{"created":"2022-05-26T06:33:51.862068+00:00","id":2000522,"links":{},"metadata":{"_buckets":{"deposit":"a646286e-ddb5-47f7-a1ec-b9380be68c4e"},"_deposit":{"id":"2000522","owners":[1],"pid":{"revision_id":0,"type":"depid","value":"2000522"},"status":"published"},"_oai":{"id":"oai:niigata-u.repo.nii.ac.jp:02000522","sets":["432:1291:1292:1653546419953","453:456"]},"author_link":[],"item_1627361970403":{"attribute_name":"出版タイプ","attribute_value_mlt":[{"subitem_version_resource":"http://purl.org/coar/version/c_970fb48d4fbd8a85","subitem_version_type":"VoR"}]},"item_7_biblio_info_6":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2014-12","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"2","bibliographicPageEnd":"98","bibliographicPageStart":"93","bibliographicVolumeNumber":"44","bibliographic_titles":[{"bibliographic_title":"新潟歯学会雑誌","bibliographic_titleLang":"ja"}]}]},"item_7_description_4":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"We present a case involving a 79-year-old man who received postoperative care as an outpatient after surgical treatment of left small cell lung cancer and right non-small cell lung cancer in Niigata University Medical and Dental Hospital. Because the patient's vital conditions had suddenly worsened and were accompanied by a high fever on 19 March 2014, the patient was admitted to the hospital on an emergency basis on 22 March. The patient had pneumonia with a patchy shadow in the right inferior lung lobe and a swollen cystic liver with internal bleeding, as occur with stroke. The patient's general condition gradually improved after establishment of an intravenous drip with antibiotics and antipyretics. However, he frequently coughed when he attempted to orally ingest medicine; he was then admitted to the Unit of Dysphagia Rehabilitation. The patient's general condition indicated undernutrition and high inflammatory marker levels. Thus, swallowing function examination was first performed and showed insufficient and poor oral hygiene with dry mucous membranes and a modified water swallow test score of 3b. On endoscopic examination 3 days after starting therapy, although pharyngeal residue remained after swallowing, clearance in the pharyngeal region was accomplished by adding swallowing of thickened water. Therefore, direct therapy was started by administering meals adjusted to a paste form on day 4. Prosthodontic insertion of complete dentures was commenced on day 15 to restore the patient's masticatory function and allow him to intake oral food. Videofluoroscopic examination on day 17 indicated that the patient's meals required thickening. The complete dentures were equipped in both jaws on day 28, and fitting adjustments were practiced several times. Reexamination of swallowing function on day 32 showed remarkable improvement in both the oral environment and swallowing function; the modified water swallow test score was 5. These improvements enabled the food consistency to be changed to solid food. On day 42, the second videofluoroscopic evaluation showed lower penetration than in the first trial. However, adjustment to a thickened meal was still required because swallowing of water caused silent aspiration. As the patient's oral health improved under our intervention, his swallowing function became satisfactory and stable. The patient was transferred to another hospital on day 43.","subitem_description_language":"en","subitem_description_type":"Abstract"},{"subitem_description":"症例は79歳男性，当院呼吸器内科に左小細胞肺癌/右非小細胞肺癌切除術後で通院中であったが，2014年3月19日から発熱を伴う全身状態悪化により3月22日に当院呼吸器内科に緊急入院となった。右下葉の斑状影を伴う肺炎，肝嚢胞の腫大と内部出血を認め，さらに脳梗塞を併発した。抗生剤，解熱剤投与にて徐々に全身状態改善みられ，内服を試みたところ，むせが頻回に認められたため，4月1日に摂食嚥下機能回復部に紹介された。初診時，全身状態として低栄養，炎症傾向が継続しており，摂食機能評価では，口腔衛生状態は不良，改定水飲みテスト3b点であった。介入3日目の嚥下内視鏡検査実施では，咽頭残留はあるもの摂取方法や食形態の制限を行うことで誤嚥・喉頭侵入なく食事摂取可能と判断し，4日目よりペースト食にて食事を開始した。口腔機能の改善，食形態の改善を図るため，15日目に義歯の製作を開始，17日目には嚥下造影検査を施行し，液体のとろみ付け継続の必要性を確認した。28日目には上下全部床義歯を装着，数回の調整を行い，32日目に行った摂食機能評価では口腔衛生状態，口腔内乾燥は顕著な改善を認め，改定水飲みテスト5点に改善，食形態の食上げは可能と判断し，粥食を米飯に食上げした。42日目に実施した嚥下造影検査では，前回と比べ喉頭侵入量の改善は認めたものの，液体の多量摂取時には不顕性誤嚥を認めたため，液体に1%程度のゆるめのとろみを付けることを継続とした。当科介入中に，口腔機能の改善に伴い摂食嚥下機能が回復し，43日目に経過良好にて転院となった。","subitem_description_language":"ja","subitem_description_type":"Abstract"}]},"item_7_publisher_7":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"新潟歯学会","subitem_publisher_language":"ja"}]},"item_7_source_id_11":{"attribute_name":"書誌レコードID","attribute_value_mlt":[{"subitem_source_identifier":"AN00182415","subitem_source_identifier_type":"NCID"}]},"item_7_source_id_9":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"0385-0153","subitem_source_identifier_type":"PISSN"}]},"item_access_right":{"attribute_name":"アクセス権","attribute_value_mlt":[{"subitem_access_right":"open access","subitem_access_right_uri":"http://purl.org/coar/access_right/c_abf2"}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"設樂, 仁子","creatorNameLang":"ja"},{"creatorName":"Shitara, Satoko","creatorNameLang":"en"}]},{"creatorNames":[{"creatorName":"手嶋, 謡子","creatorNameLang":"ja"},{"creatorName":"Tejima, Yoko","creatorNameLang":"en"}]},{"creatorNames":[{"creatorName":"真柄, 仁","creatorNameLang":"ja"},{"creatorName":"Magara, Jin","creatorNameLang":"en"}]},{"creatorNames":[{"creatorName":"谷口, 裕重","creatorNameLang":"ja"},{"creatorName":"Taniguchi, Hiroshige","creatorNameLang":"en"}]},{"creatorNames":[{"creatorName":"井上, 誠","creatorNameLang":"ja"},{"creatorName":"Inoue, Makoto","creatorNameLang":"en"}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_access","date":[{"dateType":"Available","dateValue":"2022-05-26"}],"displaytype":"detail","filename":"44(2)_93-98.pdf","filesize":[{"value":"430KB"}],"format":"application/pdf","licensetype":"license_note","mimetype":"application/pdf","url":{"objectType":"fulltext","url":"https://niigata-u.repo.nii.ac.jp/record/2000522/files/44(2)_93-98.pdf"},"version_id":"1b721ed8-a929-468d-a619-7c256fc12f24"}]},"item_keyword":{"attribute_name":"キーワード","attribute_value_mlt":[{"subitem_subject":"摂食嚥下リハビリテーション","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"dysphagia rehabilitation","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"口腔機能","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"oral function","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"口腔ケア","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"oral health care","subitem_subject_language":"en","subitem_subject_scheme":"Other"}]},"item_language":{"attribute_name":"言語","attribute_value_mlt":[{"subitem_language":"jpn"}]},"item_resource_type":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"resourcetype":"departmental bulletin paper","resourceuri":"http://purl.org/coar/resource_type/c_6501"}]},"item_title":"口腔機能の改善が嚥下機能回復に寄与した一例","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"口腔機能の改善が嚥下機能回復に寄与した一例","subitem_title_language":"ja"},{"subitem_title":"The improvement in the oral function contributed to the achievement of the recovery in swallowing function : Case Report","subitem_title_language":"en"}]},"item_type_id":"7","owner":"1","path":["456","1653546419953"],"pubdate":{"attribute_name":"PubDate","attribute_value":"2022-05-26"},"publish_date":"2022-05-26","publish_status":"0","recid":"2000522","relation_version_is_last":true,"title":["口腔機能の改善が嚥下機能回復に寄与した一例"],"weko_creator_id":"1","weko_shared_id":-1},"updated":"2022-12-15T04:17:12.717275+00:00"}