アブストラクト
Japanese
| Title | 周術期リハビリテーションによるハイリスク患者の術後合併症予防 |
|---|---|
| Subtitle | 特集企画 : 第45回総会特集 パネルディスカッション 3「チーム医療による周術期管理で合併症をなくせ」 |
| Authors | 萩山明和, 池田朋大 |
| Authors (kana) | |
| Organization | 岡山大学病院 総合リハビリテーション部 |
| Journal | 日本手術医学会誌 |
| Volume | 45 |
| Number | 1 |
| Page | 89-94 |
| Year/Month | 2024 / 2 |
| Article | 報告 |
| Publisher | 日本手術医学会 |
| Abstract | 「要旨」:手術手技や麻酔管理の発展とともに多職種による周術期管理も進歩しており, かつては手術が困難であったハイリスク患者に対しても適応範囲が拡大している. 特に胸腹部外科領域の手術は侵襲性が大きく, 術後合併症のリスクが高い場合が多いため, ハイリスク患者の特定と適切な対応が必要である. 胸腹部外科術後の合併症としては, 無気肺や肺炎などの呼吸器合併症, 廃用症候群, せん妄などが問題視される. 術後呼吸器合併症は在院死亡率の上昇や入院期間の延長と関連し, 廃用症候群やせん妄はADLやQOLの術後回復の阻害因子となる. これらの合併症を予防するためには, 術後の早期離床に加え, 手術への耐性を高めるための術前リハビリテーションが極めて重要性である. これらの背景から, 岡山大学病院では2008年から周術期管理センター(PERIO)が開設され, 多職種によるハイリスク患者の特定と術前介入を行っている. リハビリテーション部門では外来時から術前評価と有酸素運動や呼吸訓練等の自主訓練指導を実施し, 術後には翌日から病室で呼吸理学療法や離床を開始している. これらの取り組みにより, 術後の離床開始が早まり, 合併症が減少することを確認している. 本稿は胸腹部外科に焦点を当て, 当院での周術期リハビリテーションの取り組みについて理学療法士の立場から紹介する. |
| Practice | 臨床医学：外科系 |
| Keywords | 周術期, リハビリテーション, 術後合併症 |
English
| Title | Preventing postoperative complications in high-risk patients through perioperative rehabilitation[Machine Translation] (周術期リハビリテーションによるハイリスク患者の術後合併症予防) |
|---|---|
| Subtitle | |
| Authors | 萩山明和, 池田朋大 |
| Authors (kana) | |
| Organization | |
| Journal | Journal of Japanese Association for Operating Room Technology |
| Volume | 45 |
| Number | 1 |
| Page | 89-94 |
| Year/Month | 2024 / 2 |
| Article | Report |
| Publisher | Japanese Association for Operative Medicine |
| Abstract | [Abstract] With the advances in surgical techniques and anesthesia management, perioperative care involving multiple disciplines has also progressed, expanding the scope of surgery to include high-risk patients who previously faced difficulties in undergoing surgery. Particularly in thoracic and abdominal surgery, where invasiveness is high and the risk of postoperative complications is significant, it is crucial to identify high-risk patients and respond appropriately. Complications following thoracic and abdominal surgery, such as atelectasis, pneumonia, disuse syndrome, and delirium, are of concern. Postoperative respiratory complications are associated with increased in-hospital mortality and extended hospital stays, while disuse syndrome and delirium hinder the postoperative recovery of activities of daily living (ADL) and quality of life (QOL). Early postoperative mobilization and preoperative rehabilitation to enhance surgical tolerance to prevent these complications are essential to prevent these complications. Against this background, Okayama University Hospital established the Perioperative Management Center (PERIO) in 2008, conducting preoperative interventions and identifying high-risk patients through a multidisciplinary approach. The Rehabilitation Department implements preoperative assessments and instructs patients in self-exercises, including aerobic exercises and respiratory training from outpatient visits, and begins respiratory physiotherapy and mobilization in the patient's room from the day after surgery. These interventions have been confirmed to accelerate the beginning of postoperative mobilization and reduce complications. This paper introduces perioperative rehabilitation at our hospital, focusing on thoracic and abdominal surgery from a physical therapist's perspective. |
| Practice | Clinical surgery |
| Keywords |
- 全文ダウンロード： 従量制、基本料金制の方共に770円(税込) です。
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残りの14件を表示する
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