| Project/Area Number |
16K01493
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Multi-year Fund |
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| Section | 一般 |
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| Research Field |
Rehabilitation science/Welfare engineering
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| Research Institution | Japan Organization of Occupational Health and Safety, Spinal Injuries Center |
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Principal Investigator |
Hayashi Tetsuo 独立行政法人労働者健康安全機構総合せき損センター(研究部), 独立行政法人労働者健康安全機構総合せき損センター(研究部), 研究員(移行) (00769680)
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| Co-Investigator(Kenkyū-buntansha) |
前田 健 独立行政法人労働者健康安全機構総合せき損センター(研究部), 独立行政法人労働者健康安全機構総合せき損センター(研究部), 研究員(移行) (80315077)
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| Project Period (FY) |
2016-04-01 – 2019-03-31
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| Project Status |
Completed (Fiscal Year 2018)
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| Budget Amount *help |
¥4,680,000 (Direct Cost: ¥3,600,000、Indirect Cost: ¥1,080,000)
Fiscal Year 2018: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
Fiscal Year 2017: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
Fiscal Year 2016: ¥1,820,000 (Direct Cost: ¥1,400,000、Indirect Cost: ¥420,000)
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| Keywords | 頚髄損傷 / 嚥下障害 / 発生機序 / リハビリテーション / 後咽頭 / 誤嚥性肺炎 / 軟部組織損傷 / 高齢者 / 形態学的変化 / 咽頭残留 / 四肢麻痺 / 嚥下造影 / 嚥下反射 |
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| Outline of Final Research Achievements |
The objective of this study was to examine the factors associated with the severity of dysphagia following traumatic cervical spinal cord injury to elucidate its mechanism. We conducted a prospective analysis of patients with acute traumatic cervical spinal cord injury who were admitted within 2 weeks of the injury. Dysphagia was evaluated consecutively before and after injury using the Dysphagia Severity Scale. In addition, we examined the factor associated with dysphagia at 2 weeks after injury.
As a result, dysphagia occurred after injury, however, swallowing dysfunction gradually improved over time. Patients with lower ASIA motor score showed severer swallowing dysfunction. Severe paresis, tracheostomy, old age, and swelling of the retropharyngeal space were significantly affected by dysphagia following cervical spinal cord injury. Morphological changes of the pharynx, which is situated right behind the larynx, following the injury affects the mechanism of dysphagia.
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| Academic Significance and Societal Importance of the Research Achievements |
本研究は、急性期頚髄損傷患者の咽頭や喉頭の器質的変化および嚥下反射を前向きに検討する初めての研究であり、また頚髄損傷の治療に影響する様々な因子が嚥下障害に及ぼす影響についても明らかにできた。頚椎損傷の場合、損傷頚椎の後咽頭壁が腫脹し、喉頭蓋の閉鎖障害による嚥下障害が起こる可能性がある。本研究により、誤嚥リスクのある患者をスクリーニングすることができ、誤嚥性肺炎の発生率を低下させる可能性があり、肺炎予防や栄養状態の保持により、入院期間を短縮し、医療費の削減につながる意義があると思われる。
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