多発性脳梗塞例に対する嚥下と呼吸の協調性評価—非侵襲的嚥下検査法を用いて

Evaluation of cooperation between swallowing and respiration in a case of multiple cerebral infarctions using non-invasive swallowing function methods

要旨：非侵襲的嚥下検査法を用いて，多発性脳梗塞患者の嚥下と呼吸の協調性について評価した．先行研究と比較すると，症例の嚥下機能は著しく障害されており，咽頭期よりも口腔期の方が重篤であった．呼吸機能は吸気ポーズと呼気休止期の欠損により，換気障害がおこり頻呼吸が見られた．誤嚥性肺炎の原因は，症例の現有する身体機能が限界にある中で，さらに呼吸と嚥下の協調も計れない状況下で，摂食訓練が継続されたためと考えられる．ビデオレントゲン(VF)検査では解明できない嚥下と呼吸の協調性障害を把握する方法として，非侵襲的嚥下検査法は有用である．

　Using non-invasive monitoring methods of swallowing function, we evaluated the cooperative relationship between swallowing and respiration in a patient with multiple cerebral infarctions.

　The results show that swallowing function was worse for the patient when compared with preliminary research data. The preparation and oral stages of swallowing were more severe than the pharyngeal period. Respiratory function displayed ventilatory impairment in both the inspiratory, expiratory and resting phase, with incidence of tachypnea. Aspiration pneumonitis was considered attributable to eating training that was carried out in a situation in which both swallowing and respiration functions were impaired, thus indicating limited stamina on the part of the patient.

　Non-invasive swallowing function methods are useful for clarifying the cooperation between swallowing and respiration when elucidation is difficult by videofluorography.