ື⬦㥽

ྑᐊ⫧኱

ྑᡣ

ྑᐊ

ᕥᐊ ᕥᡣ

⫵ື⬦

⫵⾑ὶῶᑡ

ࢳ࢔ࣀ࣮ࢮ ࠶ࡾ

䝣䜯䝻−ᅄᚩ⑕

ᚰᐊ୰㝸Ḟᦆ㛢㙐⾡

䠇

ྑᐊὶฟ㊰ᙧᡂ⾡

э㻌 ྑᐊὶฟ㊰㻌 ⊃✽䠇㏫ὶ

ᚰᐊ୰㝸Ḟᦆ

⫵ື⬦⊃✽

኱ື⬦㥽஌

ᑵᏛ࣭ᑵປ

ᏛṔ㸸㧗ᰯ ᬑ㏻Ꮫ⣭ࢆ༞ᴗࠊ㐍Ꮫࡏࡎࠋ

ᑵ⫋㸸࢔ࣝࣂ࢖ࢺࡢ⤒㦂ࡣ࠶ࡿࡀࠊ⥅⥆࡛ࡁࡎࠋ ⤥୚㸸࡞ࡋ㹼୙ᐃ

♫఍ಖ㞀

㌟య㞀ᐖ⪅ᡭᖒ㸸 㸱⣭

⒪⫱ᡭᖒ 㸸 ࡞ࡋ㸦▱ⓗ㞀ᐖ࡞ࡋ㸧 㔜ᗘᚰ㌟㞀ᐖ⪅་⒪㈝ຓᡂไᗘ㸸 ࡞ࡋ ་⒪㈝㸸 ᭷ᩱ

㞀ᐖᇶ♏ᖺ㔠 㸸 㸰⣭

⌧≧

ᚰᶵ⬟Ᏻᐃ

⫵ື⬦ᘚ⨨᥮⾡ᚋࠊᑵ⫋ᕼᮃ ᑵປᨭ᥼

Department of Pediatric Cardiology, Children‘s Medical Center, Ehime University Hospital

䠏䠑ṓ㻌 ⏨ᛶ䚸䝣䜯䝻䞊ᅄᚩ⑕⾡ᚋ

㸯⣭

࡞ࡋ

࠶ࡾ

↓ᩱ

㸯⣭

⏕ά䜢ᨭ䛘䜛♫఍ಖ㞀ไᗘ䠄♫఍⚟♴䠅㻌 㻌

ᖺ㱋㻌㻌 ㄌ⏕㻌

䠄䠌ṓ䠅㻌㻌ᑵᏛ๓㻌㻌 ᑵᏛᮇ㻌 䠄䠒ṓ䡚㻝㻤ṓ䠅㻌㻌

Ꮚ⫱䛶䞉ᑵປᮇ㻌

䠄㻞㻜ṓ䡚㻌 㻠㻜ṓ㻌 㻢㻜ṓ㻌 ㏥⫋ᚋ㻌 䠄㻢㻡ṓ䡚㻌 㻣㻜ṓ䡚㻌

㻌 㻌 ಖ⫱ᡤ㻌㻌㻌 㻌 ௓ㆤಖ㝤㻌 㻌 㻌 㻌 㻌

㻌 㻌 ẕᏊᐙᗞ➼᪥ᖖ⏕άᨭ᥼஦ᴗ㻌㻌 㧗㱋⪅⚟♴㻌

㻌 㻌 㔛ぶጤク㻌 㻌 㻌㻌㻌 㻌 㣴ㆤ⪁ே䝩䞊䝮㻌 㻌 㻌

㻌 㻌 ඣ❺㣴ㆤ᪋タ㻌㻌㻌 㻌㻌㻌 㻌

㻌 㻌 ⒪⫱ᡭᖒ㻌㻌 㻌㻌㞀ᐖ⪅⮬❧ᨭ᥼ἲ䛻䜘䜛㻌 㻌 㻌 㻌 㻌 㻌 㻌

㻌 㻌 ⢭⚄㞀ᐖ⪅ಖ೺⚟♴ᡭᖒ㻌 㻌 ྛ✀䝃䞊䝡䝇䛾฼⏝㻌 㻌 㻌

㻌 㻌 ㌟య㞀ᐖ⪅ᡭᖒ㻌䠄⮬❧ᨭ᥼⤥௜䞉ᆅᇦ⏕άᨭ᥼஦ᴗ䠅㻌 㻌 㻌 㻌 㻌

♫

఍

⚟

♴ 同 呎 吪吐

ྛ✀䛾᭦⏕᥼ㆤ䜢ཷ䛡䜛䛯䜑䛾๓ᥦ䛸䛺䜛䚹

㻌 ⏕ά䜢ᨭ䛘䜛♫఍ಖ㞀ไᗘ䠄ಖ೺䞉་⒪䠅㻌 㻌

ᖺ㱋㻌㻌 㻌 㻌 ㄌ⏕䠄䠌ṓ䠅㻌 ᑵᏛ๓㻌 ᑵᏛᮇ㻌 䠄䠒ṓ䡚㻝㻤ṓ䠅㻌㻌

Ꮚ⫱䛶䞉ᑵປ ᮇ䠄㻞㻜ṓ䡚㻌

㻠㻜 ṓ ṓ㻌

㏥⫋ᚋ㻌 䠄㻢㻡ṓ䡚㻌

㻣㻜ṓ䡚㻌 㻌 㻌 ẕᏊ

೺ᗣ ᡭᖒ㻌

ᐙᗞゼၥ㻌 ஙᗂඣ೺デ㻌㻌 ^{㻌 㻌}

㻌 㻌 ᮍ⇍ඣ㣴⫱་⒪㈝ຓᡂ㻌 ^{㻌 㻌}

㻌 㻌 㻌 㻌 㻌 ண㜵᥋✀㻌 Ꮫᰯಖ೺㻌 ೺デ஦ᴗ䠄⪁ேಖ೺䠅

೺

೺ᗣᡭᖒ஺௜㻌 ^{㻌 㻌}

㻌 㻌 㻌 㻌 ஙᗂඣ་⒪㈝ຓᡂ㻌 ^{㻌 㻌}

㻌 㻌 㻌 㻌 ẕᏊᐙᗞ་⒪㈝ຓᡂ㻌 㻌 㻌 ^{㻌 㻌}

㻌 㻌 㻌 㻌 㔜ᗘᚰ㌟㞀ᐖ⪅་⒪㈝ຓᡂ㻌 ^{㻌 㻌 㻌 㻌 㻌 㻌 㻌 㻌 㻌 㻌}

㻌 㻌 ་⒪ಖ೺䠄ᅜẸ೺ᗣಖ㝤䞉♫఍ಖ㝤䞉ྛ✀ඹ῭䞉⯪ဨ䛺䛹䠅㻌㻌 㻌 ㏥⫋⪅་⒪㻌㻌 ⪁ேಖ೺་⒪㻌㻌

㻌 㻌 㻌 㻌 ᑠඣ៏ᛶ≉ᐃ⑌ᝈ἞⒪◊✲஦ᴗ㻌 ≉ᐃ⑌ᝈ἞⒪◊✲஦ᴗ㻌 ^{㻌 㻌}

㻌 㻌 㻌 㻌 ⮬❧ᨭ᥼་⒪䠄⫱ᡂ་⒪䠅㻌 ⮬❧ᨭ᥼་⒪䠄᭦⏕་⒪䠅㻌 ^{㻌 㻌}

㻌 㻌 㻌 㻌 ⮬❧ᨭ᥼་⒪䠄⢭⚄㏻㝔་⒪䠅㻌 㻌 㻌 ^{㻌 㻌}

㻌 㻌 㻌 㻌 㧗㢠⒪㣴㈝䚸㧗㢠་⒪㈝ไᗘ㻌㻌 䊻ᶆ‽㈇ᢸ㝈ᗘ㢠ㄆᐃド䠄ධ㝔䛾䜏䠅㻌㻌

ಖ

೺ 䞉

་

⒪ ಖ 㞀㻌

㧗㢠་⒪㈝ไᗘ㻌 㻌

་⒪㈝㻌 100୓෇

㻌 㻌 㻌 㻌 㻌 э㻌 ❆ཱྀ䛷䛾㈇ᢸ䠄3๭䠅䛜䚸30୓෇䛛䛛䜛ሙྜ

212,570෇䜢㧗㢠⒪㣴㈝䛸䛧䛶ᨭ⤥䛧䚸ᐇ㝿䛾⮬ᕫ㈇ᢸ㢠䛿䚸87,430෇䚹 䊻㻌 ⮬ᕫ㈇ᢸ㝈ᗘ㢠㐺⏝ㄆᐃド㻌

㻌 㻌 㻌 㻌 㻌 㻌 㻌 㻌 㻌 ᖹᡂ㻞㻠ᖺ㻠᭶䡚㻌 እ᮶䜒ྍ㻌

㧗㢠་⒪㈝ไᗘ㻌 㻌

㧗㢠་⒪䞉㧗㢠௓ㆤྜ⟬⒪㣴㈝ไᗘ㻌

㻌 㧗㢠⒪㣴㈝ไᗘ䛜䛂᭶䛃༢఩䛷㈇ᢸ䜢㍍ῶ䛩䜛䛾䛻ᑐ䛧䚸ྜ⟬㻌 㻌 ⒪㣴㈝ไᗘ䛿䚸䛣䛖䛧䛯䛂᭶䛃༢఩䛷䛾㈇ᢸ㍍ῶ䛜䛒䛳䛶䜒䚸䛺䛚㻌 㻌 㻌 㔜䛔㈇ᢸ䛜ṧ䜛ሙྜ䛻䛂ᖺ䛃༢఩䛷䛭䜜䜙䛾㈇ᢸ䜢㍍ῶ䛩䜛ไᗘ㻌 㻌

་⒪㈝᥍㝖ไᗘ㻌

㻌 ୍ᐃ䛾㔠㢠䛾ᡤᚓ᥍㝖䛾䛣䛸㻌

䠄䠐ᅇ┠䛛䜙䠅

㻌 ⏕ά䜢ᨭ䛘䜛♫఍ಖ㞀ไᗘ䠄ಖ೺䞉་⒪䠅㻌 㻌

ᖺ㱋㻌㻌 㻌 㻌 ㄌ⏕䠄䠌ṓ䠅㻌 ᑵᏛ๓㻌 ᑵᏛᮇ㻌 䠄䠒ṓ䡚㻝㻤ṓ䠅㻌㻌

Ꮚ⫱䛶䞉ᑵປ ᮇ䠄㻞㻜ṓ䡚㻌

㻠㻜 ṓ ṓ㻌

㏥⫋ᚋ㻌 䠄㻢㻡ṓ䡚㻌

㻣㻜ṓ䡚㻌 㻌 㻌 ẕᏊ

೺ᗣ ᡭᖒ㻌

ᐙᗞゼၥ㻌 ஙᗂඣ೺デ㻌㻌 ^{㻌 㻌}

㻌 㻌 ᮍ⇍ඣ㣴⫱་⒪㈝ຓᡂ㻌 ^{㻌 㻌}

㻌 㻌 㻌 㻌 㻌 ண㜵᥋✀㻌 Ꮫᰯಖ೺㻌 ೺デ஦ᴗ䠄⪁ேಖ೺䠅

೺

೺ᗣᡭᖒ஺௜㻌 ^{㻌 㻌}

㻌 㻌 㻌 㻌 ஙᗂඣ་⒪㈝ຓᡂ㻌 ^{㻌 㻌}

㻌 㻌 㻌 㻌 ẕᏊᐙᗞ་⒪㈝ຓᡂ㻌 㻌 㻌 ^{㻌 㻌}

㻌 㻌 㻌 㻌 㔜ᗘᚰ㌟㞀ᐖ⪅་⒪㈝ຓᡂ㻌 ^{㻌 㻌 㻌 㻌 㻌 㻌 㻌 㻌 㻌 㻌}

㻌 㻌 ་⒪ಖ೺䠄ᅜẸ೺ᗣಖ㝤䞉♫఍ಖ㝤䞉ྛ✀ඹ῭䞉⯪ဨ䛺䛹䠅㻌㻌 㻌 ㏥⫋⪅་⒪㻌㻌 ⪁ேಖ೺་⒪㻌㻌

㻌 㻌 㻌 㻌 ᑠඣ៏ᛶ≉ᐃ⑌ᝈ἞⒪◊✲஦ᴗ㻌 ≉ᐃ⑌ᝈ἞⒪◊✲஦ᴗ㻌 ^{㻌 㻌}

㻌 㻌 㻌 㻌 ⮬❧ᨭ᥼་⒪䠄⫱ᡂ་⒪䠅㻌 ⮬❧ᨭ᥼་⒪䠄᭦⏕་⒪䠅㻌 ^{㻌 㻌}

㻌 㻌 㻌 㻌 ⮬❧ᨭ᥼་⒪䠄⢭⚄㏻㝔་⒪䠅㻌 㻌 㻌 ^{㻌 㻌}

㻌 㻌 㻌 㻌 㧗㢠⒪㣴㈝䚸㧗㢠་⒪㈝ไᗘ㻌㻌䊻ᶆ‽㈇ᢸ㝈ᗘ㢠ㄆᐃド䠄ධ㝔䛾䜏䠅㻌㻌

ಖ

೺ 䞉

་

⒪ ಖ 㞀㻌

බ㈝㈇ᢸ

ຓᡂไᗘ㻌

⫱ᡂ་⒪䠄ඣ❺⚟♴ἲ䠅㻌

᭦⏕་⒪䠄㌟య㞀ᐖ⪅⚟♴ἲ䠅㻌㻌㻌㻌

⢭⚄㏻㝔་⒪㈝ຓᡂ㻌㻌㻌㻌㻌㻌㻌㻌㻌㻌㻌㻌㻌㻌㻌㻌㻌

⫱ᡂ་⒪䠄䠍䠔ṓᮍ‶䠅䠖㌟య䛻㞀ᐖ䛾䛒䜛ඣ❺ཪ䛿䛭䛾䜎䜎ᨺ⨨㻌 㻌 㻌 䛩䜛䛸ᑗ᮶㞀ᐖ䜢ṧ䛩䛸ㄆ䜑䜙䜜䜛⑌ᝈ䛜䛒䜛ඣ❺

᭦⏕་⒪䠄䠍䠔ṓ௨ୖ䠅䠖㌟య㞀ᐖ⪅⚟♴ἲ➨䠐᮲䛻つᐃ䛩䜛㌟య㻌 㻌 㻌 㞀ᐖ⪅䛷䚸䛭䛾

㞀ᐖ䜢㝖ཤ䞉㍍ῶ䛩䜛ᡭ⾡➼䛾἞⒪㻌

㻌 㻌䛻䜘䛳䛶☜ᐇ䛻ຠᯝ䛜ᮇᚅ䛷䛝䜛䜒䛾䛻ᑐ䛧䛶ᥦ౪䛥䜜䜛䚸᭦⏕

㻌 㻌 䛾䛯䜑䛻ᚲせ䛺⮬❧ᨭ᥼་⒪㈝䛾ᨭ⤥䜢⾜䛖䜒䛾䚹

⮬❧ᨭ᥼་⒪䠄⫱ᡂ་⒪䠋᭦⏕་⒪䠅㻌 㻌

㌟య㞀ᐖ⪅ᡭᖒ䠄4⣭䠅㻌 䠇㻌 ᭦⏕་⒪䠄䠍䠔ṓ௨ୖ䠅

ᴾᵐᵎᵎᵔ࠰ᴾᨦܹᎍᐯᇌૅੲඥỆợụᐯᇌૅੲҔၲỆɟΨ҄ᴾ 㻌 㻌 ⫱ᡂ་⒪㻌

㻌 㻌 ᭦⏕་⒪㻌

㻌 㻌 ⢭⚄㏻㝔་⒪㈝ຓᡂ㻌

ᚰ⮚ᡭ⾡䞉䜹䝔䞊䝔䝹἞⒪䛾་⒪㈝ຓᡂ

ᑠඣ៏ᛶ≉ᐃ⑌ᝈ἞⒪◊✲஦ᴗ䠄514⑌ᝈ䠅 㻌 㻌 ඣ❺⚟♴ἲ䛻䜒䛸䛵䛟ᚰ⮚⑓䛾ෆ⛉ⓗ἞⒪䜈䛾⿵ຓ

㻌 㻌 ⑌⑓ྡ䛤䛸䛻ᇶ‽㻌 ⤒㐣ほᐹ䛺䛹䛿㐺⏝䛥䜜䛺䛔

≉ᐃ⑌ᝈ἞⒪◊✲஦ᴗ䠄56⑌ᝈ䠅

㻌 㻌 ᕼᑡᛶ䚸἞⒪ἲ䛜☜❧䛧䛶䛔䛺䛔⑌ᝈ䛜ᑐ㇟

㻌 㻌 ἞⒪◊✲஦ᴗ䛸䛔䛖ᅜ䛾ண⟬஦ᴗ

㻌 㻌 ᑠඣ䛛䜙䛾⥅⥆ⓗ䛺἞⒪⿵ຓ䛸䛺䛳䛶䛔䛺䛔䚹

㞴⑓࣭៏ᛶ⑌ᝈᑐ⟇㸦ᑠ៏㸭≉ᐃ⑌ᝈ㸧㻌 㻌

ຓ ෆ⛉ⓗ἞⒪䜈䛾་⒪㈝ຓᡂ

㞴἞ᛶ⑌ᝈඞ᭹◊✲஦ᴗ䠄130⑌ᝈ䠅

㻌 ⑕౛ᩘ䛜ᑡ䛺䛟䚸ཎᅉ୙᫂䛷἞⒪᪉ἲ䜒ᮍ☜❧䛷䛒䜚䚸䛛䛴⏕ά 㠃䛷㛗ᮇ䛻䜟䛯䜛ᨭ㞀䛜䛒䜛⑌ᝈ䛻䛴䛔䛶䚸◊✲⌜䜢タ⨨䛧䚸ཎᅉ 䛾✲᫂䚸἞⒪᪉ἲ䛾☜❧䛻ྥ䛡䛯◊✲䜢⾜䛖䜒䛾䚹

㞀ᐖ⪅⥲ྜᨭ᥼ἲ䠖㞀ᐖ⪅䛾ᐃ⩏䛻

㞴⑓

䛜㏣ຍ

⬨㧊ᑠ⬻ኚᛶ⑕㻌 䝅䝱䜲䞉䝗䝺䞊䜺䞊⑕ೃ⩌㻌 䝰䝲䝰䝲⑓

䠄䜴䜱䝸䝇ື⬦㍯㛢ሰ⑕䠅㻌 ṇᖖᅽỈ㢌⑕㻌 ከⓎᛶ◳໬⑕㻌 㔜⑕➽↓ຊ⑕㻌 䜼䝷䞁䞉䝞䝺䞊⑕ೃ⩌㻌 䝣䜱䝑䝅䝱䞊⑕ೃ⩌㻌

៏ᛶ⅖⑕ᛶ⬺㧊ᛶከⓎ⚄⤒⅖㻌 ከᕢᛶ㐠ື䝙䝳䞊䝻䝟䝏䞊 䠄䝹䜲䝇䞉䝃䝮䝘䞊⑕ೃ⩌䠅㻌 ༢䜽䝻䞊䞁ᢠయ䜢క䛖ᮎᲈ⚄⤒⅖ 䠄䜽䝻䜴䞉䝣䜹䝉⑕ೃ⩌䠅 㻌

➽ⴎ⦰ᛶഃ⣴◳໬⑕㻌

⬨㧊ᛶ➽ⴎ⦰⑕㻌

⌫⬨㧊ᛶ➽ⴎ⦰⑕㻌

⬨㧊✵Ὕ⑕㻌 䝟䞊䜻䞁䝋䞁⑓㻌 䝝䞁䝏䞁䝖䞁⑓㻌 㐍⾜ᛶ᰾ୖᛶ㯞⑷㻌

⥺᮲య㯮㉁ኚᛶ⑕㻌 䝨䝹䜸䜻䝅䝋䞊䝮⑓㻌 䝷䜲䝋䝌䞊䝮⑓㻌 䜽䝻䜲䝒䝣䜵䝹䝖䞉䝲䝁䝤⑓㻌 䝀䝹䝇䝖䝬䞁䞉䝇䝖䝻䜲䝇䝷䞊䞉 㻌 䝅䝱䜲䞁䜹䞊⑓䠄GSS䠅 㻌

⮴Ṛᛶᐙ᪘ᛶ୙╀⑕㻌 ளᛴᛶ◳໬ᛶ඲⬻⅖(SSPE) 㻌 㐍⾜ᛶከᕢᛶⓑ㉁⬻⑕䠄PML䠅㻌 ᚋ⦪㠌ᖏ㦵໬⑕ 㻌 㯤Ⰽ㠌ᖏ㦵໬⑕ 㻌 ๓⦪㠌ᖏ㦵໬⑕㻌 ᗈ⠊⬨ᰕ⟶⊃✽⑕㻌

≉Ⓨᛶ኱⭣㦵㢌ቯṚ⑕㻌

≉Ⓨᛶ䝇䝔䝻䜲䝗ᛶ㦵ቯṚ⑕㻌

⥙⭷Ⰽ⣲ኚᛶ⑕㻌 ຍ㱋㯤ᩬኚᛶ㻌 㞴἞ᛶど⚄⤒⑕㻌

✺Ⓨᛶ㞴⫈㻌

≉Ⓨᛶ୧ഃᛶឤ㡢㞴⫈ 㻌

࣓ࢽ࢚࣮ࣝ⑓㻌 㐜ⓎᛶෆࣜࣥࣃỈ⭘㻌 PRLศἪ␗ᖖ⑕㻌 ࢦࢼࢻࢺࣟࣆࣥศἪ␗ᖖ⑕㻌 ADHศἪ␗ᖖ⑕㻌

୰ᯡᛶᦤ㣗␗ᖖ⑕㻌 ཎⓎᛶ࢔ࣝࢻࢫࢸࣟࣥ⑕㻌 ഇᛶప࢔ࣝࢻࢫࢸࣟࣥ⑕㻌 ࢢࣝࢥࢥࣝࢳࢥ࢖ࢻ᢬ᢠ⑕㻌

๪⭈㓝⣲Ḟᦆ⑕㻌

๪⭈పᙧᡂ(࢔ࢪࢯࣥ⑓)㻌 ഇᛶ๪⏥≧⭢ᶵ⬟పୗ⑕ 㻌

ࣅࢱ࣑ࣥDཷᐜᶵᵓ␗ᖖ⑕ 㻌 TSHཷᐜయ␗ᖖ⑕㻌

⏥≧⭢࣍ࣝࣔࣥ୙ᛂ⑕ 㻌

෌⏕୙Ⰻᛶ㈋⾑㻌

⁐⾑ᛶ㈋⾑㻌 㸦⮬ᕫච␿ᛶ⁐⾑ᛶ㈋⾑䞉

Ⓨసᛶኪ㛫⾑Ⰽ⣲ᒀ⑕㸧㻌

୙ᛂᛶ㈋⾑(㦵㧊␗ᙧᡂ⑕ೃ⩌)㻌 㦵㧊⥺⥔⑕㻌

≉Ⓨᛶ⾑ᰦ⑕㻌

⾑ᰦᛶ⾑ᑠᯈῶᑡᛶ⣸ᩬ⑓㻌

≉Ⓨᛶ⾑ᑠᯈῶᑡᛶ⣸ᩬ⑓㻌 㹇㹥㸿⭈⑕ 㻌 ᛴ㏿㐍⾜ᛶ⣒⌫య⭈⅖ 㻌 㞴἞ᛶࢿࣇ࣮ࣟࢮ⑕ೃ⩌㻌 ከⓎᛶᄞ⬊⭈ 㻌

⫧኱ᆺᚰ➽⑕㻌

≉Ⓨᛶᣑᙇᆺ䠄䛖䛳⾑ᆺ䠅ᚰ➽⑕

ᣊ᮰ᆺᚰ➽⑕㻌

࣑ࢺࢥࣥࢻࣜ࢔⑓

㻲㼍㼎㼞㼥⑓

ᐙ᪘ᛶ✺↛Ṛ⑕ೃ⩌

ཎⓎᛶ㧗⬡⾑⑕

≉Ⓨᛶ㛫㉁ᛶ⫵⅖ ࢧࣝࢥ࢖ࢻ࣮ࢩࢫ ࡧࡲࢇᛶỗ⣽Ẽ⟶ᨭ⅖㻌

₽⒆ᛶ኱⭠⅖ ࢡ࣮ࣟࣥ⑓

⮬ᕫච␿ᛶ⫢⅖ ཎⓎᛶ⫹Ồᛶ⫢◳ኚ

๻⑕⫢⅖

≉Ⓨᛶ㛛⬦ᅽஹ㐍⑕㻌

⫢እ㛛⬦㛢ሰ⑕

㻮㼡㼐㼐㻙㻯㼔㼕㼍㼞㼕⑕ೃ⩌㻌

⫢ෆ⤖▼⑕

⫢ෆ⫹⟶㞀ᐖ

⮅ᄞ⬊⥺⥔⑕

㔜⑕ᛴᛶ⮅⅖

៏ᛶ⮅⅖

࢔࣑ࣟ࢖ࢻ࣮ࢩࢫ

࣮࣋ࢳ࢙ࢵࢺ⑓

඲㌟ᛶ࢚ࣜࢸ࣐ࢺ࣮ࢹࢫ ከⓎᛶ➽⅖࣭⓶⭵➽⅖ ࢩ࢙࣮ࢢࣞࣥ⑕ೃ⩌

ᡂேࢫࢸ࢕ࣝ⑓

㧗Ᏻ⑓䠄኱ື⬦⅖⑕ೃ⩌䠅㻌

ࣂ࣮ࢪ࣮ࣕ⑓

⤖⠇ᛶከⓎື⬦⅖

࢙࢘ࢤࢼ࣮⫗ⱆ⭘⑕

࢔ࣞࣝࢠ࣮ᛶ⫗ⱆ⭘ᛶ⾑⟶⅖

ᝏᛶ㛵⠇࣐ࣜ࢘ࢳ

ഃ㢌ື⬦⅖ ᢠࣜࣥ⬡㉁ᢠయ⑕ೃ⩌

ᙉ⓶⑕

ዲ㓟⌫ᛶ➽⭷⅖

◳໬ᛶⴎ⦰ᛶⱏⓄ

ཎⓎᛶච␿୙඲⑕ೃ⩌

ⱝᖺᛶ⫵Ẽ⭘

ࣛࣥࢤࣝࣁࣥࢫ⣽⬊⤌⧊⌫⑕

⫧‶ప᥮Ẽ⑕ೃ⩌

⫵⬊ప᥮Ẽ⑕ೃ⩌㻌

⫵ື⬦ᛶ⫵㧗⾑ᅽ⑕

៏ᛶ⾑ᰦሰᰦᛶ⫵㧗⾑ᅽ⑕

ΰྜᛶ⤖ྜ⤌⧊⑓

⚄⤒⥺⥔⭘⑕䊠ᆺ㻌 㸦ࣞࢵࢡࣜࣥࢢࣁ࢘ࢮࣥ⑓㸧㻌

⚄⤒⥺⥔⭘⑕䊡ᆺ

⤖⠇ᛶ◳໬⑕㻔ࣉࣜࣥࢢࣝ⑓㻕

⾲⓶Ỉ⑁⑕

⮋⑁ᛶ஝Ⓞ㻌 ኳ⑁⒔㻌

኱⬻⓶㉁ᇶᗏ᰾ኚᛶ⑕

㔜⑕ከᙧⁱฟᛶ⣚ᩬ㻔ᛴᛶᮇ㻕

ࣜࣥࣃ⬦⟶➽⭘⑕㻔㹊㸿㹋㻕 㐍⾜ᛶ㦵໬ᛶ⥺⥔␗ᙧᡂ⑕㻔㻲㻻㻼㻕 Ⰽ⣲ᛶ஝⓶⑕㻔㼄㻼㻕 ࢫࣔࣥ

ୗᆶయᶵ⬟పୗ⑕

ࢡࢵࢩࣥࢢ⑓

ඛ➃ᕧ኱⑕

ཎⓎᛶഃ⣴◳໬⑕

᭷Ჲ㉥⾑⌫ࢆక࠺⯙㋃⑓

㹆㹒㹊㹔㸫㸯㛵㐃⬨㧊⑕㻔㹆㸿㹋㻕 ඛኳᛶ㨶㫣Ⓞᵝ⣚⓶⑕

ඛኳᛶᚰ⑌ᝈ

㻌 䝏䜰䝜䞊䝊䛾䛒䜛⑌ᝈ 㻌 㻌 㻌 䠄SpO2<85%? , 90%?䠅 㻌 䝣䜷䞁䝍䞁ᆺᚠ⎔

㻌 㻌 㻌 䠄༢ᚰᐊ䚸୕ᑤᘚ㛢㙐䚸䞉䞉䞉䠅 㻌 ྑᚰᐊ䜢యᚰᐊ䛸䛩䜛⑌ᝈ 㻌 㻌 㻌 䠄ಟṇ኱⾑⟶㌿఩䚸䞉䞉䞉䠅 㻌 ᘚ㏫ὶ䛜ၥ㢟䛸䛺䜛⑌ᝈ 㻌 㻌 㻌 䠄䝣䜯䝻䞊ᅄᚩ⑕⾡ᚋ䚸䞉䞉䞉䠅

䛺䛹

ຓᡂᑐ㇟⪅

㻌 㻌 ㌟య㞀ᐖ⪅ᡭᖒ䠍⣭䞉䠎⣭

㻌 㻌 㻌 㻌

㻌 㻌 ⒪⫱ᡭᖒ䠝⣭

㔜ᗘᚰ㌟㞀ᐖ⪅་⒪㈝ຓᡂไᗘ㻌 㻌

ຓᡂᑐ㇟⪅

㻌 㻌 ㌟య㞀ᐖ⪅ᡭᖒ䠍⣭䞉䠎⣭

㻌 㻌 㻌 㻌 㻌 㻌 㻌 㻌 㻌 㻌 㻌 㻌 䠄ᆅᇦ䛻䜘䛳䛶䛿䠍䡚䠏⣭䠖20㒔┴䠅 㻌 㻌 ⒪⫱ᡭᖒ䠝⣭

㻌 㻌 ⒪⫱ᡭᖒ䠞⣭䠄୰ᗘ䠅䛸㌟య㞀ᐖ⪅ᡭᖒ䠄䠏⣭䡚䠒⣭䠅

⏕ά䜢ᨭ䛘䜛♫఍ಖ㞀ไᗘ䠄♫఍ᢇຓ䠅㻌

ᖺ㱋㻌㻌 㻌 㻌 ㄌ⏕䠄䠌ṓ䠅㻌㻌ᑵᏛ๓㻌㻌 ᑵᏛᮇ㻌 䠄䠒ṓ䡚㻝㻤ṓ䠅㻌㻌

Ꮚ⫱䛶䞉ᑵປᮇ㻌

䠄㻞㻜ṓ䡚㻌 㻠㻜ṓ㻌 ㏥⫋ᚋ㻌 䠄㻢㻡ṓ䡚㻌 㻣㻜ṓ䡚㻌㻌

㻌 㻌 㻌 㻌 㻌 㻌 㻌 㻌 㻌 㻌

ฟ⏘⫱ඣ୍᫬㔠㻌㻌 ^{㻌 㻌}

ඣ❺ᡭᙜ㻌

Ꮚ䛹䜒䛾䛯䜑䛾ᡭᙜ㻌㻌㻥ṓ㻌 ඣ❺ᢇ㣴ᡭᙜ㻌㻌㻌㻌㻌㻌㻌㻌㻌㻌㻌㻌㻌㻌㻌㻝㻤ṓ㻌㻌

≉ูඣ❺ᢇ㣴ᡭᙜ㻌

㻌

㞀

㞀ᐖඣ⚟♴ᡭᙜ㻌㻌 㻞㻜ṓ䡚≉ู㞀ᐖ⪅ᡭᙜ㻌

㑇᪘ᖺ㔠㻌㻌 㻌 㻌 㻌 㻌 㻌㻌 㻌 㻌 㻌 㻌 㻌 㻌 㻌 㻌 ^{㻌 㻌}

㞀ᐖᖺ㔠㻌

㻌 㻌 㻌 䠄㞀ᐖᇶ♏ᖺ㔠䚸㞀ᐖཌ⏕ᖺ㔠䠅㻌

㻌 㻌

⪁㱋ᖺ㔠㻌㻌^{㻌 㻌 㻌 㻌}

⏕άಖㆤ㻌㻌㻌 㻌 㻌 㻌 㻌 㻌㻌 㻌 㻌 㻌 㻌 㻌 㻌 ^{㻌 㻌 㻌 㻌} 㻝㻤ṓ㻌㻌ປ⅏䞉㞠⏝ಖ㝤㻌

㻌㻌㻌㻌㻌䠄㞀ᐖᖺ㔠䚸യ⑓ᡭᙜ㔠䠅㻌 㻌 㻌 ⏕ά⚟♴㈨㔠㈚௜ไᗘ㻌 㻌 㻌㻌 㻌 㻌 㻌 㻌 㻌 㻌 㻌 㻌 ^{㻌 㻌} 㻌 㻌 㻌 㻌 ⊂❧⾜ᨻἲே஦ᨾᑐ⟇ᶵᵓ䛻䜘䜛௓ㆤᩱ➼⿵ൾ㻌 㻌 㻌 ^{㻌 㻌}

ᡤ ᚓ ಖ 㞀 ไ ᗘ㻌

ᖺ㔠ไᗘ

ᅜẸᖺ㔠䛻ຍධ䛧䛶䛔䜛㛫䛻ึデ᪥䠄㞀ᐖ䛾ཎᅉ䛸䛺䛳䛯⑓Ẽ䜔䜿䜺 䛻䛴䛔䛶䚸ึ䜑䛶་ᖌ䛾デ⒪䜢ཷ䛡䛯᪥䠅䛾䛒䜛⑓Ẽ䜔䜿䜺䛷䚸ἲ௧ 䛻䜘䜚ᐃ䜑䜙䜜䛯㞀ᐖ➼⣭䠄䠍⣭䞉䠎⣭䠅䛻䜘䜛㞀ᐖ䛾≧ែ䛻䛒䜛㛫䛿 㞀ᐖᇶ♏ᖺ㔠䛜ᨭ⤥䛥䜜䜛䚹

ᨭ⤥㢠䠄ᐃ㢠䠅㻌 1⣭ 966,000෇ 䠄᭶㢠㻌 80,500෇䠅 㻌 㻌 㻌 㻌 㻌 㻌 㻌 㻌 㻌 㻌 2⣭ 772,800෇ 䠄᭶㢠㻌 64,400෇䠅

ͤ 䠍䠔ṓ฿㐩ᖺᗘ䛾ᮎ᪥䜎䛷䛻䛒䜛Ꮚ䠄㞀ᐖ⪅䛿䠎䠌ṓᮍ‶䠅䛜䛔䜛ሙྜ䛿䚸 㻌 㻌 Ꮚ䛾ேᩘ䛻䜘䛳䛶ຍ⟬䛜⾜䜟䜜䜎䛩䚹

ͤ 㞀ᐖᇶ♏ᖺ㔠䜢ཷ䛡䜛䛯䜑䛻䛿䚸ึデ᪥䛾䛒䜛᭶䛾๓䚻᭶䜎䛷䛾බⓗᖺ㔠䛾㻌 㻌 㻌 ຍධᮇ㛫䛾䠎䠋䠏௨ୖ䛾ᮇ㛫䛻䛴䛔䛶䚸ಖ㝤ᩱ䛜⣡௜ཪ䛿ච㝖䛥䜜䛶䛔䜛䛣䛸䚸 㻌 㻌 䜎䛯䛿ึデ᪥䛾䛒䜛᭶䛾๓䚻᭶䜎䛷䛾䠍ᖺ㛫䛻ಖ㝤ᩱ䛾ᮍ⣡䛜䛺䛔䛣䛸 㻌 㻌 䠄ಖ㝤ᩱ⣡௜せ௳䠅䛜ᚲせ䚹

㞀ᐖᇶ♏ᖺ㔠㻌 㻌

ͤ㻌 ཌ⏕ᖺ㔠ຍධ୰䛻ึデ᪥䛜䛒䜜䜀䚸㞀ᐖཌ⏕ᖺ㔠䛻䛺䜚䜎䛩䚹

┿㠃┠䛻௙஦䜢䛧䛶䛔䛶䜒䚸ඛኳᛶᚰ⑌ᝈᝈ⪅䛿䚸 㞀ᐖཌ⏕ᖺ㔠䛾ᑐ㇟䛻䛿䛺䜙䛺䛔䚹

Department of Pediatric Cardiology, Children‘s Medical Center, Ehime University Hospital 䛆1⣭䛇䠄ሗ㓘ẚ౛䛾ᖺ㔠㢠䠅 㽢 1.25 + 䛊㓄അ⪅䛾ຍ⤥ᖺ㔠㢠䠄222,400෇䠅䛋 䛆2⣭䛇䠄ሗ㓘ẚ౛䛾ᖺ㔠㢠䠅 + 䛊㓄അ⪅䛾ຍ⤥ᖺ㔠㢠䠄222,400෇䠅䛋ͤ

䛆3⣭䛇䠄ሗ㓘ẚ౛䛾ᖺ㔠㢠䠅 ͤ᭱పಖ㞀㢠㻌579,700෇㻌 㻌 㻌ͤᑐ㇟⪅䛾䜏

ึデ᪥䛜ຍධᮇ㛫୰䛷䛺䛔䟿

㞀ᐖཌ⏕ᖺ㔠㻌 㻌

ཌ⏕ᖺ㔠䛻ຍධ䛧䛶䛔䜛㛫䛻ึデ᪥䛾䛒䜛⑓Ẽ䜔䜿䜺䛷 㞀ᐖᇶ♏ᖺ㔠䛾1⣭䜎䛯䛿2⣭䛻ヱᙜ䛩䜛㞀ᐖ䛾≧ែ䛻 䛺䛳䛯䛸䛝䛿䚸㞀ᐖᇶ♏ᖺ㔠䛻ୖ஌䛫䛧䛶㞀ᐖཌ⏕ᖺ㔠䛜 ᨭ⤥䛥䜜䜛䚹

䜎䛯䚸㞀ᐖ䛾≧ែ䛜2⣭䛻ヱᙜ䛧䛺䛔㍍䛔⛬ᗘ䛾㞀ᐖ䛾䛸 䛝䛿3⣭䛾㞀ᐖཌ⏕ᖺ㔠䛜ᨭ⤥䛥䜜䜛䚹

≉ูඣ❺ᢇ㣴㻌㻌 ᡭᙜ㻌

䠍⣭᭶㢠㻌 㻡㻜㻘㻠㻜㻜෇㻌 䠍⣭᭶㢠㻌 㻡㻜㻘㻜㻡㻜෇㻌 䠎⣭᭶㢠㻌 㻟㻟㻘㻡㻣㻜෇㻌 䠎⣭᭶㢠㻌 㻟㻟㻘㻟㻟㻜෇㻌 㞀ᐖඣ⚟♴㻌

ᡭᙜ㻌 㻝㻠㻘㻞㻤㻜෇㻌 㻌 㻝㻠㻘㻝㻤㻜෇㻌 㻌

≉ู㞀ᐖ⪅㻌

ᡭᙜ㻌 㻞㻢㻘㻞㻢㻜෇㻌 㻞㻢㻘㻜㻤㻜෇㻌

㞀ᐖᇶ♏ᖺ㔠㻌

䠍⣭᭶㢠㻌 㻤㻝㻘㻥㻞㻡෇㻌 㻌䠍⣭᭶㢠㻌 㻤㻜㻘㻡㻜㻜෇㻌㻌 㻌 㻌 ᖺ㢠㻌 㻥㻤㻟㻘㻝㻜㻜෇㻌 㻌 㻌 ᖺ㢠㻌㻥㻢㻢㻘㻜㻜㻜෇㻌 䠎⣭᭶㢠㻌 㻢㻡㻘㻡㻠㻝෇㻌 䠎⣭᭶㢠㻌 㻢㻠㻘㻠㻜㻜෇㻌 㻌 㻌 ᖺ㢠㻌 㻣㻤㻢㻘㻡㻜㻜෇㻌 㻌 㻌 ᖺ㢠㻌㻣㻣㻞㻘㻤㻜㻜෇㻌 㻞㻜㻝㻟ᖺ㻝㻜᭶䛛䜙ᖺ㔠㻝㻚㻜䠂䚸ᡭᙜ㻜㻚㻣䠂䛾ᘬ䛝ୗ䛢㻌

ᡭᙜ䞉㞀ᐖᖺ㔠㢠

㻞㻜㻝㻟ᖺ㻝㻜᭶䡚

ᖺ㔠㻞㻚㻡䠂䚸ᡭᙜ㻝㻚㻣䠂䛾ẁ㝵ⓗᘬ䛝ୗ䛢㻌

㻞㻜ṓ๓യ⑓䛻䜘䜛㞀ᐖᇶ♏ᖺ㔠䛻䛛䛛䜛ᡤᚓไ㝈㻌

㻌20ṓ๓䛻യ⑓䜢㈇䛳䛯ே䛾㞀ᐖᇶ♏ᖺ㔠䛻䛴䛔䛶䛿䚸ᮏே䛜ಖ

㝤ᩱ䜢⣡௜䛧䛶䛔䛺䛔䛣䛸䛛䜙䚸ᡤᚓไ㝈䛜タ䛡䜙䜜䛶䛔䜛䚹 㻌 ᡤᚓ㢠䛜360୓4ᖸ෇䠄ᢇ㣴ᐙ᪘䛺䛧䠅䜢㉸䛘䜛ሙྜ䛻䛿ᖺ㔠㢠䛾 2ศ䛾1┦ᙜ㢠䛻㝈䜚ᨭ⤥೵Ṇ䛸䛧䚸462୓1ᖸ෇䜢㉸䛘䜛ሙྜ䛻䛿

඲㢠ᨭ⤥೵Ṇ䛸䛩䜛஧ẁ㝵ไ䛜䛸䜙䜜䛶䛔䜛䚹

ᢇ㣴ᐙ᪘ 0ே 1ே 2ே 3ே 䠇1ே䛷ቑ㢠

ℐ悐㓗䴎 㬊 4,621,000 5,001,000 5,381,000 5,761,000 380,000 烀/烁㓗䴎 㬊 3,604,000 3,984,000 4,364,000 4,744,000 380,000

䠍㻛䠎㻌 ᨭ⤥೵Ṇ㻌

㻌 㻌0෇㻌 㻌 㻌 㻌 㻌 360.4୓෇㻌 㻌 㻌 462.1୓෇㻌 㻌 䠄ᡤᚓ䠅

඲㢠ᨭ⤥㻌

඲㢠㻌 ᨭ⤥೵Ṇ㻌

୍⯡㞠⏝䛻ྥ䛡䛯ᨭ᥼᪋⟇㻌

⚟♴᪋⟇䛻䜘䜛ᑵປᨭ᥼㻌 㻌 㻌

㞀ᐖ⪅⫋ᴗ⬟ຊ㛤Ⓨᰯ

➼䛻䜘䜛බඹ⫋ᴗカ⦎

බඹ⫋ᴗᏳᐃᡤ䠄䝝䝻䞊䝽䞊䜽䠅 ᆅᇦ㞀ᐖ⪅⫋ᴗ䝉䞁䝍䞊 㞀ᐖ⪅ᑵᴗ䞉⏕άᨭ᥼䝉䞁䝍䞊

ᑵປ⛣⾜ᨭ᥼

ᑵປ⥅⥆ᨭ᥼

䠞ᆺ

ᑵປ⥅⥆ᨭ᥼

⏕ά௓ㆤ 䠝ᆺ

ᆅᇦάືᨭ᥼䝉䞁䝍䞊

⮬❧カ⦎

䠄⏕άカ⦎䠅 ᅾᏯᑵᴗ

୍⯡㞠⏝

୍⯡㞠⏝䛺䛹

㞠⏝᪋⟇

⚟♴᪋⟇

㐃ᦠ

ᑵປᨭ᥼᪋⟇䛾య⣔㻌㻌 㻌

ᑵປ㛵㐃᪋⟇䛾඲యീ

㞀ᐖ⪅⥲ྜᨭ᥼ἲ 㞀ᐖ⪅㞠⏝ಁ㐍ἲ

䠄ᖹᡂ25ᖺ4᭶1᪥䡚䠅

㞠⏝㛵ಀ䛜䛒䜛

㞠⏝ಖ㝤䛻ຍධ䛩䜛

ᮏẼ䛾௙஦䛜䛷䛝䜛

→→㻌 ᚑᴗဨ䛷䛒䜛䚹

→→㻌 ᕤ㈤䛷䛿䛺䛟⤥ᩱ䛷䛒䜛䚹

→→㻌 ኻᴗಖ㝤䛜ධ䜛䚹

→→㻌 ປ⅏ಖ㝤䛷Ᏻᚰ䚹

→→㻌 ດຊ䛸ᡂᯝ䛷᪼⤥䚹

໅ົ᫬㛫

⤥୚

ఇ᪥

ᴗົෆᐜ

9:00䡚18:00䛾䛖䛱䚸4᫬㛫໅ົ䡚䚸యㄪ䛻ྜ䜟䛫䛶

᫬⤥㻌 666෇㻌 ᭱ప㈤㔠ἲ㻌 䠄ᖹᡂ25ᖺ10᭶31᪥䡚䠅

ᅵ䞉᪥䞉⚃᪥䞉఍♫䛜ᐃ䜑䛯᪥䠄ኟᏘ䞉ᖺᮎᖺጞఇᬤ䛒䜚䠅 ᕼᮃ䛸㐺ṇ䛻ᛂ䛨䛶ᚑ஦

䝟䝋䝁䞁ᴗົ䚸⎔ቃ஦ᴗ䚸䝔䞊䝥㉳䛣䛧䚸ฟᙇ䜹䝣䜵

ᨭ᥼䛴䛝௻ᴗ㻌

㞀ᐖ⪅ᑵປ⥅⥆ᨭ᥼஦ᴗ䠄䠝ᆺ䠅

㻌㻌 㻌

ᙇ䜹䝣䜵

Department of Pediatric Cardiology, Children‘s Medical Center, Ehime University Hospital

ドキュメント内 vol.4（2013年9月～2014年8月） (ページ 68-71)