周術期チームにおける口腔機能管理システムと効率よい管理のための方策─術前管理期間を左右する2つの因子と4つの管理タイプ,地域における医科歯科連携─  [in Japanese] A Scheme for an Effective System of Oral Management in the Perioperative Medical Team : Two Factors and Four Types of Systems That Influence the Duration of Preoperative Oral Management, and Regional Cooperation between Medical and Dental Personnel  [in Japanese]

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Abstract

周術期における多職種連携チームの必要性が周知されつつある中で,口腔機能管理においては,システム化され術前に十分な管理時間を割くことができる施設は実際には多くない.システム化がなされていない場合,短期間に依頼患者が集中し,一見,人的資源の不足のような状態が起こる.われわれはさまざまな病院の見学や文献的渉猟を行うことで,そのシステムを分類した.手術までの口腔管理実施期間を左右する因子としては,①術前に周術期管理部門(または麻酔科外来)を受診するか否か,そして,②全員受診または手術実施診療科からの依頼受診かの2因子であった.今回,その組み合わせによる4つの管理タイプについて論じ,その中の1タイプとしての当院周術期センターでの「口腔トリアージ」による口腔機能管理方式について触れながら,他のシステムとの比較を行った.また,周術期口腔機能管理のもう一つの問題点として,歯科・口腔外科のない病院とその周辺の歯科医院との連携体制が進んでいないことがあげられる.今回,本学附属病院や関連研修病院での医科歯科連携状況を検証し,その問題点を探る.

Although the importance of a multidisciplinary approach is increasingly emphasized during the perioperative period in the medical profession, few institutions have an effective oral management (OM) system or spend enough time on OM in the preoperative period. If OM is not systematized, referrals are concentrated in a short time period, resulting in apparent lack of human resources. Observing various hospitals and reviewing previous studies, we classified management systems into four types.<BR>Two factors affected the duration of OM prior to surgery : 1) whether patients visited a perioperative management section (or outpatient anesthesiology clinic) prior to surgery or not ; and 2) whether all patients were sent to the OM department or were selectively sent there based on a referral from the department conducting the surgery. In this study, four management systems based on the abovementioned factors were discussed. In addition, an OM method using "oral triage" as one of the four systems that is applied in our perioperative center was compared to other systems.<BR>Another issue in perioperative OM is that cooperation between hospitals without dental or oral surgery departments and the neighboring dental offices is still in the development phase. We also discuss the status of medical and dental cooperation in our university hospital and related hospitals.

Journal

  • THE JOURNAL OF JAPAN SOCIETY FOR CLINICAL ANESTHESIA

    THE JOURNAL OF JAPAN SOCIETY FOR CLINICAL ANESTHESIA 35(7), 780-789, 2015

    THE JAPAN SOCIETY FOR CLINICAL ANESTHESIA

Codes

  • NII Article ID (NAID)
    130005112795
  • Text Lang
    JPN
  • ISSN
    0285-4945
  • Data Source
    J-STAGE 
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