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要旨:先天性心疾患を有する新生児に対する心臓血管外科術後は,呼吸不全や心不全などの合併症を防ぎながら運動発達を促すことが重要とされる.近年,PICS(集中治療後症候群)により小児集中治療室(PICU)退室後のQOLの低下につながる可能性が指摘されている.今回,新生児重症エプスタイン症に対するStarnes術後,長期人工呼吸管理を要した症例を担当し,呼吸循環機能を考慮しながら座位練習や上肢運動を含んだ早期作業療法を経て抜管が可能となり,家族のリハビリテーションへの参加を経て退院に至った.周術期管理中からの作業療法介入により合併症を最小限にすることで,早期退院やQOLの改善に寄与できたと考えられた.
Multimodal supportive intervention is essential to ameliorate perioperative complications for patients with severe heart disease. However, little is known on the clinical efficacy of occupational therapy for neonates with severe congenital heart disease. In recent years, post-intensive care syndrome may lead to decreased quality of life (QOL) after leaving the pediatric intensive care unit. Herein, we report our clinical experience of early occupational therapy following extensive cardiovascular surgery for a neonate with Epstein's disease. Occupational therapy intervention from the acute phase of the disease contributed to patients' early discharge and improvement of QOL. This study highlights the importance of the early introduction of a rehabilitation program to promote patient recovery, thereby improving the quality of life of neonates with cardiopulmonary failure.
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