臨牀透析 Vol.26 No.13(2-5)


特集名 身体所見からのCKD患者の栄養評価の重要性
題名 [各論]口腔・摂食・嚥下の評価
発刊年月 2010年 12月
著者 井上 啓子 至学館大学健康科学部栄養科学科・管理栄養士
著者 長屋 敬 新生会第一病院腎臓内科
【 要旨 】 摂食・嚥下障害を伴う患者には,嚥下評価を行い,食事が摂取できるかどうかを総合的に判定し,その結果に基づき咀嚼・嚥下状態に適応した食事を提供する.そのためには嚥下レベルに応じた嚥下障害段階食を提供できる体制を整備したうえで,嚥下障害段階食の移行基準をルール化することが大切となる.さらに,嚥下障害段階食の提供後も注意深く摂食の場面の観察を行うことが必要である.入院中の透析患者では,摂食・嚥下上の問題や義歯,残存歯の問題などを多く抱えているので,日常の口腔の観察と口腔ケアに心がけ,口腔乾燥や口腔およびその周囲の廃用性萎縮,誤嚥性肺炎の予防をはかる.
Theme Importance of Nutritional Assessment by Physical Examination in CKD
Title Assessment of oral disorders and swallowing / eating functions
Author Keiko Inoue Department of Nutrition, Faculty of Wellness, Shigakkan University
Author Takashi Nagaya Department of Nephrology, Shinseikai Daiichi Hospital
[ Summary ] For patients with eating and swallowing disorders, swallowing functions and possibile of food intake complications are closely assessed. Then appropriate food in relation to the patient's mastication and swallowing abilities is provided. Therefore, it is important to formulate general guidelines for dysphagia related diets. It is also necessary to carefully observe food intake after determining appropriate dysphagia diets. With hospitalized patients receiving hemodialysis, there are several problems related to eating, including swallowing and dental conditions including dentures and remaining teeth. Daily observation of oral cavities and proper oral health care will help prevent oral dryness, disuse related atrophy of oral muscles, and aspirational pneumonia.
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