{"created":"2023-06-23T12:15:19.717635+00:00","id":5045,"links":{},"metadata":{"_buckets":{"deposit":"4b0cc524-81ae-4266-af17-5e9214bd041c"},"_deposit":{"created_by":21,"id":"5045","owners":[21],"pid":{"revision_id":0,"type":"depid","value":"5045"},"status":"published"},"_oai":{"id":"oai:asahi-u.repo.nii.ac.jp:00005045","sets":["46:190:231"]},"author_link":["4023","338","3992","8578","8579","340","4120"],"item_10002_biblio_info_77":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2011-02-20","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"3","bibliographicPageEnd":"194","bibliographicPageStart":"188","bibliographicVolumeNumber":"37","bibliographic_titles":[{"bibliographic_title":"岐阜歯科学会雑誌"},{"bibliographic_title":"The journal of Gifu Dental Society","bibliographic_titleLang":"en"}]}]},"item_10002_description_80":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"【緒言】第1第2鰓弓症候群は主に顔面、口腔および耳などに変形を生じる先天性疾患であるが、摂食・嚥下障害は少ないとされている。今回は著明な哺乳障害を伴った本症候群患児に対して、摂食機能療法を行い良好な結果を得たので報告する。【症例】4ヵ月女児。主訴:某大学病院小児科より嚥下リハビリテーション依頼。38週2,296gで帝王切開にて出生し、左耳介欠損、左耳孔閉鎖等を認め、本症候群と診断された。既往歴:出生後は経管栄養で3週間入院したが、哺乳良好のため退院となった。現病歴:生後2ヵ月時にRSウイルス感染により誤嚥性肺炎を認め、某大学病院に入院。1ヵ月間気管内挿管するも喉頭軟化症のため呼吸困難が持続し、経鼻経管栄養の状態であった。【対応と治療経過】哺乳瓶でのミルク摂取で鼻腔や口唇からのもれやむせが強くみられたため、鼻咽腔閉鎖機能不全および口唇閉鎖不全による嚥下障害と診断した。P型乳首による哺乳、口唇や舌への間接訓練や味覚刺激を指導した。VE・VF検査では鼻咽腔閉鎖機能不全、中咽頭部麻痺および披裂軟骨部肥大、鼻腔逆流を認めたが、誤嚥所見はなかった。6ヵ月児よりプラスチック製吸い口でのミルク摂取と離乳初期食による摂食指導を開始した。10ヵ月児に離乳後期食でかじり取りの指導も行った。11ヵ月児にむせがほとんどなく、経口摂取量も十分なため経鼻経管栄養を中止した。現在は3歳4ヵ月で全身状態も安定しており、乳児食が摂取可能で水分摂取も自立した。【考察】本症例はウイルス感染により長期間にわたる気管内挿管が持続したことにより、軟口蓋の運動低下が生じた結果の鼻咽腔閉鎖機能不全と考える。母親の強い希望もあり経鼻経管栄養を持続しながら、本児の摂食・嚥下機能を評価して母親への摂食指導と支援が良好な成果を得たものと考える。","subitem_description_type":"Abstract"}]},"item_10002_full_name_75":{"attribute_name":"著者別名","attribute_value_mlt":[{"nameIdentifiers":[{"nameIdentifier":"338","nameIdentifierScheme":"WEKO"}],"names":[{"name":"GEN, 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