腹部大動脈瘤、動脈閉塞症といった動脈疾患、下肢静脈瘤や深部静脈血栓症などの静脈疾患、リンパ管疾患等、血管外科全般にわたります。
※ただし、当院では、「心臓」・「胸部大動脈疾患」の手術はできません。盛岡市または仙台市の病院へ紹介させていただいております。
岩手県南地域で唯一の血管外科として、奥州胆沢地域に限らず、県南・沿岸部各地からの患者様に治療を行っています。
血管外科専門外来は、毎週 月・水・木曜日 午前中(祝日等休診日を除く)です。
完全予約制になっており、かかりつけ医からの紹介状が必要です。
・足がむくむ、足の血管がボコボコしている。足がつる(下肢静脈瘤の可能性があります)。
・足が冷える、歩くと足が痛い。長い距離歩けない、坂道・階段が登れない(足の血流が低下している可能性があります)。
・おなかがドクドクする、おなかに心臓があるようだ(腹部動脈瘤の可能性があります)。
このような症状の方は、かかりつけ・開業医にご相談のうえ、紹介状をもらって受診してください。
医療機関からの紹介につきましては、当院紹介センター宛にFAX(0197-24-4180)等にてご紹介ください。
また、急を要すると判断されました患者さんにつきましては、随時対応いたしますので
直接お電話(0197-24-4121)にてご連絡ください。
(平日診療時間内には外科外来、土日夜間の診療時間外は救急外来にて対応いたします。)
遠方で当院まで通院が困難な術後の患者様の外来フォローアップのため、県立中部病院・磐井病院・大船渡病院へ、月1回出張外来も行っております。
腹部大動脈瘤は、ステントグラフト手術(カテーテル手術)と、開腹人工血管置換術の2通りの手術方法があります。個々の患者様の病状により、最適な治療法を提示いたします。
ステントグラフト手術は、本邦で使用可能な全機種の指導・実施資格を持った専門医が、患者様に最適なデバイスを選択して治療を行います。
腹部大動脈瘤に対するステントグラフト治療
下肢の血流障害のある患者様に対しては、血栓除去・カテーテル血管拡張・ステント留置術や、通常のバイパス術の他、重症虚血肢に対するDistalBypass(ディスタルバイパス:足首、足先までの血管バイパス)、植皮・陰圧閉鎖療法・吸着式血液浄化療法(レオカーナ)なども行い、特定行為研修修了認定看護師とともに、慢性創傷・フットケア外来を開設し、下肢救済足病治療を積極的に行っています。
CLTIに対する治療
下肢静脈瘤は、下肢静脈瘤診療ガイドライン(日本皮膚科学会)、下肢静脈瘤に対する血管内焼灼術のガイドライン(日本脈管学会・日本静脈学会)に則り、適正な適応判断を行い、治療を行っております。
リンパ浮腫については専門資格(リンパドレナージセラピスト、リンパ浮腫療法士)をもった看護師、理学療法士による弾性着衣や包帯による圧迫、圧迫した状態での運動、リンパドレナージ、スキンケア、セルフケアを組み合わせた「リンパ浮腫複合的治療」を保険診療にて行っています。なお、厚生労働省の指針により、保険診療の適応となるのは、「鼠径部、骨盤部若しくは腋窩部のリンパ節郭清を伴う悪性腫瘍に対する手術を行った患者又は原発性リンパ浮腫と診断された患者」に限られます。また、リンパ管吻合等の手術治療は行っておりません。
血管外科疾患の詳細な説明は、
下記の学会ホームページ等の解説をご参照ください。
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)
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)
<2008年~2023年 血管外科の手術実績の推移>
<2023年の血管外科関連手術 内訳>
【動脈瘤】
・腹部大動脈瘤・腸骨動脈瘤 70例
ステントグラフト術 55例
開腹人工血管置換術 15例
【静脈瘤】
・下肢静脈瘤 28例
レーザー・高周波治療 27例
【末梢動脈疾患】
・急性下肢虚血(非動脈硬化) 血栓除去術 7例
・慢性虚血・閉塞性動脈硬化症 91例
血管内治療(カテーテル手術)単独 35例
バイパス手術・ハイブリッド手術(*) 56例
(うち下腿・足部へのディスタルバイパス術 10例)
((*)ハイブリッド手術とは、カテーテル手術とバイパス手術を組み合わせて、効率的かつ低侵襲に下肢の血流改善を行う手術方法です。)
【その他】 77例
血管外傷、仮性動脈瘤、末梢動脈瘤、人工血管感染手術、下肢足趾切断、デブリドマンなど
当院は、心臓血管外科専門医・修練指導医、脈管学会専門医が在籍し、下記施設認定を受けています。
・3学会構成心臓血管外科専門医認定機構 認定修練基幹施設
・日本脈管学会認定施設
・下肢静脈瘤血管内焼灼術実施施設
(*)慢性維持透析患者の下肢末梢動脈疾患指導管理加算について
平成28年診療報酬改定より、「慢性維持透析患者の下肢末梢動脈疾患指導管理加算 100点(1月につき)」として掲載され、実施されています。慢性維持透析患者全員のPADを評価し、療養上必要な指導管理を行い、ABI 0.7以下またはSPP 40mmHg以下の患者は、本人同意を得て連携先の専門医療機関へ紹介することで算定できます。当院は、連携先の専門医療機関となっています。)
江戸川病院血管病センターとの連携について
当科において、血管病ならびに血管外科のご専門である江戸川病院血管病センター長・笹嶋先生よりご指導、連携をいただいております。
→江戸川病院血管病センター長 笹嶋先生のホームページはこちらをクリック←
東北大学病院 総合外科(血管外科グループ)との連携
当科は、東北大学病院 総合外科(血管外科グループ) と診療、研究、専門医師教育において、相互連携を行っております。
当科で実施中の多施設共同臨床研究
当院 血管外科では、全国多施設と共同連携し、下記の研究に参加しています。
〇破裂性腹部大動脈瘤に対する開腹手術とステントグラフト内挿術の治療選択に関する全国多施設観察研究
〇腹部大動脈領域の人工血管・ステントグラフト感染に対する術式と予後に関する後向き研究
〇下肢重症虚血患者に対する血行再建術後の、最適皮膚潅流圧測定日の検討
〇脈管疾患に関する多施設疫学研究