| 特集名 | 維持透析患者の消化管疾患 ― 症状からみた傾向と対策 | |
|---|---|---|
| 題名 | 嚥下障害と対策 | |
| 発刊年月 | 2013年 02月 | |
| 著者 | 杉山 育子 | 聖隷浜松病院リハビリテーション科 |
| 著者 | 藤島 一郎 | 浜松市リハビリテーション病院 |
| 【 要旨 】 | 嚥下障害は，食思不振，脱水や栄養障害，誤嚥による窒息や肺炎の原因となる．2011年8月～2012年7月に聖隷浜松病院に入院し，嚥下障害にて摂食機能療法を算定した524名中，透析療法実施患者は16名（3％）であった．今後，透析患者の高齢化や脳血管疾患合併例の増加に伴い，嚥下障害のリスクが高まることが予想される．一見，経口摂取が安定しているように見える患者でも，全身状態悪化時には嚥下障害が起こりうることを念頭におくべきである．嚥下障害の対策には，ベッドサイドで簡単に行えるものも多い．嚥下障害を疑った場合には速やかに対策を行い，栄養障害や誤嚥性肺炎の併発を防止する必要がある． | |
| Theme | Diseases of alimentary tract in maintenance dialysis patients -- tendency and management from a view point of symptomatology | |
|---|---|---|
| Title | Measures against dysphagia | |
| Author | Ikuko Sugiyama | Department of Rehabilitation Medicine, Seirei Hamamatsu General Hospital |
| Author | Ichiro Fujishima | Seirei Hamamatsu City Rehabilitation Hospital |
| [ Summary ] | Dysphagia may lead to anorexia, dehydration and malnutrition, as well as asphyxia and aspirational pneumonia. Out of 524 patients who were admitted to Seirei Hamamatsu General Hospital between August 2011 and July 2012 in whom remuneration for eating function therapy for dysphagia. Sixteen of these patients (3 %) were receiving maintenance hemodialysis treatment. In the future, the incidence of dysphagia is expected to rise with the aging of the general population, along with increased comorbidity due to cerebrovascular diseases associated with dialysis patients. It should be kept in mind that even if patients nominally appear to exhibit normal swallowing functions, dysphagia may occur with deterioration of their general status. Measures against dysphagia include many methods which are easy to implement at the bedside. When dysphagia is suspected, it is necessary to immediately implement these measures to prevent occurrence of malnutrition and/or aspirational pneumonia. |
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