当院におけるEffective Medical Creation（EMC）による認知機能障害予防の試み
術後認知機能障害の原因は多様でさまざまな角度からの予防が必要である．当院のコホート研究で，非心臓手術後3カ月の認知機能悪化の発生率は27％であった．術後認知機能悪化の関連因子として，年齢，症候性脳血管障害，血清クレアチニン値，スタチンの使用，体格指数，栄養障害，悪性疾患，再手術などが認められた．術後認知機能障害には認知予備能が関連しており，当院ではEffective Medical Creation（EMC）として，五感（視覚，聴覚，嗅覚，味覚，触角）と想感（知恵，思いやり）に働きかける快適な環境づくりを目指している．当院で実施している，アロマ，疑似窓，壁面装飾，ロボットセラピーの試みを紹介す...
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| Published in | 日本臨床麻酔学会誌 Vol. 40; no. 4; pp. 384 - 391 |
|---|---|
| Main Authors | , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
日本臨床麻酔学会
15.07.2020
|
| Subjects | |
| Online Access | Get full text |
| ISSN | 0285-4945 1349-9149 |
| DOI | 10.2199/jjsca.40.384 |
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| Abstract | 術後認知機能障害の原因は多様でさまざまな角度からの予防が必要である．当院のコホート研究で，非心臓手術後3カ月の認知機能悪化の発生率は27％であった．術後認知機能悪化の関連因子として，年齢，症候性脳血管障害，血清クレアチニン値，スタチンの使用，体格指数，栄養障害，悪性疾患，再手術などが認められた．術後認知機能障害には認知予備能が関連しており，当院ではEffective Medical Creation（EMC）として，五感（視覚，聴覚，嗅覚，味覚，触角）と想感（知恵，思いやり）に働きかける快適な環境づくりを目指している．当院で実施している，アロマ，疑似窓，壁面装飾，ロボットセラピーの試みを紹介する． |
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| AbstractList | 術後認知機能障害の原因は多様でさまざまな角度からの予防が必要である．当院のコホート研究で，非心臓手術後3カ月の認知機能悪化の発生率は27％であった．術後認知機能悪化の関連因子として，年齢，症候性脳血管障害，血清クレアチニン値，スタチンの使用，体格指数，栄養障害，悪性疾患，再手術などが認められた．術後認知機能障害には認知予備能が関連しており，当院ではEffective Medical Creation（EMC）として，五感（視覚，聴覚，嗅覚，味覚，触角）と想感（知恵，思いやり）に働きかける快適な環境づくりを目指している．当院で実施している，アロマ，疑似窓，壁面装飾，ロボットセラピーの試みを紹介する． |
| Author | 川口, 昌彦 井上, 聡己 位田, みつる 武澤, 恵理子 |
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| References | 10) 品川俊一郎：脳予備能と認知予備能．老年精神医学雑誌 28：19-23，2017 6) 位田みつる，内藤祐介，松成泰典ほか：プレハビリテーションプログラムの役割．臨床麻酔 41：949-958，2017 19) Ulrich RS：View through a window may influence recovery from surgery. Science 224：420-421, 1984 21) Sawami K, Kimura M, Kitamura T, et al.：The effect of cognitive dance therapy as dementia prevention. International Medicine 1：140-146, 2019 18) 三木光範，佐藤輝希：疑似窓の有効性に関する研究．日本建築学会・情報システム技術委員会 第35回情報・システム・利用・技術シンポジウム 2012報告．2012，H34：1-40 5) Kawaguchi M, Ida M, Naito Y：The role of Perioperative Surgical Home on health and longevity in society：importance of the surgical prehabilitation program. J Anesth 31：319-324, 2017 11) Feinkohl I, Winterer G, Spies CD, et al.：Cognitive Reserve and the Risk of Postoperative Cognitive Dysfunction. Dtsch Arztebl Int 114：110-117, 2017 13) 佐藤幸世，若林健二，武澤恵理子ほか：五感を活用したICUケアー─Effective Medical Creation─．臨床麻酔 42：955-963，2018 3) Ida M, Naito Y, Matsunari Y, et al.：Prevalence and associated factors of preoperative functional disability in elective surgical patients over 55 years old：a prospective cohort study. J Anesth 32：381-386, 2018 8) Lohsiriwat V, Chinswangwatanakul V, Lohsiriwat S, et al.：Hypoalbuminemia is a predictor of delayed postoperative bowel function and poor surgical outcomes in right-sided colon cancer patients. Asia Pac J Clin Nutr 16：213-217, 2007 12) O’Gara BP, Mueller A, Gasangwa DVI, et al.：Prevention of Early Postoperative Decline：A Randomized, Controlled Feasibility Trial of Perioperative Cognitive Training. Anesth Analg 130：586-595, 2020 15) Komori T, Kageyama M, Tamura Y, et al.：Anti-stress effects of simplified aroma hand massage. Ment Illn 10：7619, 2018 1) Kotekar N, Shenkar A, Nagaraj R：Postoperative cognitive dysfunction - current preventive strategies. Clin Interv Aging 13：2267-2273, 2018 7) Kawano T, Eguchi S, Iwata H, et al.：Impact of Preoperative Environmental Enrichment on Prevention of Development of Cognitive Impairment following Abdominal Surgery in a Rat Model. Anesthesiology 123：160-170, 2015 14) 井上聡己，武澤恵理子，重光秀信ほか：EMC（Effective Medical Creation）：奈良医大の試み．臨床麻酔 43：1337-1342，2019 23) Sawami K, Kimura M, Kitamura T, et al.：Robots Visit Homes For Elderly People Who Have Difficulty Going Out and Practice Brain Training. EJMED 2：1-4, 2020 9) Zhang JQ, Curran T, McCallum JC, et al.：Risk factors for readmission after lower extremity bypass in the American College of Surgeons National Surgery Quality Improvement Program. J Vasc Surg 59：1331-1339, 2014 17) Chamine I, Oken BS：Aroma Effects on Physiologic and Cognitive Function Following Acute Stress：A Mechanism Investigation. J Altern Complement Med 22：713-721, 2016 20) 井上聡己，武澤恵理子，三木光範ほか：疑似窓，装飾を施したICUに対する患者，患者家族へのアンケート．臨床麻酔 43：1125-1128，2019 22) Sawami K, Kimura M, Kitamura T, et al.：Cognitive ability and psychological effectiveness of brain training dance robot therapy for elderly people. OAJ Neuropsychiatr 1：004, 2019 16) Lee SH, Kim JY, Yeo S, et al.：Meta-Analysis of Massage Therapy on Cancer Pain. Integr Cancer Ther 14：297-304, 2015 4) Egawa J, Inoue S, Nishiwada T, et al.：Effects of anesthetics on early postoperative cognitive outcome and intraoperative cerebral oxygen balance in patients undergoing lung surgery：a randomized clinical trial. Can J Anaesth 63：1161-1169, 2016 2) Ida M, Naito Y, Tanaka Y, et al.：Feasibility, reliability, and validity of the Japanese version of the 12-item World Health Organization Disability Assessment Schedule-2 in preoperative patients. J Anesth 31：539-544, 2017 |
| References_xml | – reference: 1) Kotekar N, Shenkar A, Nagaraj R：Postoperative cognitive dysfunction - current preventive strategies. Clin Interv Aging 13：2267-2273, 2018 – reference: 15) Komori T, Kageyama M, Tamura Y, et al.：Anti-stress effects of simplified aroma hand massage. Ment Illn 10：7619, 2018 – reference: 17) Chamine I, Oken BS：Aroma Effects on Physiologic and Cognitive Function Following Acute Stress：A Mechanism Investigation. J Altern Complement Med 22：713-721, 2016 – reference: 7) Kawano T, Eguchi S, Iwata H, et al.：Impact of Preoperative Environmental Enrichment on Prevention of Development of Cognitive Impairment following Abdominal Surgery in a Rat Model. Anesthesiology 123：160-170, 2015 – reference: 2) Ida M, Naito Y, Tanaka Y, et al.：Feasibility, reliability, and validity of the Japanese version of the 12-item World Health Organization Disability Assessment Schedule-2 in preoperative patients. J Anesth 31：539-544, 2017 – reference: 22) Sawami K, Kimura M, Kitamura T, et al.：Cognitive ability and psychological effectiveness of brain training dance robot therapy for elderly people. OAJ Neuropsychiatr 1：004, 2019 – reference: 20) 井上聡己，武澤恵理子，三木光範ほか：疑似窓，装飾を施したICUに対する患者，患者家族へのアンケート．臨床麻酔 43：1125-1128，2019 – reference: 12) O’Gara BP, Mueller A, Gasangwa DVI, et al.：Prevention of Early Postoperative Decline：A Randomized, Controlled Feasibility Trial of Perioperative Cognitive Training. Anesth Analg 130：586-595, 2020 – reference: 16) Lee SH, Kim JY, Yeo S, et al.：Meta-Analysis of Massage Therapy on Cancer Pain. Integr Cancer Ther 14：297-304, 2015 – reference: 8) Lohsiriwat V, Chinswangwatanakul V, Lohsiriwat S, et al.：Hypoalbuminemia is a predictor of delayed postoperative bowel function and poor surgical outcomes in right-sided colon cancer patients. Asia Pac J Clin Nutr 16：213-217, 2007 – reference: 18) 三木光範，佐藤輝希：疑似窓の有効性に関する研究．日本建築学会・情報システム技術委員会 第35回情報・システム・利用・技術シンポジウム 2012報告．2012，H34：1-40 – reference: 13) 佐藤幸世，若林健二，武澤恵理子ほか：五感を活用したICUケアー─Effective Medical Creation─．臨床麻酔 42：955-963，2018 – reference: 5) Kawaguchi M, Ida M, Naito Y：The role of Perioperative Surgical Home on health and longevity in society：importance of the surgical prehabilitation program. J Anesth 31：319-324, 2017 – reference: 9) Zhang JQ, Curran T, McCallum JC, et al.：Risk factors for readmission after lower extremity bypass in the American College of Surgeons National Surgery Quality Improvement Program. J Vasc Surg 59：1331-1339, 2014 – reference: 21) Sawami K, Kimura M, Kitamura T, et al.：The effect of cognitive dance therapy as dementia prevention. International Medicine 1：140-146, 2019 – reference: 3) Ida M, Naito Y, Matsunari Y, et al.：Prevalence and associated factors of preoperative functional disability in elective surgical patients over 55 years old：a prospective cohort study. J Anesth 32：381-386, 2018 – reference: 6) 位田みつる，内藤祐介，松成泰典ほか：プレハビリテーションプログラムの役割．臨床麻酔 41：949-958，2017 – reference: 23) Sawami K, Kimura M, Kitamura T, et al.：Robots Visit Homes For Elderly People Who Have Difficulty Going Out and Practice Brain Training. EJMED 2：1-4, 2020 – reference: 11) Feinkohl I, Winterer G, Spies CD, et al.：Cognitive Reserve and the Risk of Postoperative Cognitive Dysfunction. Dtsch Arztebl Int 114：110-117, 2017 – reference: 19) Ulrich RS：View through a window may influence recovery from surgery. Science 224：420-421, 1984 – reference: 4) Egawa J, Inoue S, Nishiwada T, et al.：Effects of anesthetics on early postoperative cognitive outcome and intraoperative cerebral oxygen balance in patients undergoing lung surgery：a randomized clinical trial. Can J Anaesth 63：1161-1169, 2016 – reference: 10) 品川俊一郎：脳予備能と認知予備能．老年精神医学雑誌 28：19-23，2017 – reference: 14) 井上聡己，武澤恵理子，重光秀信ほか：EMC（Effective Medical Creation）：奈良医大の試み．臨床麻酔 43：1337-1342，2019 |
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| Title | 当院におけるEffective Medical Creation（EMC）による認知機能障害予防の試み |
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| ispartofPNX | 日本臨床麻酔学会誌, 2020/07/15, Vol.40(4), pp.384-391 |
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