気管切開後の嚥下訓練の経験—2症例を通して

Two reports on rehabilitation for dysphagia patients with tracheotomy

要旨：気管切開後嚥下障害を呈した2症例について経口摂取可能となった過程について報告する．

　食道癌術後の症例1は，疾量が多く，基礎的嚥下訓練から開始し，食事摂取量を調節しながら経口訓練を進めた．

　また脳卒中後呼吸障害のため気管切開術が施された症例2は，失語症，失行症，痴呆症を合併していたが，嚥下反射を確認し，嚥下訓練を実施した．その結果，経口による自己摂取可能となった．

　症例を通し，カニューレ留置中の嚥下訓練について留意点を述べる．

　There are reports that two patients with dysphagia after a tracheotomy were able to intake food oraly.

　Case 1 was operated on for esophageal carucinoma ; he first began basic swallowing training because he had much sputa. He was able to control the amount of feeding by oral intake.

　Case 2 was a stroke patient who had a tracheotomy because of a respiration disorder. Though this patient experienced total aphagia, apraxia and dementia, he could feed himself.

　As a result of these two cases, I will discuss approaches for patients with tracheotomies.