{"id":42,"date":"2023-07-18T19:00:32","date_gmt":"2023-07-18T10:00:32","guid":{"rendered":"http:\/\/aquacurrent.com\/rheuma-net\/securewp\/?page_id=42"},"modified":"2025-02-20T13:06:23","modified_gmt":"2025-02-20T04:06:23","slug":"surgery","status":"publish","type":"page","link":"https:\/\/www.rheuma-net.or.jp\/rheuma\/rheuma\/surgery\/","title":{"rendered":"\u95a2\u7bc0\u30ea\u30a6\u30de\u30c1\u306e\u6cbb\u7642 \u2013 \u624b\u8853\u7642\u6cd5"},"content":{"rendered":"<h2>\u95a2\u7bc0\u30ea\u30a6\u30de\u30c1\u306e\u6cbb\u7642 \u2013 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loading=\"lazy\" decoding=\"async\" class=\"alignright size-full wp-image-144\" src=\"https:\/\/www.rheuma-net.or.jp\/rheuma\/securewp\/wp-content\/uploads\/2025\/02\/e79f61a6baca46b24df8b1f92d141ae5.png\" alt=\"\u3044\u3064\u624b\u8853\u3092\u8003\u3048\u308c\u3070\u3088\u3044\u306e\uff1f\" width=\"141\" height=\"205\" \/>\u3000\u85ac\u7269\u7642\u6cd5\u306a\u3069\u3092\u99c6\u4f7f\u3057\u3066\u5feb\u9069\u306a\u65e5\u5e38\u751f\u6d3b\u3092\u904e\u3054\u305b\u308b\u3088\u3046\u6700\u5927\u9650\u306e\u52aa\u529b\u3092\u6255\u3046\u3079\u304d\u3053\u3068\u306f\u8a00\u3046\u307e\u3067\u3082\u3042\u308a\u307e\u305b\u3093\u304c\u3001\u95a2\u7bc0\u969c\u5bb3\u306e\u305f\u3081\u65e5\u5e38\u751f\u6d3b\u306b\u652f\u969c\u3092\u304d\u305f\u3057\u305f\u5834\u5408\u306b\u306f\u3001\u624b\u9045\u308c\u306b\u306a\u3089\u306a\u3044\u3046\u3061\u306b\u9060\u616e\u305b\u305a\u624b\u8853\u7642\u6cd5\u306b\u3064\u3044\u3066\u5c02\u9580\u533b\u3068\u76f8\u8ac7\u3059\u3079\u304d\u3067\u3059\u3002\u9069\u5207\u306a\u85ac\u7269\u6cbb\u7642\u3092\u884c\u3063\u3066\u3044\u308b\u306b\u3082\u304b\u304b\u308f\u3089\u305a\u3001\u8efd\u5fae\u306a\u95a2\u7bc0\u708e\u304c\u6301\u7d9a\u3057\u3066\u7d4c\u904e\u3068\u3068\u3082\u306b\u95a2\u7bc0\u306e\u7834\u58ca\u304c\u9032\u884c\u3059\u308b\u3053\u3068\u3082\u3042\u308a\u307e\u3059\u3002<\/p>\n<p>\u3000\u95a2\u7bc0\u30ea\u30a6\u30de\u30c1\u306e\u624b\u8853\u306f\u95a2\u7bc0\u5909\u5f62\u3092\u4e88\u9632\u3059\u308b\u76ee\u7684\u3067\u3001\u75c5\u6c17\u306e\u65e9\u671f\u304b\u3089\u3082\u884c\u3046\u3053\u3068\u304c\u3042\u308a\u307e\u3059\u3002\u305d\u3057\u3066\u9045\u304f\u306a\u308c\u3070\u306a\u308b\u307b\u3069\u624b\u8853\u65b9\u6cd5\u306e\u9078\u629e\u80a2\u306f\u6e1b\u308a\u3001\u624b\u8853\u306e\u7d50\u679c\u3082\u5b8c\u5168\u306a\u56de\u5fa9\u3067\u306f\u306a\u304f\u306a\u308b\u3068\u3044\u3048\u307e\u3059\u3002<\/p>\n<p>\u3000\u95a2\u7bc0\u30ea\u30a6\u30de\u30c1\u306e\u624b\u8853\u6cd5\u306f\u5927\u304d\u304f\u5206\u3051\u3066<\/p>\n<ol>\n<li>\u6ed1\u819c\u5207\u9664\u8853<\/li>\n<li>\u4eba\u5de5\u95a2\u7bc0\u7f6e\u63db\u8853<\/li>\n<li>\u95a2\u7bc0\u56fa\u5b9a\u8853<\/li>\n<li>\u95a2\u7bc0\u5f62\u6210\u8853<\/li>\n<\/ol>\n<p>\u3000\u306e4\u7a2e\u985e\u304c\u3042\u308a\u307e\u3059\u3002\u95a2\u7bc0\u3054\u3068\u306b\u4e3b\u306b\u65bd\u884c\u3055\u308c\u308b\u8853\u5f0f\u306f\u7570\u306a\u3063\u3066\u3044\u307e\u3059\u3002\u9ad8\u5ea6\u306b\u7834\u58ca\u3055\u308c\u305f\u95a2\u7bc0\u306e\u624b\u8853\u3067\u3042\u308c\u3070\u4eba\u5de5\u95a2\u7bc0\u7f6e\u63db\u8853\u304c\u884c\u308f\u308c\u3066\u3044\u307e\u3059\u3002\u6b63\u5e38\u306a\u95a2\u7bc0\u306b\u306f\u7121\u75db\u6027\uff08\u75db\u304f\u306a\u3044\u3053\u3068\uff09\u30fb\u53ef\u52d5\u6027\uff08\u52d5\u304f\u3053\u3068\uff09\u30fb\u652f\u6301\u6027\uff08\u3050\u3089\u3064\u304b\u306a\u3044\u3053\u3068\uff09\u306e3\u8981\u7d20\u304c\u8981\u6c42\u3055\u308c\u307e\u3059\u304c\u3001\u4eba\u5de5\u95a2\u7bc0\u306f\u308f\u305a\u304b\u306a\u52d5\u304d\u306e\u5236\u9650\u3092\u6b8b\u3059\u3053\u3068\u306f\u3042\u308b\u3082\u306e\u306e\u30013\u3064\u306e\u8981\u7d20\u5168\u3066\u3092\u7372\u5f97\u51fa\u6765\u308b\u8853\u5f0f\u3067\u3059\u3002\u3057\u304b\u3057\u306a\u304c\u3089\u7a00\u306b\u5408\u4f75\u75c7\u304c\u51fa\u73fe\u3059\u308b\u3053\u3068\u3082\u3042\u308b\u305f\u3081\u3001\u5c02\u9580\u533b\u3068\u5341\u5206\u76f8\u8ac7\u3057\u3066\u884c\u3046\u3088\u3046\u306b\u3057\u3066\u4e0b\u3055\u3044\u3002<\/p>\n<h3>\u95a2\u7bc0\u30ea\u30a6\u30de\u30c1\u306e\u95a2\u7bc0\u75c5\u5909\u306b\u5bfe\u3059\u308b\u624b\u8853<\/h3>\n<h4 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aria-describedby=\"caption-attachment-147\" class=\"size-full wp-image-147\" src=\"https:\/\/www.rheuma-net.or.jp\/rheuma\/securewp\/wp-content\/uploads\/2023\/07\/surgery-image003.jpg\" alt=\"\u6ed1\u819c\u304c\u7d68\u6bdb\u72b6\uff08\u201c\u3072\u3060\u201d\u306e\u3088\u3046\u306b\uff09\u306b\u816b\u308c\u3066\u3044\u308b\u72b6\u614b\" width=\"366\" height=\"275\" srcset=\"https:\/\/www.rheuma-net.or.jp\/rheuma\/securewp\/wp-content\/uploads\/2023\/07\/surgery-image003.jpg 366w, https:\/\/www.rheuma-net.or.jp\/rheuma\/securewp\/wp-content\/uploads\/2023\/07\/surgery-image003-300x225.jpg 300w, https:\/\/www.rheuma-net.or.jp\/rheuma\/securewp\/wp-content\/uploads\/2023\/07\/surgery-image003-80x60.jpg 80w\" sizes=\"(max-width: 366px) 100vw, 366px\" \/><p id=\"caption-attachment-147\" class=\"wp-caption-text\">\u6ed1\u819c\u304c\u7d68\u6bdb\u72b6\uff08\u201c\u3072\u3060\u201d\u306e\u3088\u3046\u306b\uff09\u306b\u816b\u308c\u3066\u3044\u308b\u72b6\u614b<br \/>\n\u6ed1\u819c\u5207\u9664\u8853\u3067\u306f\u7d68\u6bdb\u72b6\u306b\u816b\u308c\u305f\u6ed1\u819c\u3092\u5207\u9664\u3057\u307e\u3059\u3002<br \/>\n\uff08\u60a3\u8005\u3055\u3093\u306e\u305f\u3081\u306e\u95a2\u7bc0\u30ea\u30a6\u30de\u30c1\u6cbb\u7642\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3, \u8ca1\u56e3\u6cd5\u4eba \u65e5\u672c\u30ea\u30a6\u30de\u30c1\u8ca1\u56e3\u7de8,\u533b\u6b6f\u85ac\u51fa\u7248 2006\u3088\u308a\u5f15\u7528\uff09<\/p><\/div><\/p>\n<h4 id=\"surgery1-2\">2\uff0e\u4eba\u5de5\u95a2\u7bc0\u7f6e\u63db\u8853<\/h4>\n<p>\u3000\u4eba\u5de5\u95a2\u7bc0\u7f6e\u63db\u8853\u306f\u95a2\u7bc0\u30ea\u30a6\u30de\u30c1\u306b\u3088\u308b\u95a2\u7bc0\u708e\u3084\u95a2\u7bc0\u306e\u5909\u5f62\u30fb\u7834\u58ca\u306a\u3069\u306b\u3088\u308a\u3001\u95a2\u7bc0\u306e\u9aa8\u3084\u8edf\u9aa8\u304c\u3059\u308a\u6e1b\u308a\u3001\u75db\u307f\u3084\u95a2\u7bc0\u306e\u53ef\u52d5\u57df\uff08\u52d5\u304f\u7bc4\u56f2\uff09\u306e\u5236\u9650\u304c\u51fa\u3066\u3001\u65e5\u5e38\u751f\u6d3b\u306b\u652f\u969c\u3092\u6765\u3059\u60a3\u8005\u3055\u3093\u306b\u884c\u306a\u3046\u624b\u8853\u65b9\u6cd5\u3067\u3059\u3002\u5f37\u3044\u95a2\u7bc0\u5909\u5f62\u3092\u653e\u7f6e\u3059\u308b\u3068\u65e5\u5e38\u751f\u6d3b\u306e\u5236\u9650\u30fb\u56f0\u96e3\u304c\u9032\u884c\u3059\u308b\u53ef\u80fd\u6027\u3082\u3042\u308a\u307e\u3059\u306e\u3067\u65e9\u3081\u306b\u4e3b\u6cbb\u533b\u3068\u76f8\u8ac7\u3057\u307e\u3057\u3087\u3046\u3002\u8853\u5f0f\u3068\u3057\u3066\u4e3b\u306b\u4eba\u5de5\u95a2\u7bc0\u304c\u9078\u629e\u3055\u308c\u3066\u304d\u305f\u95a2\u7bc0\u306f\u819d\u95a2\u7bc0\u3068\u80a1\u95a2\u7bc0\u3067\u3059\u3002\u3057\u304b\u3057\u6700\u8fd1\u3067\u306f\u80a9\u30fb\u8098\u30fb\u6307\u30fb\u624b\u30fb\u8db3\u30fb\u8db3\u8dbe\u306a\u3069\u306e\u95a2\u7bc0\u3067\u3082\u826f\u597d\u306a\u8853\u5f8c\u6210\u7e3e\u304c\u5831\u544a\u3055\u308c\u308b\u3088\u3046\u306b\u306a\u3063\u3066\u304d\u307e\u3057\u305f\u3002<br \/>\n\u3000\u4eba\u5de5\u95a2\u7bc0\u7f6e\u63db\u8853\u306e\u4e00\u756a\u306e\u76ee\u7684\u306f\u3001\u75db\u307f\u306a\u304f\u65e5\u5e38\u751f\u6d3b\u3092\u9001\u308b\u3053\u3068\u3067\u3059\u3002\u624b\u8853\u306b\u3088\u308a\u75db\u307f\u306f\u307b\u3068\u3093\u3069\u306a\u304f\u306a\u308a\u307e\u3059\u304c\u3001\u591a\u5c11\u306e\u9055\u548c\u611f\u3084\u8efd\u5ea6\u306e\u75bc\u75db\u304c\u6b8b\u308b\u3053\u3068\u304c\u3042\u308a\u307e\u3059\u3002\u307e\u305f\u73fe\u5728\u306e\u4eba\u5de5\u95a2\u7bc0\u306f\u6b63\u5e38\u306a\u95a2\u7bc0\u306e\u52d5\u304d\u3092100\uff05\u306f\u518d\u73fe\u3067\u304d\u307e\u305b\u3093\u3002\u305d\u306e\u305f\u3081\u624b\u8853\u524d\u3088\u308a\u95a2\u7bc0\u306e\u53ef\u52d5\u57df\uff08\u52d5\u304f\u7bc4\u56f2\uff09\u304c\u6e1b\u5c11\u3057\u305f\u308a\u3001\u4eba\u5de5\u95a2\u7bc0\u7279\u6709\u306e\u5408\u4f75\u75c7\u304c\u751f\u3058\u308b\u53ef\u80fd\u6027\u3082\u3042\u308a\u307e\u3059\u3002\u3055\u3089\u306b\u65b0\u3057\u3044\u4eba\u5de5\u95a2\u7bc0\u304c\u4f53\u306b\u306a\u3058\u3080\u307e\u3067\uff08\u9055\u548c\u611f\u306a\u304f\u4f7f\u3048\u308b\u307e\u3067\uff09\u3042\u308b\u7a0b\u5ea6\u306e\u6642\u9593\u304c\u304b\u304b\u308a\u307e\u3059\u3002\u500b\u4eba\u5dee\u306f\u3042\u308a\u307e\u3059\u304c\u3001\u3053\u306e\u624b\u8853\u3092\u53d7\u3051\u3089\u308c\u305f\u60a3\u8005\u3055\u3093\u304c\u3001\u9055\u548c\u611f\u304c\u306a\u304f\u306a\u3063\u3066\u304d\u305f\u3068\u611f\u3058\u308b\u306e\u306f\u901a\u5e38\u3001\u8853\u5f8c3\u304b\u6708\u3050\u3089\u3044\u3067\u3059\u3002\u307e\u305f\u60a3\u8005\u3055\u3093\u306e\u4f53\u683c\u3084\u751f\u6d3b\u6d3b\u52d5\u306e\u7a0b\u5ea6\u306b\u3088\u308a\u4eba\u5de5\u95a2\u7bc0\u306e\u5bff\u547d\u306f\u7570\u306a\u308a\u3001\u307e\u305f\u90e8\u4f4d\u3054\u3068\u306b\u3082\u3084\u3084\u7570\u306a\u308a\u307e\u3059\u3002\u819d\u30fb\u80a1\u95a2\u7bc0\u3067\u306f\u7d0420\u5e74\uff08\u3042\u308b\u3044\u306f\u305d\u308c\u4ee5\u4e0a\uff09\u3068\u5831\u544a\u3055\u308c\u3066\u3044\u307e\u3059\u304c\u3001\u6307\u30fb\u80a9\u30fb\u8098\u30fb\u8db3\u30fb\u8db3\u8dbe\u95a2\u7bc0\u306e\u4eba\u5de5\u95a2\u7bc0\u5bff\u547d\u306f\u819d\u30fb\u80a1\u95a2\u7bc0\u307b\u3069\u9577\u304f\u306a\u3044\u3068\u8003\u3048\u3089\u308c\u3066\u3044\u307e\u3059\u3002<\/p>\n<h4 id=\"surgery1-3\">3\uff0e\u95a2\u7bc0\u56fa\u5b9a\u8853<\/h4>\n<p>\u3000\u95a2\u7bc0\u56fa\u5b9a\u8853\u306f\u95a2\u7bc0\u7834\u58ca\u304c\u8457\u3057\u3044\u5834\u5408\u306b\u884c\u3044\u307e\u3059\u3002\u95a2\u7bc0\u306b\u3088\u3063\u3066\u306f\u4eba\u5de5\u95a2\u7bc0\u304c\u4f5c\u3089\u308c\u3066\u3044\u306a\u3044\u95a2\u7bc0\u3082\u3042\u308a\u3001\u307e\u305f\u4eee\u306b\u4eba\u5de5\u95a2\u7bc0\u3092\u5165\u308c\u308b\u3053\u3068\u304c\u3067\u304d\u3066\u3082\u3001\u8853\u5f8c\u306e\u5b89\u5b9a\u6027\u3084\u9577\u671f\u306e\u6709\u7528\u6027\u304c\u898b\u8fbc\u3081\u306a\u3044\u5834\u5408\u306a\u3069\u306b\u95a2\u7bc0\u56fa\u5b9a\u8853\u3092\u884c\u3044\u307e\u3059\u3002\u95a2\u7bc0\u56fa\u5b9a\u8853\u3067\u306f\u95a2\u7bc0\u3092\u56fa\u5b9a\u3059\u308b\u3053\u3068\u3067\u53ef\u52d5\u6027\u3092\u72a0\u7272\u306b\u3057\u307e\u3059\u304c\u3001\u78ba\u5b9f\u306a\u9664\u75db\u3068\u652f\u6301\u6027\u3092\u5f97\u308b\u305f\u3081\u306b\u884c\u308f\u308c\u307e\u3059\u3002\u95a2\u7bc0\u3092\u6a5f\u80fd\u3057\u3084\u3059\u3044\u89d2\u5ea6\u3067\u56fa\u5b9a\u3059\u308b\u306e\u3067\u3001\u5b89\u5b9a\u6027\u3068\u3044\u3046\u610f\u5473\u3067\u306f\u3068\u3066\u3082\u6539\u5584\u3057\u307e\u3059\u304c\u3001\u4e00\u65b9\u3067\u95a2\u7bc0\u304c\u52d5\u304b\u306a\u3044\u3053\u3068\u3067\u3001\u65e5\u5e38\u751f\u6d3b\u52d5\u4f5c\u306e\u5236\u9650\u3082\u751f\u3058\u308b\u305f\u3081\u3001\u8fd1\u5e74\u3067\u306f\u884c\u308f\u308c\u308b\u983b\u5ea6\u304c\u5c11\u306a\u304f\u306a\u308a\u3064\u3064\u3042\u308a\u307e\u3059\u3002\u4e3b\u306b\u884c\u308f\u308c\u308b\u306e\u306f\u9838\u690e\u30fb\u624b\u95a2\u7bc0\u30fb\u8db3\u95a2\u7bc0\uff08\u4e0b\u56f3\uff09\u30fb\u624b\u6307\uff08\u7279\u306b\u6bcd\u6307\uff09\u3084\u8db3\u306e\u6bcd\u8dbe\u306a\u3069\u3067\u3059\u3002<\/p>\n<h4 id=\"surgery1-4\">4\uff0e\u95a2\u7bc0\u5f62\u6210\u8853<\/h4>\n<p>\u3000\u4e0a\u8a18\u306e\u4eba\u5de5\u95a2\u7bc0\u624b\u8853\u306f\u4e00\u822c\u306b\u8853\u5f8c\u6210\u7e3e\u306f\u826f\u3044\u3067\u3059\u304c\u3001\u4eba\u5de5\u95a2\u7bc0\u306b\u306f\u5bff\u547d\u304c\u3042\u308b\u3053\u3068\u304c1\u3064\u306e\u554f\u984c\u3067\u3059\u3002\u4e00\u65b9\u3067\u8fd1\u5e74\u306e\u85ac\u7269\u6cbb\u7642\u306e\u9032\u5316\u306b\u3088\u308a\u3001\u8853\u5f8c\u306e\u95a2\u7bc0\u708e\u306e\u30b3\u30f3\u30c8\u30ed\u30fc\u30eb\u304c\u826f\u597d\u306b\u306a\u3063\u305f\u3053\u3068\u3067\u3001\u53ef\u80fd\u3067\u3042\u308c\u3070\u81ea\u5206\u306e\u95a2\u7bc0\u3092\u6b8b\u3059\u3053\u3068\u306f\u3067\u304d\u306a\u3044\u304b\uff1f\u3068\u3044\u3046\u30cb\u30fc\u30ba\u304c\u51fa\u3066\u304d\u307e\u3057\u305f\u3002\u305d\u3053\u3067\u8fd1\u5e74\u3067\u306f\u95a2\u7bc0\u69cb\u9020\u3092\u53ef\u80fd\u306a\u9650\u308a\u6b8b\u3057\u3064\u3064\u3001\u95a2\u7bc0\u306e\u6a5f\u80fd\u306e\u6539\u5584\u3092\u306f\u304b\u308b\u95a2\u7bc0\u5f62\u6210\u8853\u304c\u5897\u52a0\u3057\u3066\u304d\u307e\u3057\u305f\u3002\u624b\u8853\u90e8\u4f4d\u306b\u3088\u3063\u3066\u306f\u95a2\u7bc0\u5f62\u6210\u8853\u304c\u624b\u8853\u6cbb\u7642\u306e\u4e2d\u5fc3\u3068\u306a\u3063\u3066\u3044\u307e\u3059\u3002\u3053\u306e\u624b\u8853\u306f\u521d\u671f\u304b\u3089\u4e2d\u671f\u306e\u307e\u3060\u95a2\u7bc0\u306e\u5f62\u72b6\u304c\u6b8b\u3063\u3066\u3044\u308b\u72b6\u614b\u3067\u3001\u95a2\u7bc0\u306e\u4e00\u90e8\u3092\u524a\u3063\u305f\u308a\u5f62\u3092\u6574\u3048\u305f\u308a\u3057\u3066\u6a5f\u80fd\u3084\u6574\u5bb9\u3092\u56de\u5fa9\u3055\u305b\u308b\u8853\u5f0f\u3067\u3059\u3002\u4e3b\u306b\u8098\u30fb\u8db3\u8dbe\u30fb\u624b\u9996\u30fb\u8098\u30fb\u6307\u306e\u5404\u95a2\u7bc0\u3067\u884c\u308f\u308c\u307e\u3059\u3002<br \/>\n\u3000\u4e0a\u8a18\u306e\u5404\u624b\u8853\u65b9\u6cd5\u306f\u90e8\u4f4d\u5225\u306b\u63a8\u5968\u5ea6\uff08\u3069\u306e\u304f\u3089\u3044\u52e7\u3081\u3089\u308c\u308b\u624b\u8853\u304b\uff1f\uff09\u304c\u5831\u544a\u3055\u308c\u3066\u3044\u307e\u3059\u3002<\/p>\n<div id=\"attachment_148\" style=\"width: 490px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-148\" class=\"size-full wp-image-148\" src=\"https:\/\/www.rheuma-net.or.jp\/rheuma\/securewp\/wp-content\/uploads\/2023\/07\/surgery-image005.jpg\" alt=\"\" width=\"480\" height=\"360\" srcset=\"https:\/\/www.rheuma-net.or.jp\/rheuma\/securewp\/wp-content\/uploads\/2023\/07\/surgery-image005.jpg 480w, https:\/\/www.rheuma-net.or.jp\/rheuma\/securewp\/wp-content\/uploads\/2023\/07\/surgery-image005-300x225.jpg 300w, https:\/\/www.rheuma-net.or.jp\/rheuma\/securewp\/wp-content\/uploads\/2023\/07\/surgery-image005-80x60.jpg 80w\" sizes=\"(max-width: 480px) 100vw, 480px\" \/><p id=\"caption-attachment-148\" class=\"wp-caption-text\">\uff08\u95a2\u7bc0\u30ea\u30a6\u30de\u30c1\u306e\u8a3a\u7642\u30de\u30cb\u30e5\u30a2\u30eb\uff08\u6539\u8a02\u7248\uff09, \u8a3a\u65ad\u306e\u30de\u30cb\u30e5\u30a2\u30eb\u3068EBM\u306b\u57fa\u3065\u304f\u6cbb\u7642\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3, \u8ca1\u56e3\u6cd5\u4eba \u65e5\u672c\u30ea\u30a6\u30de\u30c1\u8ca1\u56e3\u767a\u884c, 2004\u3088\u308a\u5f15\u7528<\/p><\/div>\n<h3>\u95a2\u7bc0\u306e\u90e8\u4f4d\u3054\u3068\u306e\u4ee3\u8868\u7684\u306a\u624b\u8853<\/h3>\n<h4 id=\"surgery2-1\">1\uff0e\u819d\u95a2\u7bc0<\/h4>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-full wp-image-149\" src=\"https:\/\/www.rheuma-net.or.jp\/rheuma\/securewp\/wp-content\/uploads\/2023\/07\/surgery-image022.jpg\" alt=\"\u819d\u95a2\u7bc0\" width=\"164\" height=\"188\" srcset=\"https:\/\/www.rheuma-net.or.jp\/rheuma\/securewp\/wp-content\/uploads\/2023\/07\/surgery-image022.jpg 164w, https:\/\/www.rheuma-net.or.jp\/rheuma\/securewp\/wp-content\/uploads\/2023\/07\/surgery-image022-70x80.jpg 70w\" sizes=\"(max-width: 164px) 100vw, 164px\" \/>\u3000\u95a2\u7bc0\u30ea\u30a6\u30de\u30c1\u306e\u819d\u95a2\u7bc0\u624b\u8853\u3067\u306f\u4eba\u5de5\u95a2\u7bc0\u7f6e\u63db\u8853\u304c\u884c\u308f\u308c\u308b\u3053\u3068\u304c\u3068\u3066\u3082\u591a\u3044\u3067\u3059\u304c\u3001\u60a3\u8005\u3055\u3093\u306b\u3088\u3063\u3066\u306f\u6ed1\u819c\u5207\u9664\u8853\u306e\u9078\u629e\u3068\u306a\u308b\u3053\u3068\u3082\u3042\u308a\u307e\u3059\u3002\u4e0a\u8a18\u306e\u3001\u95a2\u7bc0\u30ea\u30a6\u30de\u30c1\u306e\u8a3a\u7642\u30de\u30cb\u30e5\u30a2\u30eb\uff08\u6539\u8a02\u7248\uff09, \u8a3a\u65ad\u306e\u30de\u30cb\u30e5\u30a2\u30eb\u3068EBM\u306b\u57fa\u3065\u304f\u6cbb\u7642\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\uff08\u65e5\u672c\u30ea\u30a6\u30de\u30c1\u8ca1\u56e3\u767a\u884c\uff09\u3067\u306f\u3001\u819d\u95a2\u7bc0\u306f\u4eba\u5de5\u95a2\u7bc0\u7f6e\u63db\u8853\u3001\u6ed1\u819c\u5207\u9664\u8853\u3068\u3082\u306b\u63a8\u5968A\uff08\u884c\u3046\u3088\u3046\u5f37\u304f\u52e7\u3081\u3089\u308c\u308b\uff09\u3068\u306a\u3063\u3066\u3044\u307e\u3059\u3002<br \/>\n\u3000\u4eba\u5de5\u819d\u95a2\u7bc0\u7f6e\u63db\u8853\u3067\u306f\u5927\u817f\u9aa8\uff08\u592a\u3082\u3082\u306e\u9aa8)\u3001\u811b\u9aa8\uff08\u819d\u4e0b\u306e\u9aa8\uff09\u3001\u819d\u84cb\u9aa8\uff08\u819d\u306e\u304a\u3055\u3089\u306e\u9aa8\uff09\u306e\u5404\u3005\u306e\u7834\u58ca\u3055\u308c\u305f\u95a2\u7bc0\u306e\u9aa8\u3092\u5207\u9664\u3057\u305f\u5f8c\u3001\u4eba\u5de5\u819d\u95a2\u7bc0\u3092\u633f\u5165\u3057\u307e\u3059\uff08\u4e0b\u56f3\uff09\u3002\u901a\u5e38\u306f\u91d1\u5c5e\u88fd\u306e\u95a2\u7bc0\u3092\u5927\u817f\u9aa8\u3068\u811b\u9aa8\u306b\u56fa\u5b9a\u3057\u3066\u3001\u305d\u306e\u9593\u306b\u533b\u7642\u7528\u306e\u30dd\u30ea\u30a8\u30c1\u30ec\u30f3\uff08\u30d7\u30e9\u30b9\u30c1\u30c3\u30af\u306e\u69d8\u306a\u3082\u306e\uff09\u3092\u306f\u3081\u8fbc\u307f\u307e\u3059\u3002\u4eba\u5de5\u95a2\u7bc0\u306e\u56fa\u5b9a\u306f\u7279\u6b8a\u306a\u8868\u9762\u5f62\u72b6\u306b\u3088\u308a\u56fa\u5b9a\u3059\u308b\u3082\u306e\u3084\u3001\u9aa8\u30bb\u30e1\u30f3\u30c8\u3092\u4f7f\u7528\u3057\u3066\u884c\u306a\u3046\u3082\u306e\u304c\u3042\u308a\u307e\u3059\u3002\u307e\u305f\u95a2\u7bc0\u7834\u58ca\u306e\u7a0b\u5ea6\u306e\u5f37\u3044\u65b9\u3084\u91d1\u5c5e\u30a2\u30ec\u30eb\u30ae\u30fc\u306e\u3042\u308b\u65b9\u306a\u3069\u306f\u4e0a\u8a18\u4ee5\u5916\u306e\u4eba\u5de5\u95a2\u7bc0\u3092\u4f7f\u3046\u5834\u5408\u304c\u3042\u308a\u307e\u3059\u3002\u4eba\u5de5\u819d\u95a2\u7bc0\u306b\u306f\u69d8\u3005\u306a\u7a2e\u985e\u304c\u3042\u308a\u307e\u3059\u304c\u3001\u95a2\u7bc0\u30ea\u30a6\u30de\u30c1\u306e\u60a3\u8005\u3055\u3093\u3067\u306e\u4eba\u5de5\u95a2\u7bc0\u306e\u5bff\u547d\u306b\u306f\u5927\u304d\u306a\u5dee\u306f\u306a\u304f\u3001\u4e00\u822c\u7684\u306a\u8010\u7528\u5e74\u6570\u306f\u7d0420\u5e74\u3068\u8003\u3048\u3089\u308c\u3066\u3044\u307e\u3059\u3002<\/p>\n<div id=\"attachment_150\" style=\"width: 420px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-150\" class=\"size-full wp-image-150\" src=\"https:\/\/www.rheuma-net.or.jp\/rheuma\/securewp\/wp-content\/uploads\/2023\/07\/surgery-image007.jpg\" alt=\"\u53f3\u819d\u95a2\u7bc0\u3092\u524d\u304b\u3089\u898b\u305f\u30a4\u30e1\u30fc\u30b8\uff08\u7070\u8272\u306e\u90e8\u5206\u304c\u4eba\u5de5\u95a2\u7bc0\uff09\" width=\"410\" height=\"301\" srcset=\"https:\/\/www.rheuma-net.or.jp\/rheuma\/securewp\/wp-content\/uploads\/2023\/07\/surgery-image007.jpg 410w, https:\/\/www.rheuma-net.or.jp\/rheuma\/securewp\/wp-content\/uploads\/2023\/07\/surgery-image007-300x220.jpg 300w, https:\/\/www.rheuma-net.or.jp\/rheuma\/securewp\/wp-content\/uploads\/2023\/07\/surgery-image007-80x59.jpg 80w\" sizes=\"(max-width: 410px) 100vw, 410px\" \/><p id=\"caption-attachment-150\" class=\"wp-caption-text\">\u53f3\u819d\u95a2\u7bc0\u3092\u524d\u304b\u3089\u898b\u305f\u30a4\u30e1\u30fc\u30b8\uff08\u7070\u8272\u306e\u90e8\u5206\u304c\u4eba\u5de5\u95a2\u7bc0\uff09<br \/>\n\uff08\u95a2\u7bc0\u30ea\u30a6\u30de\u30c1\u306e\u8a3a\u7642\u30de\u30cb\u30e5\u30a2\u30eb\uff08\u6539\u8a02\u7248\uff09, \u8a3a\u65ad\u306e\u30de\u30cb\u30e5\u30a2\u30eb\u3068EBM\u306b\u57fa\u3065\u304f\u6cbb\u7642\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3, \u8ca1\u56e3\u6cd5\u4eba \u65e5\u672c\u30ea\u30a6\u30de\u30c1\u8ca1\u56e3\u767a\u884c, 2004\u3088\u308a\u5f15\u7528\uff09<\/p><\/div>\n<h4 id=\"surgery2-2\">2\uff0e\u80a1\u95a2\u7bc0<\/h4>\n<p>\u3000\u95a2\u7bc0\u30ea\u30a6\u30de\u30c1\u306e\u80a1\u95a2\u7bc0\u624b\u8853\u3067\u306f\u307b\u3068\u3093\u3069\u306e\u4f8b\u3067\u4eba\u5de5\u80a1\u95a2\u7bc0\u7f6e\u63db\u8853\u304c\u884c\u308f\u308c\u307e\u3059\u3002\u5909\u5f62\u6027\u80a1\u95a2\u7bc0\u75c7\u306e\u60a3\u8005\u3055\u3093\u3067\u884c\u308f\u308c\u308b\u3088\u3046\u306a\u95a2\u7bc0\u5f62\u6210\u8853\u3001\u9aa8\u5207\u308a\u8853\u3001\u95a2\u7bc0\u56fa\u5b9a\u8853\u306a\u3069\u306f\u3001\u95a2\u7bc0\u30ea\u30a6\u30de\u30c1\u306e\u60a3\u8005\u3055\u3093\u306b\u306f\u3042\u307e\u308a\u884c\u308f\u308c\u307e\u305b\u3093\u3002\u85ac\u7269\u6cbb\u7642\u304c\u3088\u304f\u306a\u3063\u305f\u8fd1\u5e74\u3067\u306f\u3001\u3054\u304f\u307e\u308c\u306b\u6ed1\u819c\u5207\u9664\u8853\u304c\u9078\u629e\u3068\u306a\u308b\u3053\u3068\u3082\u3042\u308a\u307e\u3059\u3002\u80a1\u95a2\u7bc0\u306f\u4eba\u5de5\u95a2\u7bc0\u7f6e\u63db\u8853\u306e\u307f\u304c\u63a8\u5968A\u3067\u3059\u3002<br \/>\n\u3000\u4eba\u5de5\u80a1\u95a2\u7bc0\u7f6e\u63db\u8853\u3067\u306f\u5927\u817f\u9aa8\u3092\u4e0b\u80a2\u306e\u4ed8\u3051\u6839\u8fd1\u304f\u3067\u5207\u308a\u3001\u5909\u5f62\u3057\u305f\u5927\u817f\u9aa8\u3092\u53d6\u308a\u9664\u3044\u305f\u5f8c\u3001\u4eba\u5de5\u80a1\u95a2\u7bc0\u3092\u633f\u5165\u3057\u307e\u3059\uff08\u4e0b\u56f3\uff09\u3002\u9aa8\u76e4\u5074\u306f\u901a\u5e38\u30c9\u30fc\u30e0\u72b6\u306e\u91d1\u5c5e\u306e\u30ab\u30c3\u30d7\uff08\u53d7\u3051\u624b\uff09\u3092\u306d\u3058\u3084\u9aa8\u306e\u30bb\u30e1\u30f3\u30c8\u3067\u9aa8\u76e4\u306b\u56fa\u5b9a\u3057\u3066\u3001\u305d\u306e\u91d1\u5c5e\u306e\u30ab\u30c3\u30d7\u306e\u4e2d\u306b\u533b\u7642\u7528\u306e\u30dd\u30ea\u30a8\u30c1\u30ec\u30f3\uff08\u30d7\u30e9\u30b9\u30c1\u30c3\u30af\u306e\u81fc\u306e\u69d8\u306a\u3082\u306e\uff09\u3042\u308b\u3044\u306f\u30bb\u30e9\u30df\u30c3\u30af\u88fd\u306e\u53d7\u3051\u624b\u3092\u306f\u3081\u8fbc\u307f\u307e\u3059\u3002\u5927\u817f\u9aa8\u5074\u306f\u304f\u3055\u3073\u72b6\u306e\u5927\u817f\u9aa8\u5074\u306e\u4eba\u5de5\u95a2\u7bc0\u3092\u9aa8\u306b\u633f\u5165\u3057\u307e\u3059\u3002\u56fa\u5b9a\u306f\u819d\u95a2\u7bc0\u3068\u540c\u69d8\u306b\u7279\u6b8a\u306a\u8868\u9762\u5f62\u72b6\u3092\u5229\u7528\u3057\u3066\u56fa\u5b9a\u3059\u308b\u3082\u306e\u3084\u3001\u9aa8\u306e\u30bb\u30e1\u30f3\u30c8\u3092\u4f7f\u7528\u3057\u3066\u884c\u306a\u3046\u3082\u306e\u304c\u3042\u308a\u307e\u3059\u3002\u305d\u306e\u5148\u306b\u4eba\u5de5\u306e\u9aa8\u982d\uff08\u5c0f\u3055\u306a\u30dc\u30fc\u30eb\u306e\u3088\u3046\u306a\u3082\u306e\uff09\u3092\u3064\u3051\u3001\u9aa8\u76e4\u5074\u306e\u53d7\u3051\u624b\u3068\u7d44\u307f\u5408\u308f\u305b\u307e\u3059\u3002\u95a2\u7bc0\u7834\u58ca\u306e\u7a0b\u5ea6\u306b\u3088\u3063\u3066\u306f\u4e0a\u8a18\u306e\u4eba\u5de5\u95a2\u7bc0\u4ee5\u5916\u306e\u4eba\u5de5\u95a2\u7bc0\u3092\u4f7f\u3046\u5834\u5408\u3084\u9aa8\u304c\u8db3\u308a\u306a\u3044\u90e8\u5206\u306b\u81ea\u5206\u306e\u9aa8\u3084\u4eba\u5de5\u9aa8\u3092\u79fb\u690d\u3059\u308b\u5834\u5408\u304c\u3042\u308a\u307e\u3059\u3002\u4eba\u5de5\u80a1\u95a2\u7bc0\u306b\u3082\u591a\u304f\u306e\u7a2e\u985e\u304c\u3042\u308a\u307e\u3059\u304c\u3001\u95a2\u7bc0\u30ea\u30a6\u30de\u30c1\u306e\u60a3\u8005\u3055\u3093\u3067\u306e\u4eba\u5de5\u95a2\u7bc0\u306e\u5bff\u547d\u306b\u306f\u5927\u304d\u306a\u5dee\u306f\u306a\u304f\u3001\u4e00\u822c\u7684\u306a\u8010\u7528\u5e74\u6570\u306f20\u5e74\u3068\u8003\u3048\u3089\u308c\u3066\u3044\u307e\u3059\u3002\u4eba\u5de5\u80a1\u95a2\u7bc0\u7f6e\u63db\u8853\u5f8c\u306e\u7279\u6709\u306a\u5408\u4f75\u75c7\u3068\u3057\u3066\u3001\u95a2\u7bc0\u306e\u8131\u81fc\u304c\u6319\u3052\u3089\u308c\u307e\u3059\u3002\u8131\u81fc\u3092\u4e88\u9632\u3059\u308b\u305f\u3081\u3001\u8853\u5f8c\u306e\u751f\u6d3b\u306e\u4e2d\u3067\u306e\u811a\u306e\u4f4d\u7f6e\u3084\u89d2\u5ea6\u306b\u6ce8\u610f\u304c\u5fc5\u8981\u3067\u3059\u3002<\/p>\n<div id=\"attachment_151\" style=\"width: 419px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-151\" class=\"size-full wp-image-151\" src=\"https:\/\/www.rheuma-net.or.jp\/rheuma\/securewp\/wp-content\/uploads\/2023\/07\/surgery-image009.jpg\" alt=\"\u4eba\u5de5\u80a1\u95a2\u7bc0\u5168\u7f6e\u63db\u8853\" width=\"409\" height=\"252\" srcset=\"https:\/\/www.rheuma-net.or.jp\/rheuma\/securewp\/wp-content\/uploads\/2023\/07\/surgery-image009.jpg 409w, https:\/\/www.rheuma-net.or.jp\/rheuma\/securewp\/wp-content\/uploads\/2023\/07\/surgery-image009-300x185.jpg 300w, https:\/\/www.rheuma-net.or.jp\/rheuma\/securewp\/wp-content\/uploads\/2023\/07\/surgery-image009-80x49.jpg 80w\" sizes=\"(max-width: 409px) 100vw, 409px\" \/><p id=\"caption-attachment-151\" class=\"wp-caption-text\">\u4eba\u5de5\u80a1\u95a2\u7bc0\u5168\u7f6e\u63db\u8853<br \/>\n\uff08\u95a2\u7bc0\u30ea\u30a6\u30de\u30c1\u306e\u8a3a\u7642\u30de\u30cb\u30e5\u30a2\u30eb\uff08\u6539\u8a02\u7248\uff09, \u8a3a\u65ad\u306e\u30de\u30cb\u30e5\u30a2\u30eb\u3068EBM\u306b\u57fa\u3065\u304f\u6cbb\u7642\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3, \u8ca1\u56e3\u6cd5\u4eba \u65e5\u672c\u30ea\u30a6\u30de\u30c1\u8ca1\u56e3\u767a\u884c, 2004\u3088\u308a\u5f15\u7528\uff09<\/p><\/div>\n<h4 id=\"surgery2-3\">3\uff0e\u624b\u95a2\u7bc0\u30fb\u624b\u6307\u95a2\u7bc0<\/h4>\n<p>\u3000\u624b\u95a2\u7bc0\uff08\u624b\u9996\uff09\u3067\u306f\u95a2\u7bc0\u30ea\u30a6\u30de\u30c1\u306b\u3088\u308b\u6ed1\u819c\u708e\u3067\u5909\u5f62\u3084\u75db\u307f\u3092\u751f\u3058\u308b\u3053\u3068\u304c\u3042\u308a\u307e\u3059\u3002\u75db\u307f\u3092\u6e1b\u3089\u3057\u3001\u624b\u95a2\u7bc0\u306e\u6a5f\u80fd\u3092\u6539\u5584\u3059\u308b\u76ee\u7684\u3067\u624b\u8853\u3092\u884c\u3044\u307e\u3059\u3002\u624b\u8853\u65b9\u6cd5\u306f\u3055\u307e\u3056\u307e\u306a\u65b9\u6cd5\u304c\u3042\u308a\u307e\u3059\u304c\u3001\u4e00\u822c\u7684\u306b\u624b\u95a2\u7bc0\u3067\u306f\u6ed1\u819c\u5207\u9664\u3092\u884c\u3063\u305f\u5f8c\u306b\u3001\u90e8\u5206\u7684\u306b\u95a2\u7bc0\u306e\u9aa8\u3092\u56fa\u5b9a\u3059\u308b\u3053\u3068\u304c\u591a\u3044\u3067\u3059\u3002\u90e8\u5206\u7684\u306b\u56fa\u5b9a\u3059\u308b\u3053\u3068\u3067\u95a2\u7bc0\u304c\u5b89\u5b9a\u3057\u3001\u75db\u307f\u306e\u6539\u5584\u304c\u671f\u5f85\u3067\u304d\u307e\u3059\u3002\u5909\u5f62\u306e\u7a0b\u5ea6\u306b\u3088\u3063\u3066\u306f\u9aa8\u5207\u9664\u306e\u307f\u306e\u5834\u5408\u3082\u3042\u308a\u307e\u3059\u3002\u624b\u95a2\u7bc0\u306f\u6ed1\u819c\u5207\u9664\u8853\u304c\u63a8\u5968A\u3067\u3001\u95a2\u7bc0\u56fa\u5b9a\u8853\u3068\u95a2\u7bc0\u5f62\u6210\u8853\u306f\u63a8\u5968B\uff08\u884c\u3046\u3088\u3046\u52e7\u3081\u3089\u308c\u308b\uff09\u3067\u3059\u3002<br \/>\n\u3000\u624b\u6307\u95a2\u7bc0\u3067\u306f\u6307\u306e\u5c0f\u95a2\u7bc0\u306b\u6ed1\u819c\u708e\u304c\u8d77\u3053\u308a\u3001\u69d8\u3005\u306a\u5909\u5f62\u3092\u751f\u3058\u3066\u65e5\u5e38\u751f\u6d3b\u52d5\u4f5c\u306e\u969c\u5bb3\u306b\u306a\u3063\u3066\u3044\u308b\u5834\u5408\u3084\u75db\u307f\u306e\u539f\u56e0\u3068\u306a\u3063\u3066\u3044\u308b\u5834\u5408\u306b\u4e3b\u306b\u6ed1\u819c\u5207\u9664\u8853\u3001\u4eba\u5de5\u95a2\u7bc0\u7f6e\u63db\u8853\u3084\u95a2\u7bc0\u5f62\u6210\u8853\u3092\u884c\u3044\u307e\u3059\u3002\u307e\u305f\u624b\u6307\u95a2\u7bc0\u3068\u3068\u3082\u306b\u624b\u95a2\u7bc0\u306e\u5909\u5f62\u3084\u6ed1\u819c\u708e\u306b\u3088\u308a\u6307\u3092\u66f2\u3052\u305f\u308a\u4f38\u3070\u3057\u305f\u308a\u3059\u308b\u8171\u306e\u65ad\u88c2\u3092\u4f34\u3046\u3053\u3068\u304c\u3042\u308a\u307e\u3059\u3002\u75db\u307f\u3092\u6e1b\u3089\u3057\u3001\u5207\u308c\u305f\u8171\u3092\u518d\u5efa\u3059\u308b\uff08\u5143\u901a\u308a\u306b\u3059\u308b\u3053\u3068\u3067\u306f\u3042\u308a\u307e\u305b\u3093\uff09\u76ee\u7684\u3067\u3082\u624b\u8853\u6cbb\u7642\u3092\u884c\u3044\u307e\u3059\u3002\u624b\u8853\u65b9\u6cd5\u306f\u591a\u304f\u306e\u65b9\u6cd5\u304c\u3042\u308a\u307e\u3059\u304c\u3001\u8171\u304c\u65ad\u88c2\u3057\u3066\u3044\u308b\u5834\u5408\u306b\u306f\u3001\u8171\u3092\u96a3\u306e\u6307\u306e\u8171\u306b\u3088\u305b\u3066\u7e2b\u5408\u3057\u305f\u308a\u3001\u65b0\u305f\u306b\u8171\u3092\u79fb\u690d\u3059\u308b\u51e6\u7f6e\u3092\u8ffd\u52a0\u3057\u307e\u3059\u3002\u624b\u6307\u95a2\u7bc0\u3067\u306f\u6ed1\u819c\u5207\u9664\u8853\u304c\u63a8\u5968A\u3067\u3001\u4ed6\u306e\u624b\u8853\u306f\u63a8\u5968B\u3067\u3059\u3002\u4eba\u5de5\u95a2\u7bc0\u7f6e\u63db\u8853\u3084\u95a2\u7bc0\u5f62\u6210\u8853\u3092\u884c\u306a\u3063\u3066\u3082\u3001\u8853\u5f8c\u306b\u5909\u5f62\u306e\u5341\u5206\u306a\u6539\u5584\u304c\u306a\u3044\u5834\u5408\u3084\u3001\u307e\u305f\u8171\u306e\u518d\u5efa\u8853\u3092\u884c\u3063\u3066\u3082\u3001\u3082\u3046\u4e00\u5ea6\u65ad\u88c2\u3059\u308b\uff08\u518d\u65ad\u88c2\uff09\u53ef\u80fd\u6027\u306f\u3042\u308a\u307e\u3059\u3002<\/p>\n<div id=\"attachment_152\" style=\"width: 427px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-152\" class=\"size-full wp-image-152\" src=\"https:\/\/www.rheuma-net.or.jp\/rheuma\/securewp\/wp-content\/uploads\/2023\/07\/surgery-image011.jpg\" alt=\"2\uff5e5\u6307\uff08\u4eba\u5dee\u3057\u6307\u304b\u3089\u5c0f\u6307\uff09\u306b\u5bfe\u3059\u308b\u4eba\u5de5\u95a2\u7bc0\u7f6e\u63db\u8853\" width=\"417\" height=\"238\" srcset=\"https:\/\/www.rheuma-net.or.jp\/rheuma\/securewp\/wp-content\/uploads\/2023\/07\/surgery-image011.jpg 417w, https:\/\/www.rheuma-net.or.jp\/rheuma\/securewp\/wp-content\/uploads\/2023\/07\/surgery-image011-300x171.jpg 300w, https:\/\/www.rheuma-net.or.jp\/rheuma\/securewp\/wp-content\/uploads\/2023\/07\/surgery-image011-80x46.jpg 80w\" sizes=\"(max-width: 417px) 100vw, 417px\" \/><p id=\"caption-attachment-152\" class=\"wp-caption-text\">2\uff5e5\u6307\uff08\u4eba\u5dee\u3057\u6307\u304b\u3089\u5c0f\u6307\uff09\u306b\u5bfe\u3059\u308b\u4eba\u5de5\u95a2\u7bc0\u7f6e\u63db\u8853<br \/>\n\uff08\u95a2\u7bc0\u30ea\u30a6\u30de\u30c1\u306e\u8a3a\u7642\u30de\u30cb\u30e5\u30a2\u30eb\uff08\u6539\u8a02\u7248\uff09, \u8a3a\u65ad\u306e\u30de\u30cb\u30e5\u30a2\u30eb\u3068EBM\u306b\u57fa\u3065\u304f\u6cbb\u7642\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3, \u8ca1\u56e3\u6cd5\u4eba \u65e5\u672c\u30ea\u30a6\u30de\u30c1\u8ca1\u56e3\u767a\u884c, 2004\u3088\u308a\u5f15\u7528\uff09<\/p><\/div>\n<h4 id=\"surgery2-4\">4\uff0e\u8db3\u95a2\u7bc0\u30fb\u8db3\u8dbe\u95a2\u7bc0<\/h4>\n<p>\u3000\u8db3\u95a2\u7bc0\uff08\u8db3\u9996\uff09\u3067\u306f\u95a2\u7bc0\u306e\u72b6\u614b\u306b\u3088\u3063\u3066\u3001\u6ed1\u819c\u5207\u9664\u8853\u3001\u4eba\u5de5\u95a2\u7bc0\u7f6e\u63db\u8853\u3001\u95a2\u7bc0\u56fa\u5b9a\u8853\u306a\u3069\u69d8\u3005\u306a\u624b\u8853\u304c\u884c\u308f\u308c\u307e\u3059\u3002\u6ed1\u819c\u5207\u9664\u8853\u3084\u4eba\u5de5\u95a2\u7bc0\u7f6e\u63db\u8853\u3067\u306f\u8db3\u95a2\u7bc0\u306e\u52d5\u304d\uff08\u53ef\u52d5\u57df\uff09\u306f\u3042\u308b\u7a0b\u5ea6\u6b8b\u308a\u307e\u3059\u304c\u3001\u95a2\u7bc0\u56fa\u5b9a\u8853\u3067\u306f\u5b8c\u5168\u306b\u52d5\u304b\u306a\u304f\u306a\u308a\u307e\u3059\u3002\u305f\u3060\u3057\u3001\u95a2\u7bc0\u56fa\u5b9a\u8853\u3092\u53d7\u3051\u3066\u3082\u4ed6\u306e\uff08\u8db3\u306e\u7532\u306b\u3042\u308b\u95a2\u7bc0\u306a\u3069\uff09\u8db3\u90e8\u306e\u95a2\u7bc0\u306f\u6b8b\u308b\u306e\u3067\u3001\u8db3\u90e8\u304c\u5168\u304f\u52d5\u304b\u306a\u304f\u306a\u308b\u308f\u3051\u3067\u306f\u3042\u308a\u307e\u305b\u3093\u3002\u8db3\u95a2\u7bc0\u56fa\u5b9a\u8853\u306b\u3088\u308a\u5b89\u5b9a\u6027\u304c\u78ba\u4fdd\u3055\u308c\u308b\u306e\u3067\u3001\u6b69\u884c\u306f\u75db\u307f\u306a\u304f\u5b89\u5b9a\u3057\u3066\u53ef\u80fd\u306b\u306a\u308a\u307e\u3059\u3002\u8db3\u95a2\u7bc0\u306f\u95a2\u7bc0\u56fa\u5b9a\u8853\u304c\u63a8\u5968A\u3067\u3001\u6ed1\u819c\u5207\u9664\u8853\u3068\u4eba\u5de5\u95a2\u7bc0\u7f6e\u63db\u8853\u306f\u63a8\u5968B\u3067\u3059\u3002<br \/>\n\u3000\u8db3\u8dbe\u306e\u624b\u8853\u3067\u306f\u4ee5\u524d\u306f\u95a2\u7bc0\u5207\u9664\u8853\u304c\u3088\u304f\u884c\u308f\u308c\u3066\u3044\u307e\u3057\u305f\u304c\u3001\u8fd1\u5e74\u306f\u95a2\u7bc0\u5f62\u6210\u8853\u304c\u591a\u304f\u884c\u308f\u308c\u3066\u3044\u307e\u3059\u3002\u8db3\u8dbe\u306e\u95a2\u7bc0\u5f62\u6210\u8853\u3067\u306f\u3001\u8db3\u8dbe\u306e\u7834\u58ca\u3055\u308c\u305f\u95a2\u7bc0\u306e\u9aa8\u3092\u4e00\u90e8\u5207\u9664\u3057\u305f\u308a\u3001\u5411\u304d\u3092\u5909\u3048\u305f\u308a\u3057\u307e\u3059\u3002\u8db3\u8dbe\u306e\u5909\u5f62\u306e\u5ea6\u5408\u3044\u3084\u5404\u3005\u306e\u60a3\u8005\u3055\u3093\u306e\u72b6\u6cc1\u306b\u3088\u308a\u624b\u8853\u65b9\u6cd5\u3092\u9078\u629e\u3057\u307e\u3059\u3002\u4eba\u5de5\u8db3\u8dbe\u95a2\u7bc0\u3092\u4f7f\u7528\u3059\u308b\u5834\u5408\u306f\u30b7\u30ea\u30b3\u30f3\u88fd\u306e\u4eba\u5de5\u95a2\u7bc0\u3092\u633f\u5165\u3057\u307e\u3059\u3002\u8db3\u8dbe\u95a2\u7bc0\u3067\u306f\u95a2\u7bc0\u5f62\u6210\u8853\u306e\u307f\u304c\u63a8\u5968A\u3067\u3059\u3002\u8db3\u8dbe\u306e\u624b\u8853\u306f\u65bd\u8a2d\u306b\u3088\u308a\u884c\u306a\u3046\u624b\u8853\u6cd5\u304c\u7570\u306a\u308b\u5834\u5408\u304c\u3042\u308a\u307e\u3059\u3002<\/p>\n<p><div id=\"attachment_153\" style=\"width: 426px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-153\" class=\"size-full wp-image-153\" src=\"https:\/\/www.rheuma-net.or.jp\/rheuma\/securewp\/wp-content\/uploads\/2023\/07\/surgery-image013.jpg\" alt=\"\u8db3\u95a2\u7bc0\u56fa\u5b9a\u8853\" width=\"416\" height=\"222\" srcset=\"https:\/\/www.rheuma-net.or.jp\/rheuma\/securewp\/wp-content\/uploads\/2023\/07\/surgery-image013.jpg 416w, https:\/\/www.rheuma-net.or.jp\/rheuma\/securewp\/wp-content\/uploads\/2023\/07\/surgery-image013-300x160.jpg 300w, https:\/\/www.rheuma-net.or.jp\/rheuma\/securewp\/wp-content\/uploads\/2023\/07\/surgery-image013-80x43.jpg 80w\" sizes=\"(max-width: 416px) 100vw, 416px\" \/><p id=\"caption-attachment-153\" class=\"wp-caption-text\">\u8db3\u95a2\u7bc0\u56fa\u5b9a\u8853<\/p><\/div> <div id=\"attachment_154\" style=\"width: 271px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-154\" class=\"size-full wp-image-154\" src=\"https:\/\/www.rheuma-net.or.jp\/rheuma\/securewp\/wp-content\/uploads\/2023\/07\/surgery-image015.jpg\" alt=\"\u6bcd\u8dbe\u306f\u95a2\u7bc0\u56fa\u5b9a\u8853\u30012-5\u8dbe\u306f\u95a2\u7bc0\u5207\u9664\u8853\" width=\"261\" height=\"298\" srcset=\"https:\/\/www.rheuma-net.or.jp\/rheuma\/securewp\/wp-content\/uploads\/2023\/07\/surgery-image015.jpg 261w, https:\/\/www.rheuma-net.or.jp\/rheuma\/securewp\/wp-content\/uploads\/2023\/07\/surgery-image015-70x80.jpg 70w\" sizes=\"(max-width: 261px) 100vw, 261px\" \/><p id=\"caption-attachment-154\" class=\"wp-caption-text\">\u6bcd\u8dbe\u306f\u95a2\u7bc0\u56fa\u5b9a\u8853\u30012-5\u8dbe\u306f\u95a2\u7bc0\u5207\u9664\u8853<br \/>\n\uff08\u95a2\u7bc0\u30ea\u30a6\u30de\u30c1\u306e\u8a3a\u7642\u30de\u30cb\u30e5\u30a2\u30eb\uff08\u6539\u8a02\u7248\uff09, \u8a3a\u65ad\u306e\u30de\u30cb\u30e5\u30a2\u30eb\u3068EBM\u306b\u57fa\u3065\u304f\u6cbb\u7642\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3, \u8ca1\u56e3\u6cd5\u4eba \u65e5\u672c\u30ea\u30a6\u30de\u30c1\u8ca1\u56e3\u767a\u884c, 2004\u3088\u308a\u5f15\u7528\uff09<\/p><\/div><\/p>\n<h4 id=\"surgery2-5\">5\uff0e\u80a9\u95a2\u7bc0\u30fb\u8098\u95a2\u7bc0<\/h4>\n<p>\u3000\u80a9\u95a2\u7bc0\u3067\u306f\u4eba\u5de5\u95a2\u7bc0\u7f6e\u63db\u8853\u304c\u63a8\u5968A\u3001\u6ed1\u819c\u5207\u9664\u8853\u306f\u63a8\u5968B\u3068\u306a\u3063\u3066\u3044\u307e\u3059\u304c\u3001\u8fd1\u5e74\u3067\u306f\u5927\u304d\u306a\u5275\u3092\u958b\u304b\u305a\u3001\u95a2\u7bc0\u93e1\u3092\u4f7f\u7528\u3057\u3066\u884c\u3046\u6ed1\u819c\u5207\u9664\u8853\u304c\u60a3\u8005\u3055\u3093\u3078\u306e\u8ca0\u62c5\u3082\u5c11\u306a\u304f\u3001\u826f\u597d\u306a\u8853\u5f8c\u6210\u7e3e\u3082\u5831\u544a\u3055\u308c\u3066\u3044\u307e\u3059\u3002\u307e\u305f\u4eba\u5de5\u80a9\u95a2\u7bc0\u7f6e\u63db\u8853\u3067\u306f\u65b0\u3057\u3044\u6a5f\u7a2e\u306e\u5c0e\u5165\u3082\u9032\u3081\u3089\u308c\u3066\u3044\u307e\u3059\u3002<br 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