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[长期护理的面部和口腔触觉过敏老年人的口腔功能和营养状况]

[Oral function and nutritional status among the elderly with facial and oral tactile hypersensitivity who are under long-term care].

作者信息

Shirobe Maki, Nakayama Rena, Hirano Hirohiko, Ohara Yuki, Endo Keiko, Watanabe Yutaka, Hakuta Chiyoko

机构信息

Research Team for Promoting Independence of the Elderly, Tokyo Metropolitan Institute of Gerontology.

Department Orofacial Pain Management, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University.

出版信息

Nihon Koshu Eisei Zasshi. 2017;64(7):351-358. doi: 10.11236/jph.64.7_351.

Abstract

Objective In oral health care, a refusal action can cause difficulties, and tactile hypersensitivity (TH) may be a contributing factor. People with TH of the face and mouth clench their jaws. Despite numerous reports on TH among children with disabilities, reports on TH in the elderly who are under long-term care are scarce. The purpose of this study was to investigate TH among the elderly who are under long-term care.Methods We selected 80 residents (8 men and 72 women; mean age: 91.1±6.2y) in a Tokyo nursing home and investigated the presence of TH in them. We also obtained patients' (1) basic information (sex, age, stage of long-term care needs (SCN), and the degree of independent living (IL)); (2) oral information (swallowing status, choking tendency, and intraoral residue); and (3) nutritional information (serum albumin (Alb) levels and body mass index (BMI)). We assessed the face (the forehead, cheek, and perioral area) and the intraoral environment (buccal mucosa, buccal cavity, and palate) as testing sites for TH, using the tester's palm and forefinger. We confirmed the presence of TH when the tested areas reacted partially or fully by shuddering. We classified the subjects into 2 groups based on the presence or absence of TH and analyzed our results using a chi-square test and Mann-Whitney U test. This investigation was approved by the Dentistry Ethics Screening Committee, Tokyo Medical and Dental University.Results A total of 18 residents were diagnosed with TH (22.5%). Significant differences in SCN, IL, choking tendency, intraoral residue, swallowing status, serum Alb levels, and BMI (P<0.05) were reported between this group and the non-TH group.Conclusion We demonstrated that residents with TH were in an advanced SCN and had a lower IL score and a decreased swallowing and nutritional status. Therefore, oral health care, promotion of nutritional status, and meal support are particularly important for the elderly with TH.

摘要

目的 在口腔保健中,拒绝行为可能会造成困难,而触觉过敏(TH)可能是一个促成因素。面部和口腔存在触觉过敏的人会紧咬牙关。尽管有大量关于残疾儿童触觉过敏的报道,但关于长期护理老年人触觉过敏的报道却很少。本研究的目的是调查长期护理老年人中的触觉过敏情况。

方法 我们选取了东京一家养老院的80名居民(男性8名,女性72名;平均年龄:91.1±6.2岁),调查他们是否存在触觉过敏。我们还获取了患者的(1)基本信息(性别、年龄、长期护理需求阶段(SCN)和独立生活程度(IL));(2)口腔信息(吞咽状况、呛噎倾向和口腔内残留物);以及(3)营养信息(血清白蛋白(Alb)水平和体重指数(BMI))。我们使用测试者的手掌和食指,对面部(额头、脸颊和口周区域)和口腔内环境(颊黏膜口腔前庭和硬腭)作为触觉过敏的测试部位进行评估。当测试区域出现部分或完全颤抖反应时,我们确认存在触觉过敏。我们根据是否存在触觉过敏将受试者分为两组,并使用卡方检验和曼-惠特尼U检验分析结果。本调查获得了东京医科齿科大学牙科伦理审查委员会的批准。

结果 共有18名居民被诊断为触觉过敏(22.5%)。该组与非触觉过敏组在SCN、IL、呛噎倾向、口腔内残留物、吞咽状况、血清Alb水平和BMI方面存在显著差异(P<0.05)。

结论 我们证明,存在触觉过敏的居民处于高级SCN阶段,IL评分较低,吞咽和营养状况下降。因此,口腔保健、营养状况促进和进餐支持对患有触觉过敏的老年人尤为重要。

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