日本未熟児新生児学会雑誌　第20巻　第2号　69～75頁（2008年）

日本未熟児新生児学会雑誌　20(2)：261-267；2008　

受付日：平成17．07．13

受理日：平成19．10．05

新生児の哺乳における舌運動と口腔内圧力変動

The Relationship Between Tongue Movement and Expression/Suction Pressure During Feeding

＊1東京理科大学　理工学部　機械工学科，＊2昭和大学　医学部　小児科学教室

＊1　Department of Mechanical Engineering, Tokyo University of Science，＊2　Department of Pediatnics, Showa University

可児桂子＊1・水野克巳＊2・河村　洋＊1

Keiko KANI＊1，Katsumi MIZUNO＊2，Hiroshi KAWAMURA＊1

Key Words：Sucking pressure，Expression pressure，Tongue movement，Breast feeding and Bottle feeding

　哺乳形態の研究では，従来，圧出圧と吸啜圧の測定，またそれらとは独立に超音波断層撮影による口腔内運動の評価などが行われてきた。しかし，圧力が発生するときにどのような口腔内運動のメカニズムが働いているのかは十分に解明されていない。そこで本研究では，哺乳時の圧出圧と吸啜圧，口腔内圧力変動の測定と同時に超音波断層撮影を行い，これらを画像分割装置に通して圧力変動と口腔内運動を，リアルタイムで同時表示させるシステムを構築することにより，圧力変動と口腔内運動の相互関係を測定した。また，直接授乳と人工乳首時での哺乳形態について，超音波断層撮影によって得られた画像を解析した。その結果，直接授乳と人工乳首哺乳の比較では，上顎に対する舌運動において，顕著な差異がみられた。すなわち，直接授乳では舌の先端部から後方部にかけて舌の動きが大きくなり，これに対し，人工乳首では舌が全体的によく動いていた。

　The neonatal feeding behaviors have been evaluated by ultrasonography and pressure measurement, in most of the forgoing studies, however, the tongue movements and pressure measurements were analyzed separately. The first aim of this study is to evaluate the tongue movements and pressure measurements simultaneously and to know at what stage of the tongue movement the positive expression and the negative suction pressures occur. The second aim is to compare the tongue movement objectively during bottle and breast feedings. Methods：Two infants were enrolled in the simultaneous evaluation and three infants in the comparison of bottle and breast feedings. The tongue movements were captured through ultrasonography with a frame rate of 30 pictures per second. These pictures and the measured pressure variations were analyzed simultaneously. In the comparison between the bottle and breast feedings, the distance between the tongue and the hard palate was measured and compared at four points along the tongue. Results：The sucking pressure was generated when a space is formed among the tongue, the palate and the teat. The expression pressure was generated when the teat is compressed between the tongue and the palate. A noticeable difference between bottle and breast feedings was captured in the relative movement of the tongue against the hard palate. Conclusion：By simultaneously measuring the tongue movement and pressure variation, precise timing of pressure generation during feeding is elucidated. In addition, objective tongue movement analysis demonstrates the difference between bottle and breast feedings.