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Robin Sequence 患者における舌前方固定術前・後の栄養摂食経路および体重増加に関する検

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Title: Robin Sequence 患者における舌前方固定術前・後の栄養摂食経路および体重増加に関する検
Other Titles: Study on the Nutrition Route and Weight Gain Before and After Tongue Lip Adhesion in Patients with Robin Sequence
Authors: 青海, 哲也1 Browse this author →KAKEN DB
大廣, 洋一2 Browse this author →KAKEN DB
古郷, 幹彦3 Browse this author →KAKEN DB
鄭, 漢忠4 Browse this author →KAKEN DB
Authors(alt): Seikai, Tetsuya1
Ohiro, Youichi2
Kogo, Mikihiko3
Tei, Kanchu4
Keywords: Robin Sequence
Argamaso 法
Argamaso method
Tongue lip adhesion
Tongue release
Issue Date: Sep-2019
Publisher: 北海道歯学会
Journal Title: 北海道歯学雑誌
Volume: 40
Issue: 1
Start Page: 13
End Page: 19
Abstract: Robin Sequence(RS)は,胎生期の下顎発育不全に基づく小下顎,舌根沈下による吸気性気道閉塞,特徴ある U字形口蓋裂を主徴とする疾患1)であり,出生後から呼吸障害と経口摂取障害に対する管理が必要となる.呼吸障害に対して,軽度であれば側臥・腹臥への体位変換2)や口蓋床の装着3),nasal airway の挿入などの保存処置2)を,保存処置で対応困難であれば気管挿管や舌前方固定術,気管切開術,下顎仮骨延長術などの外科的処置が必要となる4).経口摂取障害に対しては経鼻経管栄養が適応される.舌前方固定術5)は,他の外科処置と比べて極めて低侵襲であること,術後合併症を低減できること,術後管理の煩雑さが不用であることから適応を選べば,患児・家族のQOL 改善にとって極めて有効な手法であると考えられる.しかし,現在のところ舌固定術後の経口摂取改善についての報告はほとんどない.今回,RS 患者における舌前方固定術後の栄養摂取経路と体重発育に関する検討を行ったので報告する.
Robin Sequence (RS) is a disease with micrognathia airway obstruction caused by glossoptosis and a U shaped cleft palate as a cardinal symptom. Here, we report on the nutrition route and weight gain after tongue lip adhesion in patients with Robin Sequence. 【Materials and Methods】 Of the RS cases examined during 2011-2015, 7 nonsyndromic RSs (2 boys, 5 girls) who underwent tongue lip adhesion by the Argamaso method were selected. All cases improved respiratory conditions after the operation. We studied the nutrition route and weight gain before and after the operation. 【Results】6 out of 7 cases (86 %) needed management of tube feeding before the operation. 5 out of 7 cases (71 %) were able to orally feed in early postoperative time after the operation. One case could not withdraw from nasal feeding, and ingestion became possible after 11.5 months. The remaining one case required 6 months before ingestion became possible. Regarding the amount consumed by sucking, for 4 out of 5 cases (80 %) where ingestion was possible from a few days after performing tongue lip adhesion, suckling at the same level as the age guidance. 4 of 7 (57 %) cases, weight gain was poor before the operation, but 6 out of 7 cases (88 %) improved after the operation. 3 cases showed marked improvementwhen respiratory conditions stabilized after the operation. 【Conclusion】 Tongue lip adhesion in RS children is an effective method that can not only stabilize respiratory conditions, but can also improve the disorder of oral ingestion, and it was suggested that this method can promote stable weight gain.
Type: article
Appears in Collections:北海道歯学雑誌 > 第40巻 第1号

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