medicina60巻8号

2023年07月発行

特集 浮腫と脱水—Q＆Aで学ぶジェネラリストのための体液量異常診療 体液量異常の診断

脱水のフィジカル

著者： 樋口大¹

所属機関： ¹島根県立中央病院救命救急科

ページ範囲：P.1210 - P.1215

Point
◎脱水症は，臨床経過や複数の身体所見から総合的に判断する．
◎身体評価は，口腔内と腋窩の乾燥，皮膚ツルゴール，眼窩の陥没，毛細血管再充満時間（CRT）を確認する．
◎判断に迷う際は，エコー，血液検査，輸液負荷試験，受動的下肢挙上を行い，総合的に判断する．
◎起立性低血圧を疑った際は，発症時の状況を確認し，服薬歴，循環血液量，基礎疾患を確認する．
◎起立性低血圧を疑った際は，起立試験による評価を行う．

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