306a\u304f\u5265\u96e2\u3059\u308b\u3053\u3068\u304c\u3067\u304d\u308b\u5834\u5408\uff08finger test\u967d\u6027\uff09<\/span>\u306f\u3001NSTI\u306e\u53ef\u80fd\u6027\u304c\u6975\u3081\u3066\u9ad8\u3044\u3002<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<h4 class=\"st-matome\"><span class=\"ez-toc-section\" id=\"%E5%A4%96%E7%A7%91%E7%9A%84%E6%B2%BB%E7%99%82\"><\/span><strong>\u5916\u79d1\u7684\u6cbb\u7642<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h4>\n<ul>\n<li>NSTI\u306f\u53ef\u80fd\u306a\u9650\u308a\u65e9\u671f\u306b<span class=\"bmarker\">\u5916\u79d1\u7684\u30c7\u30d6\u30ea\u30fc\u30c9\u30de\u30f3<\/span>\u3092\u8981\u3059\u308b\u75c5\u614b\u3067\u3042\u308b\u3002<\/li>\n<li>\u53d7\u8a3a \u5f8c\uff1c 24 \u6642\u9593\u306b\u624b\u8853\u3092\u884c\u3063\u305f\u60a3\u8005\u306e\u307b\u3046\u304c \uff1e24 \u6642\u9593\u7d4c\u904e\u5f8c\u306b\u624b\u8853\u3092\u884c\u3063\u305f\u60a3\u8005\u3088\u308a\u751f \u5b58\u7387\u304c\u9ad8\u304f\u3001\u22666 \u6642\u9593\u306b\u624b\u8853\u3092\u884c\u3048\u3070\u3055\u3089\u306b \u751f\u5b58\u7387\u3092\u6539\u5584\u3059\u308b\u3053\u3068\u304b\u304c\u3067\u304d\u308b\u3068\u3044\u3046\u5831\u544a\u3082\u3042\u308b<sup>(8)<\/sup>\u3002<\/li>\n<\/ul>\n<p style=\"padding-left: 40px;\"><span style=\"font-size: 70%;\">(8) Stevens DL, et al. Necrotizing soft\u2012tissue infections. N Engl J Med 2017;377:2253\u20122265.<\/span><\/p>\n<ul>\n<li>\u96c6\u4e2d\u6cbb\u7642\u5ba4\u3067\u5168\u8eab\u7ba1\u7406\u304c\u53ef\u80fd\u306a\u75c5\u9662\u3067\u306e\u6cbb\u7642\u304c\u5fc5\u9808\u3067\u3042\u308b\u3002<\/li>\n<li>\u521d\u56de\u624b\u8853\u3067\u3069\u3053\u307e\u3067\u75c5\u5909\u90e8\u3092\u5207\u9664\u3067\u304d\u308b\u304b\u304c\u751f\u547d\u4e88\u5f8c\u306b\u76f4\u7d50\u3059\u308b\u305f\u3081\u3001\u751f\u304d\u3066\u3044\u308b\u7d44\u7e54\u306b\u5230\u9054\u3059\u308b\u307e\u3067\u58ca\u6b7b\u3057\u305f\u75c5\u5909\u306f\u5fb9\u5e95\u7684\u306b\u5207\u9664\u3059\u308b\u3002<\/li>\n<li>\u5275\u306f\u958b\u653e\u7ba1\u7406\u3068\u3057\u3001\u9031\u306b2\u301c3\u56de\u306e\u30da\u30fc\u30b9\u3067\u611f\u67d3\u5fb4\u5019\u304c\u843d\u3061\u7740\u304f\u307e\u3067\u5275\u306e\u518d\u8a55\u4fa1\u3068\u30c7\u30d6\u30ea\u30fc\u30c9\u30de\u30f3\u3092\u304f\u308a\u8fd4\u3059\uff082nd look\u30013rd look\u3068\u547c\u3076\uff09\u3002<\/li>\n<li>\u5275\u51e6\u7f6e\u6642\u306e\u5916\u7528\u5264\u306f<span class=\"bmarker\">\u30dd\u30d4\u30c9\u30f3\u30e8\u30fc\u30c9\u30b2\u30eb<\/span>\u3084<span class=\"bmarker\">\u30b9\u30eb\u30d5\u30a1\u30b8\u30a2\u30b8\u30f3\u9280\u30af\u30ea\u30fc\u30e0\uff08\u30b2\u30fc\u30d9\u30f3<sup>\u00ae<\/sup>\uff09<\/span>\u3092\u7528\u3044\u308b\u3053\u3068\u304c\u591a\u3044\u3002<\/li>\n<li>\u5b8c\u5168\u306b\u58ca\u6b7b\u7d44\u7e54\u304c\u9664\u53bb\u3067\u304d\u305f\u3053\u3068\u3092\u78ba\u8a8d\u3057\u3066\u304b\u3089\u9589\u5275\u3092\u3059\u308b\u3002\u9589\u5275\u307e\u3067\u306e\u9593\u306b\u9670\u5727\u9589\u9396\u7642\u6cd5\u3092\u4f75\u7528\u3059\u308b\u3053\u3068\u3082\u3042\u308b\u3002\u30c7\u30d6\u30ea\u30fc\u30c9\u30de\u30f3\u6642\u306b\u76ae\u819a\u3082\u540c\u6642\u306b\u5207\u9664\u3055\u308c\u3066\u3044\u308b\u3053\u3068\u304c\u591a\u3044\u305f\u3081\u3001\u9589\u5275\u6642\u306b\u5206\u5c64\u690d\u76ae\u3092\u8981\u3059\u308b\u3053\u3068\u304c\u591a\u3044\u3002<\/li>\n<li>\u6297\u751f\u5264\u306e\u9078\u629e\u306f\u3001\u30b0\u30e9\u30e0\u67d3\u8272\u3067\u30b0\u30e9\u30e0\u967d\u6027\u9023\u9396\u7403\u83cc\u3001\u3082\u3057\u304f\u306fA\u7fa4\u03b2\u6eb6\u8840\u9023\u9396\u7403\u83cc\u6297\u539f\u30ad\u30c3\u30c8\u3067\u967d\u6027\u304c\u78ba\u8a8d\u3067\u304d\u308c\u3070<span class=\"bmarker\">\u30da\u30cb\u30b7\u30ea\u30f3<\/span>\u6295\u4e0e\u304c\u539f\u5247\u3067\u3042\u308b\u3002\u78ba\u8a8d\u3067\u304d\u306a\u3044\u5834\u5408\u306f<span class=\"bmarker\">\u30ab\u30eb\u30d0\u30da\u30cd\u30e0\u7cfb\u306e\u6297\u83cc\u85ac<\/span>\u3092\u9078\u629e\u3059\u308b\u3002<\/li>\n<li>\u307e\u305fNSTI\u306f\u6bd2\u7d20\u304c\u539f\u56e0\u3067\u7d44\u7e54\u58ca\u6b7b\u304c\u9032\u884c\u3059\u308b\u305f\u3081\u3001\u86cb\u767d\uff08\u6bd2\u7d20\uff09\u5408\u6210\u963b\u5bb3\u85ac\u3067\u3042\u308b<span class=\"bmarker\">\u30af\u30ea\u30f3\u30c0\u30de\u30a4\u30b7\u30f3<\/span>\u3092\u4e0a\u8a18\u306e\u6297\u751f\u5264\u306b\u8ffd\u52a0\u3059\u308b\u3053\u3068\u304c\u63a8\u5968\u3055\u308c\u3066\u3044\u308b\u3002\u307e\u305f\u3001A\u7fa4\u03b2\u6eb6\u9023\u83cc\u306b\u3088\u308b\u91cd\u75c7\u4f8b\u3067\u306f\u30ac\u30f3\u30de\u30b0\u30ed\u30d6\u30ea\u30f3\u6295\u4e0e\u3082\u691c\u8a0e\u3059\u308b\u3002<\/li>\n<\/ul>\n<p>&nbsp;<\/p>","protected":false},"excerpt":{"rendered":"<p>\u5b9a\u7fa9 \u58ca\u6b7b\u6027\u8edf\u90e8\u7d44\u7e54\u611f\u67d3\u75c7\uff08necrotizing soft tissue infection: \u4ee5\u4e0b\u3001NSTI\uff09\u306f\u3001\u8edf\u90e8\u7d44\u7e54\uff08\u76ae\u819a\u3001\u76ae\u4e0b\u7d44\u7e54\u3001\u6d45\u7b4b\u819c\u3001\u6df1\u7b4b\u819c\u3001\u7b4b\u8089\uff09\u306e\u3044\u305a\u308c\u304b\u306e\u90e8\u4f4d\u304b\u3089\u6025\u901f\u304b\u3064\u5e83\u7bc4\u56f2 &#8230; <\/p>","protected":false},"author":2,"featured_media":4314,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[29,7],"tags":[659,1444,1443,658,413,414,1442],"class_list":{"0":"post-4824","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","6":"hentry","7":"category-er","8":"category-plastic-surgery","9":"tag-a","11":"tag-lrinec","12":"tag-nsti","13":"tag-413","14":"tag-414","15":"tag-1442"},"_links":{"self":[{"href":"https:\/\/imedica.jp\/en\/wp-json\/wp\/v2\/posts\/4824","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/imedica.jp\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/imedica.jp\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/imedica.jp\/en\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/imedica.jp\/en\/wp-json\/wp\/v2\/comments?post=4824"}],"version-history":[{"count":5,"href":"https:\/\/imedica.jp\/en\/wp-json\/wp\/v2\/posts\/4824\/revisions"}],"predecessor-version":[{"id":5959,"href":"https:\/\/imedica.jp\/en\/wp-json\/wp\/v2\/posts\/4824\/revisions\/5959"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/imedica.jp\/en\/wp-json\/wp\/v2\/media\/4314"}],"wp:attachment":[{"href":"https:\/\/imedica.jp\/en\/wp-json\/wp\/v2\/media?parent=4824"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/imedica.jp\/en\/wp-json\/wp\/v2\/categories?post=4824"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/imedica.jp\/en\/wp-json\/wp\/v2\/tags?post=4824"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}