アブストラクト（19巻4号：神奈川歯学）

神奈川歯学

Japanese

Title　： 障害者歯科医療の臨床的指針に関する研究 - 術前検査における赤血球数およびその平均恒数の比較 -
Subtitle　： 原著
Authors　： 酒井信明
Authors（kana）　：
Organization　： 神奈川歯科大学小児歯科学教室, 神奈川歯科大学口腔外科学教室
Journal　： 神奈川歯学
Volume　： 19
Number　： 4
Page　： 341-359
Year/Month　： 1985 / 3
Article　： 原著
Publisher　： 神奈川歯科大学学会
Abstract　： 「緒言」 近年, 社会福祉思想の変容とあいまって, 障害者に対する福祉が強く推し進められ, また, いわゆるノーマライゼーションなどの基本的概念がみられる情勢のなかでも, 障害者医療に対し高い関心が払われるようになってきた. 一方, 障害者の歯科医療には多くの困難が伴い, しかもリスクの高い患者が多いと考えられ勝ちのこともあって, 一般にはいまだに敬遠される傾向が強い. 1940年代後半, 米国で小児歯科が発足して以来, 障害児への関心が次第に高まり, 1950年代前半にかけてBooth, N. A., Smith, ER., Album, M. M. などにより全身麻酔が導入された. このことは, 障害児の診療に際して行動管理上の困難性を克服する上で, 一つの解決を与えたことになる. 以来, 全身麻酔下での治療を推奨する流れと, 意識下での行動変容のもとに治療を行う流れとが2本柱となり, ときには競合し, ときには協調して発展して来ているようである.
Practice　： 歯科学
Keywords　：

English

Title　： Clinical Study on Dentistry for the Handicapped - Comparison of Red Blood Cell Count and Mean Corpuscular Constants among Handicapped Conditions -
Subtitle　：
Authors　： Nobuaki SAKAI
Authors（kana）　：
Organization　： Department of Pedodontics, Kanagawa Dental College, Department of Oral Surgery, Kanagawa Dental College
Journal　： Kanagawa Shigaku
Volume　： 19
Number　： 4
Page　： 341-359
Year/Month　： 1985 / 3
Article　： Original article
Publisher　： Kanagawa Odontological Society
Abstract　： In many cases of the handicapped, general anaesthetics may be administred for behavioral and/or medical management of the patient on dental treatment. It is essential to evaluate the physical state of the patient before the administration of general anaesthetics. We however, are often confronted with patients who do not allow us to get samples for laboratory examinations. Therefore, it is very beneficial for future cases to investigate the results of tests which were gotten from many handicapped patients who could offer the samples. As tremendously many are the pre-anaesthetic examinations carried out routinely, among them, the aspect of the red blood cells represents the oxygen carrying capacity of the patient's blood, it is, accordingly, one of the most important factors for anaesthesiologic management of the patient. The author experienced 2,351 cases of handiapped dental patients to whom general anaesthesia or psychosedation was administered from 1969 to 1984 in the Dentistry of St. Joseph Hospital, Yokosuka, Japan. out of them, the findings about red blood cell count, haemoglobin amount, haematocrit, mean corpucular volume, mean corpuscular haemoglobin amount, and mean corpuscular haemoglobin concentration could be gotten from 785 cases. The results of this study are as follows: 1) Mental ratardation group : in general, the most of the items were within normal range, but the female patients from 25 years to 30 years of age tended to anaemic. 2) Down's syndrome group : all the items but MCHC are significantly different from those of the other groups. And it was suggegted that an oligocythaemic tendency was compensated by an increase in MCV. 3) Epilepsy group : generally, all the items showed almost normal values, but the male patients between 19 years and 24 years of age tended to macrocytic anaemia. This may suggest some effect of anticonvulsants. 4) Emotional disturbance-autism group : the female patients showed normal values, while the values of the male tended to lower than normal. 5) Cerebal palsy group : an anaemic tendency was inferred in the male of 7 to 12 years of age. From the above mentioned, the aspect related to the red blood cell of the handicapped patients was within normal range in general but slightly anaemic. As for the patient with Down's syndrome, however, a particular consideration should be given before the administration of general anaesthetics.
Practice　： Dentistry
Keywords　：