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<meta name="description" content="[第21巻紹介]　眼瞼のスペシャリストである編者が送る，「ありきたりではない」眼瞼治療の教科書です．　　眼瞼診療において，大きな切開を伴う手術は技術的にも設備的にもハードルは低くありません．　そこで，本書では眼科の多くが備えている「処置室」があればできる範囲に内容を絞りました．　　具体的には，　１．網羅的な保存的治療　２．「あまり切らないけど，少しだけ切る」プチ手術　３．美容，たるみ予防等のケア，">

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		<div class="headers"><h3 class="current content">内容</h3><h3 class="preface">序文</h3><h3 class="indexes">主要目次</h3></div><section class="current content">[第21巻紹介]<br>眼瞼のスペシャリストである編者が送る，「ありきたりではない」眼瞼治療の教科書です．<br><br>眼瞼診療において，大きな切開を伴う手術は技術的にも設備的にもハードルは低くありません．<br>そこで，本書では眼科の多くが備えている「処置室」があればできる範囲に内容を絞りました．<br><br>具体的には，<br>１．網羅的な保存的治療<br>２．「あまり切らないけど，少しだけ切る」プチ手術<br>３．美容，たるみ予防等のケア，自由診療など眼瞼にまつわる内容<br>以上の3テーマを中心に，眼科・形成外科・皮膚科などあらゆる分野のエキスパートが明日の診療ですぐに役立つテクニックを解説しています．<br><br>「処置室」と範囲を限定してはいるものの，シリーズ最大級のイラスト・ボリュームで，多岐にわたる内容を余すところなく盛り込み，むしろ「処置室だけでここまでできる」と好奇心を刺激するはず．<br>「切らない眼科医」の方はもちろん，眼瞼に関わるすべての方の世界をきっと広げる一冊です．<br><br>【シリーズ概要】<br>「日常臨床にすぐ役立つ」をコンセプトとした「眼科プラクティス」の最新シリーズ．今シリーズでは図版をより効果的に示すことで，さらにビジュアル面を大幅強化．直感的に理解できる「視る教科書」を目指した．</section><section class="preface">『新篇眼科プラクティス21 処置室でできる 低侵襲・眼瞼診療』序文<br><br>　本書はありきたりな眼瞼の教科書ではありません．<br>　外来における眼瞼疾患は，まず一般眼科医が診察して薬物投与や経過観察をしたうえで，必要ならば眼瞼の専門家に送る流れが通常と思います．そのためには，保存的治療の選択肢を多数持っておくことが大切です．できれば切らないで治療を済ませたいのは，医師も患者も同じ気持ちでしょう．<br>　そこで悩ましいのが，保存的治療では十分でないと判断され，ちょっとした切るか切らないか程度の加療が必要となる場合です．そのような場合に，患者さんをわざわざ遠方の専門施設に紹介するのはもどかしくはないでしょうか．自分がここで施術してあげられたらどんなにいいだろうと思ったことはありませんか？<br>　環境は整っているはずです．多くの施設には，オペ室があります．内眼手術が中心で，止血縫合を伴うような眼瞼手術はしないという眼科も多いことでしょう．しかしそれは，やらないというだけのことで道具はそろっているはずです．また，オペ室がない眼科の8 割程度に処置室はあるとされます．ですからほとんどの眼科医が，“ちょっと切る”程度の処置ならできる環境にはあるはずなのです．<br>　そこで本書では, あえて「切らない眼科医」を主な対象とし，眼瞼疾患に対して保存的治療でできることを幅広く網羅する構成としました．また，将来的に本格的な手術をする予定はないが，「あまり切らずに」処置室レベルで対応可能な低リスクの処置・小手術まで手を広げたいという先生方を想定し，バイポーラを使わず，皮膚は切っても穿刺する程度の範囲の施術にも着目しました．<br>　その結果，本書は診断と薬物治療に加えて，「あまり切らないけれど，少しだけ切る」プチ手術まで，明日からの診療で役立つテクニックを集めた内容となっています．他科の先生に執筆を依頼した項が多いのも本書の特徴です．<br>　こうして普通の眼瞼の教科書ではなくなったところで，ご自分が知りたい美容に関すること，たるみの予防としてできるケアや，保険診療からは外れるけれど一般人として知りたかった眼瞼にまつわる内容にも踏み込んでみました．<br>　これで，目の前まで来てくれた患者さんに，保存的治療の幅広い選択肢を提示することができ，「ここでやってあげたい」と思ったことを提供できるようになるでしょう．小さい施術からで結構です．やってみれば越えられるハードルです．あとは先生ご自身が踏み出すかどうかだけです．<br>　本書をお読みになった先生のご診療が豊かなものになり，より多くの患者さんの利益になりますことを祈念しております．<br><br>2025年9月<br>野田実香</section><section class="indexes">【総説】			<br>　総説		<br><br>【解説】			<br>　Ⅰ．解剖・生理			<br>　　1：眼瞼の解剖		<br>　　1．外見上の解剖	<br>　　2．機能的解剖	<br>　　3．上眼瞼翻転	<br>　　4．画像解剖(MRI)	<br>　　5．組織学的解剖	<br>　　6．加齢性変化	<br>　2：その他の解剖		<br>　　1．睫毛の解剖	<br>　　2．義眼床の解剖	<br>Ⅱ．MGD			<br>　1：病態の理解		<br>　　1．MGDの病態	<br>　2：MGDの治療		<br>　　1．マイボケア（温罨法　清拭）	<br>　　2．デモデックス	<br>　　3．マイバム圧出	<br>　　4．薬物治療	<br>　　5．IPL, Lipiflow	<br>　　6．Tixcel C	<br>Ⅲ．麦粒腫・霰粒腫			<br>　1：病態の理解		<br>　　1．麦粒腫・霰粒腫の病態	<br>　　2．麦粒腫		<br>　　3．霰粒腫		<br>　　　1．霰粒腫との鑑別	<br>　　　　a.マイボーム腺嚢胞<br>　　　　b．脂腺癌<br>　　　2．霰粒腫の処置	<br>　　　　a．ステロイド注射<br>　　　　b．経結膜的摘出術<br>　　　　c．経皮的摘出術<br>　　　　d．無麻酔下経皮的圧出術<br>　　4：眼瞼縁炎		<br>　　［O］眼瞼の化粧によるトラブル	<br>Ⅳ．腫瘤			<br>　1：評価		<br>　　1．眼瞼腫瘤の評価	<br>　2：腫瘤の処置（切除含む）		<br>　　1．皮膚腫瘤切除	<br>　　2．稗粒腫・汗管腫処置	<br>　　3．黄色腫切除	<br>　　4．瞼縁の母斑切除	<br>　3：他機関との連携		<br>　　1．病理組織の提出方法　伝票の書き方	<br>　　2．悪性腫瘍の説明と紹介状	<br>Ⅴ．眼瞼皮膚			<br>　1：皮膚科に送るべき眼瞼疾患		<br>　2：皮膚のたるみ		<br>　　a．たるみの治療	<br>　　b．皮膚弛緩予防の自宅ケア（皮膚科）	<br>　　c．皮膚弛緩予防の自宅ケア（美容外科）	<br>Ⅵ．眼瞼腫脹・甲状腺眼症			<br>　1：眼瞼眼窩腫脹		<br>　2：甲状腺眼症（眼科）		<br>　3：甲状腺眼症（内科・外科）		<br>Ⅶ．内反症			<br>　1：評価		<br>　　1．先天内反症の評価	<br>　　2．老人性内反症の評価	<br>　　［O］内反症に内眼角切開は有効か	<br>　2：内反症の処置		<br>　　1．睫毛抜去	<br>　3：切らない内反症手術		<br>　　1．毛根焼灼	<br>　　2．睫毛内反症埋没法	<br>　　3．眼瞼内反埋没法	<br>　4：他機関との連携		<br>　　1．小児内反症の紹介状	<br>Ⅷ．眼瞼下垂			<br>　1：評価		<br>　　1．眼瞼下垂の評価	<br>　　2．偽眼瞼下垂の評価	<br>　　3．先天眼瞼下垂の評価（眼科の視点）	<br>　　4．先天眼瞼下垂の評価（形成外科の視点）	<br>　　［O］子供の先天眼瞼下垂と弱視の関係について	<br>　　5．アイスパックテスト・テンシロンテスト	<br>　　［C］眼瞼下垂　美容と保険の境界	<br>　　［O］眼瞼下垂術後の視力の変化について	<br>　　［O］眼瞼下垂術後のドライアイのケア	<br>　　［O］眼瞼下垂術後のクレーム	<br>　　6．顔面神経麻痺の評価	<br>　　7．眼瞼けいれんの評価	<br>　2：眼瞼下垂の治療		<br>　　1．クラッチメガネ	<br>　　2．ボツリヌス治療	<br>　　3．閉瞼不全時の処方とケア	<br>　　［A］在宅診療における眼瞼ケア	<br>　3：切らない眼瞼下垂手術		<br>　　1．切らない吊り上げ術	<br>　　2．切らない眼瞼下垂①	<br>　　3．切らない眼瞼下垂②	<br>　　5．切らない二重形成①	<br>　　6．切らない二重形成②	<br>　　7．切らない二重形成②	<br>　4：他機関との連携		<br>　　1．眼瞼下垂の紹介状	<br>Ⅸ．眼瞼術後・裂傷			<br>　1：術後早期		<br>　　1．術創，眼瞼裂傷のケア	<br>　　2．open treatment	<br> 　3．皮膚抜糸	<br>　　4．結膜に出た糸の摘出	<br>　　［O］創傷治癒	<br>　2：術後慢性期		<br>　　1．傷痕のケア	<br>　　2．リハビリメイク	<br>　3：他機関との連携		<br>　　1．眼瞼外傷の紹介状	<br>Ⅹ．その他の手技と，眼瞼にまつわる知識			<br>　1：検査		<br>　　1．培養検査のオーダーの仕方	<br>　　2．細菌培養検査結果の見方	<br>　　［O］顔写真の撮り方	<br>　2：処方薬		<br>　［T］眼瞼疾患と漢方	<br>　［O］眼軟膏のヒミツ	<br>　3：麻酔		<br>　　1．局所麻酔	<br>　　2．小児の鎮静	<br>　　［O］小児に全身麻酔をかけて大丈夫なのか	<br>　　［O］眼瞼診療の判例集<br><br>Topics=［T］<br>One Point Advice=［O］<br>Controversy=［C］<br>Advanced Techniques=［A］</section></article>
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