食道癌患者における積極的な術前呼吸リハビリテーションと術後呼吸器合併症との関係

【目的】食道癌の診断による食道切除再建術施行患者について，術前より積極的な呼吸リハを実施することが術後呼吸器合併症予防につながるかを検討することである。【方法】対象は，食道切除再建術を施行した患者84名（男性72名，女性12名，平均年齢66.1 ± 8.8歳）とし，積極的な術前呼吸リハを実施できた群（実施群）53名（男性44名，女性9名，平均年齢67.0 ± 9.3歳）と積極的な術前呼吸リハが実施できなかった群（非実施群）31名（男性28名，女性3名，平均年齢64.6 ± 7.9歳）の2群に分け，術後呼吸器合併症の発症率を比較検討した。【結果】術後呼吸器合併症は実施群では4名（7.5%），非実...

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Published in理学療法学 Vol. 38; no. 3; pp. 201 - 206
Main Authors 井上, 順一朗, 小野, 玲, 柏, 美由紀, 宇佐美, 眞, 牧浦, 大祐, 三浦, 靖史, 黒坂, 昌弘, 黒田, 大介
Format Journal Article
LanguageJapanese
Published 日本理学療法士学会 20.06.2011
日本理学療法士協会
Japanese Society of Physical Therapy
Subjects
術前呼吸リハビリテーション
術後呼吸器合併症
食道癌
Online AccessGet full text
ISSN0289-3770
2189-602X
DOI10.15063/rigaku.KJ00007296813

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Abstract 【目的】食道癌の診断による食道切除再建術施行患者について，術前より積極的な呼吸リハを実施することが術後呼吸器合併症予防につながるかを検討することである。【方法】対象は，食道切除再建術を施行した患者84名（男性72名，女性12名，平均年齢66.1 ± 8.8歳）とし，積極的な術前呼吸リハを実施できた群（実施群）53名（男性44名，女性9名，平均年齢67.0 ± 9.3歳）と積極的な術前呼吸リハが実施できなかった群（非実施群）31名（男性28名，女性3名，平均年齢64.6 ± 7.9歳）の2群に分け，術後呼吸器合併症の発症率を比較検討した。【結果】術後呼吸器合併症は実施群では4名（7.5%），非実施群では8名（25.8%）と実施群において有意に術後呼吸器合併症が低下していた（p = 0.02）。【結論】食道切除再建術施行患者において，術前からの積極的な呼吸リハ介入により術後呼吸器合併症が予防できることが示唆された。
AbstractList Purpose: The purpose of this study was to investigate whether the intensive preoperative respiratory rehabilitation could prevent the postoperative pulmonary complications in esophageal cancer patients undergoing esophagectomy. Methods: The subjects were 84 patients undergoing esophagectomy (72 males, 12 females, mean age 66.1 ± 8.8 years). They were divided into two groups; 53 patients (44 males, 9 females, mean age 67.0 ± 9.3 years) in the preoperative rehabilitation group (PR group), who received the respiratory rehabilitation sufficiently before operation and 31 patients (28 males, 3 females, mean age 64.6 ± 7.9 years) in the non-preoperative rehabilitation group (NPR group), who did not receive or insufficiently received the preoperative respiratory rehabilitation. The rates of postoperative pulmonary complications were compared between the two groups. Results: Postoperative pulmonary complications occurred in 4 patients (7.5%) in the PR group and 8 patients (25.8%) in the NPR group (p = 0.02). Conclusion: This study showed that the intensive preoperative respiratory rehabilitation reduced the postoperative pulmonary complications in esophageal cancer patients undergoing esophagectomy. 【目的】食道癌の診断による食道切除再建術施行患者について，術前より積極的な呼吸リハを実施することが術後呼吸器合併症予防につながるかを検討することである。【方法】対象は，食道切除再建術を施行した患者84名（男性72名，女性12名，平均年齢66.1 ± 8.8歳）とし，積極的な術前呼吸リハを実施できた群（実施群）53名（男性44名，女性9名，平均年齢67.0 ± 9.3歳）と積極的な術前呼吸リハが実施できなかった群（非実施群）31名（男性28名，女性3名，平均年齢64.6 ± 7.9歳）の2群に分け，術後呼吸器合併症の発症率を比較検討した。【結果】術後呼吸器合併症は実施群では4名（7.5%），非実施群では8名（25.8%）と実施群において有意に術後呼吸器合併症が低下していた（p = 0.02）。【結論】食道切除再建術施行患者において，術前からの積極的な呼吸リハ介入により術後呼吸器合併症が予防できることが示唆された。
【目的】食道癌の診断による食道切除再建術施行患者について，術前より積極的な呼吸リハを実施することが術後呼吸器合併症予防につながるかを検討することである。【方法】対象は，食道切除再建術を施行した患者84名（男性72名，女性12名，平均年齢66.1 ± 8.8歳）とし，積極的な術前呼吸リハを実施できた群（実施群）53名（男性44名，女性9名，平均年齢67.0 ± 9.3歳）と積極的な術前呼吸リハが実施できなかった群（非実施群）31名（男性28名，女性3名，平均年齢64.6 ± 7.9歳）の2群に分け，術後呼吸器合併症の発症率を比較検討した。【結果】術後呼吸器合併症は実施群では4名（7.5%），非実施群では8名（25.8%）と実施群において有意に術後呼吸器合併症が低下していた（p = 0.02）。【結論】食道切除再建術施行患者において，術前からの積極的な呼吸リハ介入により術後呼吸器合併症が予防できることが示唆された。
「要旨」 【目的】 食道癌の診断による食道切除再建術施行患者について, 術前より積極的な呼吸リハを実施することが術後呼吸器合併症予防につながるかを検討することである. 【方法】 対象は, 食道切除再建術を施行した患者84名(男性72名, 女性12名, 平均年齢66.1±8.8歳)とし, 積極的な術前呼吸リハを実施できた群(実施群)53名(男性44名, 女性9名, 平均年齢67.0±9.3歳)と積極的な術前呼吸リハが実施できなかった群(非実施群)31名(男性28名, 女性3名, 平均年齢64.6±7.9歳)の2群に分け, 術後呼吸器合併症の発症率を比較検討した. 【結果】 術後呼吸器合併症は実施群では4名(7.5%), 非実施群では8名(25.8%)と実施群において有意に術後呼吸器合併症が低下していた(p=0.02). 【結論】 食道切除再建術施行患者において, 術前からの積極的な呼吸リハ介入により術後呼吸器合併症が予防できることが示唆された.
Author 小野, 玲
柏, 美由紀
牧浦, 大祐
宇佐美, 眞
井上, 順一朗
黒坂, 昌弘
黒田, 大介
三浦, 靖史
Author_FL INOUE Junichiro
KURODA Daisuke
KUROSAKA Masahiro
ONO Rei
MIURA Yasushi
KASHIWA Miyuki
MAKIURA Daisuke
USAMI Makoto
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  fullname: ONO Rei
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  fullname: KASHIWA Miyuki
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  fullname: MAKIURA Daisuke
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  fullname: MIURA Yasushi
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  fullname: KUROSAKA Masahiro
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  fullname: USAMI Makoto
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  fullname: KURODA Daisuke
Author_xml – sequence: 1
  fullname: 井上, 順一朗
  organization: 神戸大学医学部附属病院リハビリテーション部
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  fullname: 小野, 玲
  organization: 神戸大学大学院保健学研究科
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  fullname: 柏, 美由紀
  organization: 神戸大学医学部附属病院リハビリテーション部
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  fullname: 宇佐美, 眞
  organization: 神戸大学大学院保健学研究科
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  fullname: 牧浦, 大祐
  organization: 神戸大学医学部附属病院リハビリテーション部:神戸大学大学院保健学研究科
– sequence: 1
  fullname: 三浦, 靖史
  organization: 神戸大学医学部附属病院リハビリテーション部:神戸大学大学院保健学研究科:神戸大学大学院医学研究科
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  fullname: 黒坂, 昌弘
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  fullname: 黒田, 大介
  organization: 神戸大学大学院医学研究科
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References_xml – reference: 13) VRACIU JK. Effectiveness of breathing exercise in preventing pulmonary complications following open heart surgery. Phys Ther. (1977) vol.57, p.1367-1371.
– reference: 25) SHARMA RR. Diaphragmatic activity after laparoscopic cholecystectomy. Anesthesiology. (1999) vol.91, p.406-413.
– reference: 29) CASTILLO R. Chest physical therapy-comparative efficacy of preoperative and postoperative in the elderly. Arch Phys Med Rehabil. (1985) vol.66, p.376-379.
– reference: 33) 大澤 智恵子. ほか. 食道癌根治術の肺合併症への影響要因 : 高齢者と非高齢者の比較. 理学療法学. 公益社団法人日本理学療法士協会. (2005) vol.32, no.3, p.123-129. http://search.jamas.or.jp/link/ui/2005239360
– reference: 14) ARTHUR HM. Effect of a preoperative intervention on preoperative and postoperative outcomes in low-risk patients awaiting elective coronary artery bypass graft surgery : a randomized controlled trial. Ann Intern Med. (2000) vol.133, p.253-262.
– reference: 40) GOSSELINK R. Incentive spirometry does not enhance recovery after thoracic surgery. Crit Care Med. (2000) vol.28, p.679-683. doi:10.1097/00003246-200003000-00013
– reference: 31) NAGAMATSU Y. Preoperative evaluation of cardiopulmonary reserve with the use of expired gas analysis during exercise testing in patients with squamous cell carcinoma of the thoracic esophagus. J Thorac Cardiovasc Surg. (2001) vol.121, p.1064-1068.
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Snippet 【目的】食道癌の診断による食道切除再建術施行患者について，術前より積極的な呼吸リハを実施することが術後呼吸器合併症予防につながるかを検討することである。【方法】対...
「要旨」 【目的】 食道癌の診断による食道切除再建術施行患者について, 術前より積極的な呼吸リハを実施することが術後呼吸器合併症予防につながるかを検討することである. 【...
Purpose: The purpose of this study was to investigate whether the intensive preoperative respiratory rehabilitation could prevent the postoperative pulmonary...
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SubjectTerms 術前呼吸リハビリテーション
術後呼吸器合併症
食道癌
Title 食道癌患者における積極的な術前呼吸リハビリテーションと術後呼吸器合併症との関係
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