| Project/Area Number |
20K11163
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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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| Review Section |
Basic Section 59010:Rehabilitation science-related
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| Research Institution | Nara Medical University |
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Principal Investigator |
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| Co-Investigator(Kenkyū-buntansha) |
宮尾 晋太朗 奈良県立医科大学, 医学部附属病院, 研究員 (00833708)
切畑屋 友希 奈良県立医科大学, 医学部附属病院, 研究員 (20865282)
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| Project Period (FY) |
2020-04-01 – 2023-03-31
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| Project Status |
Completed (Fiscal Year 2022)
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| Budget Amount *help |
¥3,770,000 (Direct Cost: ¥2,900,000、Indirect Cost: ¥870,000)
Fiscal Year 2022: ¥1,040,000 (Direct Cost: ¥800,000、Indirect Cost: ¥240,000)
Fiscal Year 2021: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000)
Fiscal Year 2020: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
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| Keywords | 咀嚼力 / 術後栄養障害 / 口腔・嚥下機能 / 嚥下機能 / 食道切除 / 術後後遺症 |
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| Outline of Research at the Start |
高齢化社会の癌治療の解決課題に栄養障害を原因とするフレイルがある.口腔での咀嚼は食物の消化・吸収の第一段階で，咀嚼力低下は栄養障害の一因となり，嚥下機能の障害とも関連し誤嚥性肺炎などフレイル特有の疾病につながる可能性がある.上部消化管手術は胃切除を伴い，本来の胃の機能である蠕動運動や器械的咀嚼が障害され，残胃運動や食物の消化・吸収に悪影響を与えている.特に口腔での咀嚼力低下患者は，さらに栄養障害のリスクを上昇させている.本研究では上部消化管周術期の咀嚼機能に着目し，咀嚼と残胃の運動生理および咀嚼機能と周術期の栄養状態との関連を検討する.また咀嚼機能向上が術後栄養障害を軽減するか否かを検証する.
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| Outline of Final Research Achievements |
e investigated the relationship between the nutritional status of upper gastrointestinal tract surgery and the decline in oral swallowing function and nutritional status.
We created a model of decreased masticatory function using Wister rats with extracted teeth, and evaluated its gastric and intestinal motility function in comparison with that of healthy rats. However, the results were not as expected because the decrease in chewing ability was less than expected even after tooth extraction in rats, and nutritional disorders were less.
An experiment using chewing gum was planned, but this experiment was delayed because of the risk of spreading infection and the difficulty of measuring mastication ability in person due to the COVID-19. The repeated salivary swallow test was found to be strongly associated with postoperative complications and postoperative malnutrition after esophageal cancer surgery, and the results were presented at an academic conference.
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| Academic Significance and Societal Importance of the Research Achievements |
口腔嚥下機能とくに反復唾液嚥下テストと術後合併症および患者の栄養状態は密接に関連することが判明した．この測定は簡便にベッドサイドで施行することができるため，非常に有用な検査である．反復唾液嚥下テストが低下している患者に対しては術後の低栄養を防ぐため，術直後から長期にわたる嚥下リハビリの継続の必要性が示唆された．これらの知見により周術期管理が見直されることが想定されるため，非常に重要なことがわかったと考えられた．
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