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 - 全身麻酔下歯科治療症例の実態 -
Subtitle　： 原著
Authors　： 酒井信明, 宮城敦, 岩崎克夫, 檜垣旺夫, 三宅久実男*, 小林裕*, 野口政宏*, 松本隆行**, 大谷仁**
Authors（kana）　：
Organization　： 神奈川歯科大学小児歯科学教室, *神奈川歯科大学麻酔学教室, **＊聖ヨゼフ病院歯科口腔外科
Journal　： 神奈川歯学
Volume　： 19
Number　： 4
Page　： 418-427
Year/Month　： 1985 / 3
Article　： 原著
Publisher　： 神奈川歯科大学学会
Abstract　： 「緒言」 障害者の口腔疾患状況の調査から脱却して, 歯科治療の必要性とその開発が叫ばれてから, すでに約40年経過しようとしている. その間, 障害者に対する歯科治療に伴う困難性の認識と, その克服とが華やかに議論され, 患者の行動変化を期待して, 歯科治療の場に好都合な状況を得ようとする試み (心理学的管理法) と, 薬物によって患者の意識状態を抑制し, 治療処置に対する抵抗を減少ないしは消去しようとする試み (薬理学的あるいは麻酔学的方法) とが, 互いにその成果を競って進歩してきた. 前者については, 試行錯誤の段階から, 行動変容法の応用に至る経過を取り, 障害者歯科の開発が急速に進展しているものの, 一般臨床の場ではまだ理論的裏付けに乏しい嫌いがある. 後者については, 精神安定薬の急速な開発と麻酔学の著しい発展によって, 障害者歯科での応用は最近20年間に飛躍的な発展を遂げた.
Practice　： 歯科学
Keywords　：

English

Title　： Clinical Study on Dentistry for the Handicapped - Aspect of the Cases Treated under the Administration of General Anaesthetics -
Subtitle　：
Authors　： Nobuaki SAKAI, Atsushi MIYAGI, Katsuo IWASAKI, Morio HIGAKI, Kumio MIYAKE*, Yutaka KOBAYASHI*, Masahiro NOGUCHI*, Takayuki MATSUMOTO**, Hitoshi OHTANI**
Authors（kana）　：
Organization　： Department of Pedodontics, Kanagawa Dental College, *Department of Anaesthesiology, **Dentistry and Oral Surgery, St. Joseph Hospital
Journal　： Kanagawa Shigaku
Volume　： 19
Number　： 4
Page　： 418-427
Year/Month　： 1985 / 3
Article　： Original article
Publisher　： Kanagawa Odontological Society
Abstract　： In dentistry for the handicapped, behaviour management of the patient is one of the most essential subjects to be solved. Although psychological or behavioral approaches are usual ways to cope effestively with patient's behaviour for dental treatment, their results may fall short of our expectations. In such cases, an administration of general anaesthctics will be helpful and this means has been brought into practice since two decades. The authors have been continuing dental care for the handicapped since twenty years in St. Joseph Hospital, Yokosuka, and general anaesthetics have been administered to 2351 cases for handicapped dental patients from 1969 to April 1984. These cases were surveyed for a contribution to a clinical guide to dental management of handicapped persons. The results are as follows: 1. The male was about twice the number of the female. Cases from 0 to 24 years of age accounted for about 90% with a peak between 7 and 12 years of age. 2. The bulk was patients with mental disabilities such as metal retardation, emotional disturbance, childhood autism, etc. 3. The most cases had been admitted up to 1974, thereafter so-called out patient anaesthesia increased remarkably. 4. Anaesthesia was slowly induced with a face mask in most cases, and maintained with nitrous oxide-oxygen-halothane or nitrous oxide-oxygen-enflurane. The most outpatients were intubated naso-pharyngeally, while the inpatients naso-tracheally. 5. The intravenous sedation technique with diazepam was effectively applied for many handicapping conditions, especilly for the involuntary movements of the cerabral palsied. 6. The duration of anaesthesia was between 60 minutes and 90 minutes in most outpatient cases, and between 120 minutes and 180 minutes in most inpatient cases.
Practice　： Dentistry
Keywords　：