臨牀透析 Vol.24 No.8(4-3)


特集名 透析患者の呼吸器合併症
題名 肺炎 (3) 誤嚥性肺炎の予防対策
発刊年月 2008年 07月
著者 石飛 進吾 長崎大学医学部・歯学部附属病院特殊歯科総合治療部口腔ケア・摂食・嚥下リハビリテーションセンター
【 要旨 】 誤嚥性肺炎は摂食・嚥下機能の低下を背景に生じるが,肺炎の発症頻度や重症度は誤嚥の程度や免疫力によって異なる.摂食・嚥下機能の低下は特定の基礎疾患に基づく場合が多いが,活動性の低下や加齢による機能低下によっても生じる.誤嚥性肺炎を起こした場合,単に肺炎だけの問題ではなく治療期間中の廃用による身体機能低下などさまざまな問題が発生する.誤嚥性肺炎を予防するためには,反復唾液嚥下テスト,水飲みテストなどによる嚥下機能の評価が重要であり,これらによって障害が疑われる場合には専門機関の受診が望まれる.日常的な誤嚥性肺炎の予防対策としては,口腔ケア,身体機能の廃用防止,低栄養の防止などが重要である.
Theme Complications of Respiratory Organs in Dialysis Patients
Title Preventive measures for aspiration pneumonia
Author Shingo Ishitobi Department of Special Care Dentistry, Nagasaki University Hospital of Medicine and Dentistry
[ Summary ] Aspiration pneumonia occurs as a result of the loss of eating and swallowing functions. However, the frequency of occurrence and severity of the pneumonia varies depending on the degree of aspiration and immunity. In many cases, the loss of eating and swallowing functions is related to a specific underlying disease. However, it is also caused by a decline in activity or a reduction of functionality with age. When aspiration pneumonia occurs, it is not simply a problem of pneumonia alone, but rather, a combination of various problems such as low functional capacity due to disuse during treatment periods. In order to prevent aspiration pneumonia, evaluations of swallowing function, such as a repetitive saliva-swallowing test or a water-swallowing test are important. If a disorder is suspected as a result of these tests, then it is desirable for the patient to visit a specialist. Oral care, maintenance of physical activity and the prevention of malnutrition, are important daily preventive measures to guard against aspiration pneumonia.
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