| Project/Area Number |
17K17376
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| Research Category |
Grant-in-Aid for Young Scientists (B)
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| Allocation Type | Multi-year Fund |
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| Research Field |
Social dentistry
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| Research Institution | Nagasaki University |
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Principal Investigator |
KAWAKITA Akiko 長崎大学, 医歯薬学総合研究科(歯学系), 助教 (10647241)
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| Project Period (FY) |
2017-04-01 – 2019-03-31
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| Project Status |
Completed (Fiscal Year 2018)
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| Budget Amount *help |
¥4,030,000 (Direct Cost: ¥3,100,000、Indirect Cost: ¥930,000)
Fiscal Year 2018: ¥2,080,000 (Direct Cost: ¥1,600,000、Indirect Cost: ¥480,000)
Fiscal Year 2017: ¥1,950,000 (Direct Cost: ¥1,500,000、Indirect Cost: ¥450,000)
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| Keywords | 食道がん / 術後肺炎 / 抗菌薬局所投与 / 細菌数 / 多施設共同研究 / 食道癌肺炎予防 / 歯学 |
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| Outline of Final Research Achievements |
Postoperative pneumonia occurred in 99 (12.8%) of 775 patients with thoracic esophageal cancer undergoing thoracoscopic surgery. The risk factors for development of pneumonia were old age, smoking habit, lower hemoglobin level, higher creatinine level, postoperative dysphagia, and lack of oral care.
The number of bacteria1 in the saliva was measured the day before and after surgery in esophageal cancer patients. The bacterial count did not increase after surgery in patients who took orally, whereas it significantly increased in those with fasting or intubation. Povidone iodine or tetracycline was administrated topically on the tongue in intubated patients, and the number of bacteria in the saliva was measured. As a result, topical tetracycline was the most effective in reducing the number of bacteria.
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| Academic Significance and Societal Importance of the Research Achievements |
平成24年度に「周術期口腔機能管理」が診療報酬に新設された。食道がん手術は手術侵襲が大きく、嚥下機能障害や喀痰排出障害が高頻度で出現することなどから、術後肺炎のリスクが高いことが知られている。食道がん手術における周術期口腔機能管理の意義についてはいまだ不明確であり、実際に口腔内細菌の多寡と肺炎発症との関連性はあるのかどうか、抗菌薬局所投与により肺炎を抑制できるかなどについて明らかにすることが必要であると考えられた。
本研究の結果、抗菌薬局所投与は口腔内細菌数を減少させることが明らかとなり、肺炎予防に関与する可能性がある。
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