æ ¢æ§çãªèäžã®çã¿ãè©ç²éªšã®äžèª¿ãããææ ¢ããå¿ èŠã¯ãããŸããããã®ããŒãžã§ã¯ããã®æ©ãŸããé¢ä¿æ§ãšåå ã詳ãã解説ãã广çãªã»ã«ãã±ã¢ã®æ¹æ³ãã玹ä»ããããŸããè©ç²éªšã¯ãããè©ç²éªšåããªã©ã®ã¹ãã¬ããããããµãŒãžãçãã¬ãªã©ãèªå® ã§ç°¡åã«ã§ããã±ã¢ãè±å¯ã«æ²èŒãããã«ãæ¥åžžçæŽ»ã§æ°ãä»ããã¹ããã€ã³ãããçç¶ãæ¹åããªãå Žåã®å¯ŸåŠæ³ãŸã§ç¶²çŸ ããŠããŸãããã®å®å šã¬ã€ããèªã¿é²ããããšã§ãçã¿ã®æ ¹æ¬åå ãçè§£ãããèªèº«ã«åã£ãé©åãªã±ã¢ãå®è·µã§ããããã«ãªããŸããèŸãçã¿ããè§£æŸãããå¿«é©ãªæ¯æ¥ãæã«å ¥ããŸãããã
1. èäžã®çã¿ãšè©ç²éªšã®äžèª¿ããã®é¢ä¿æ§ãšã¯ïŒ
èäžãšè©ç²éªšã¯ã坿¥ãªé¢ä¿ã«ãããŸããè©ç²éªšã¯ãè骚ã®èé¢ã«äœçœ®ããé骚ãšäžè 骚ãšé¢ç¯ã§ã€ãªãã£ãŠããŸããçèã«ãã£ãŠæ¯ããããŠããããã®æè»æ§ãé«ãããšã§ãè ãæ§ã ãªæ¹åã«åããããšãã§ããŸãã
ãã®è©ç²éªšã®åããæ¯ããŠããã®ããå§åžœçãè±åœ¢çãè©ç²æçãåéžçãšãã£ãå€ãã®çèã§ãããããã®çèã¯ãèäžå šäœã®çèãšãè€éã«é£æºããŠããŸãããã®ãããå§¿å¢ãæªããªã£ãããç¹å®ã®çèãç·åŒµããããéã«åŒ±åããããããšãè©ç²éªšã®äœçœ®ããããåšèŸºã®çèãç¥çµãå§è¿«ããããšããããŸããããããèäžã®çã¿ãè©ç²éªšã®äžèª¿ã«ã€ãªããã®ã§ãã
äŸãã°ãç«èã«ãªããšè©ç²éªšãå€åŽã«åºãããèäžã®çèã䌞ã°ãããŸãããããšãè©ç²éªšãå®å®ãããçèãåžžã«ç·åŒµã匷ããããçã¿ãåããåŒãèµ·ããã®ã§ãããŸããé·æéã®ãã¹ã¯ã¯ãŒã¯ãªã©ã§åãå§¿å¢ãç¶ãããšãç¹å®ã®çèãç²åŽããè©ç²éªšã®åããæªããªããèäžã®çã¿ãè©ç²éªšã®äžèª¿ã«ã€ãªããããšããããŸãã
ã€ãŸããèäžã®çã¿ãšè©ç²éªšã®äžèª¿ã¯ãåç¬ã§èµ·ããã®ã§ã¯ãªããäºãã«åœ±é¿ãåããæªåŸªç°ãçã¿åºãããšãå€ãã®ã§ããè©ç²éªšã®åãã®æªããèäžã®çã¿ãåŒãèµ·ããããšãããã°ãèäžã®çèã®ç·åŒµãè©ç²éªšã®åããå¶éããäžèª¿ã«ã€ãªããããšãããã®ã§ãã
1.1 è©ç²éªšã®å¯ååãšèäžã®çã¿ã®çš®é¡
è©ç²éªšã®å¯ååã®å¶éãšèäžã®çã¿ã®çš®é¡ã«ã¯é¢é£æ§ããããŸããäŸãã°ãè©ç²éªšã®åããæªããªããšãç¹å®ã®çèã«è² æ ãããããèäžã®çã¿ãšããŠçŸããããšããããŸããå ·äœçã«ã¯ã以äžã®ãããªé¢é£æ§ãèããããŸãã
| è©ç²éªšã®å¯ååå¶é | èäžã®çã¿ã®çš®é¡ | é¢é£ããçè |
| æäžå¶é | è©ãéŠã®ä»ãæ ¹ã®çã¿ãè©ãã | è©ç²æçãå§åžœçäžéš |
| äžå¶å¶é | è©ç²éªšåšèŸºã®çã¿ãã ãã | åºèçãå°èžç |
| å 転å¶é | è©ç²éªšã®éã®çã¿ãèäžã®åŒµã | è±åœ¢çãå§åžœçäžéš |
| å€è»¢å¶é | è©ç²éªšã®å åŽã®çã¿ãèžã®å§è¿«æ | åéžç |
| äžæ¹åæå¶é | è ãäžãããšãã®çã¿ãè©ã® impingement syndrome | å§åžœçäžéšãåéžç |
| äžæ¹åæå¶é | è©ç²éªšã®äžè§ã®çã¿ãèäžã®ããã°ã | è±åœ¢çãå°èžç |
ãããã®é¢é£æ§ã¯äžäŸã§ãããçã¿ã®æãæ¹ãåå ã¯å人ã«ãã£ãŠç°ãªããŸããèªå·±å€æãããå°éå®¶ã®ã¢ããã€ã¹ãåããããšãéèŠã§ãã
1.2 èäžã®çã¿ãšè©ç²éªšã®äžèª¿ãæŸçœ®ãããšã©ããªãïŒ
èäžã®çã¿ãšè©ç²éªšã®äžèª¿ãæŸçœ®ãããšãæ§ã ãªæªåœ±é¿ãåãŒãå¯èœæ§ããããŸããäŸãã°ãçã¿ãæ ¢æ§åããæ¥åžžçæŽ»ã«æ¯éããããããã«ãªããããããŸããããŸããé çãåãæ°ãèªåŸç¥çµã®ä¹±ããªã©ã®çç¶ãçŸããããšããããŸããããã«ãè©ãéŠã®çã¿ãè ã®ãã³ããšãã£ãä»ã®éšäœãžã®çç¶ã®åºãããæžå¿µãããŸããæ©æã«é©åãªå¯ŸåŠãããããšã倧åã§ãã
2. èäžã®çã¿ãšè©ç²éªšã®äžèª¿ãåŒãèµ·ããåå
èäžã®çã¿ãšè©ç²éªšã®äžèª¿ã¯ãæ§ã ãªåå ãè€éã«çµ¡ã¿åã£ãŠåŒãèµ·ããããŸããåå ãç¹å®ãé©åãªå¯ŸçãããããšãéèŠã§ããããã§ã¯äž»ãªåå ã詳ãã解説ããŸãã
2.1 å§¿å¢ã®æªã
ãã¹ã¯ã¯ãŒã¯ãã¹ããã®äœ¿ããããªã©ãé·æéåãå§¿å¢ã§ãããšãç«èã«ãªãããããè©ç²éªšãå€åŽã«åºãããèäžã®çèãç·åŒµãããããªããŸãããã®ç¶æ ãç¶ããšãè©ç²éªšåšãã®çèã®ãã©ã³ã¹ã厩ããçã¿ãäžèª¿ã«ã€ãªãããŸããç¹ã«ãé ãåã«åºãŠèäžãäžžãŸã£ãå§¿å¢ã¯ãè©ç²éªšåšèŸºã®çèã«è² æ ããããçã¿ãæªåãããå¯èœæ§ããããŸãã
2.2 éåäžè¶³
éåäžè¶³ã«ãªããšãè©ç²éªšåšãã®çèã匱ããªããè©ç²éªšãå®å®ãããããšãã§ããªããªããŸãããã®çµæãè©ç²éªšã®äœçœ®ãããããããªããçã¿ãäžèª¿ãçãããããªããŸãããŸããå šèº«ã®è¡è¡ãæªããªãããšã§ãçèãé¢ç¯ã«ååãªæ é€ãè¡ãæž¡ããªããªããèäžã®çã¿ãè©ç²éªšã®äžèª¿ãæªåãããå¯èœæ§ããããŸãã
2.3 é·æéã®ããœã³ã³äœæ¥ãã¹ããæäœ
ããœã³ã³äœæ¥ãã¹ããæäœãé·æéè¡ããšãã©ãããŠãé ãåã«åºãŠç«èã«ãªããã¡ã§ãããã®å§¿å¢ã¯ãè©ç²éªšãåæ¹ã«åŒã£åŒµãçèãç·åŒµãããè©ç²éªšãåŸãã«åŒãçèã匱åãããŸããçµæãšããŠãè©ç²éªšã®åããæªããªããçã¿ãäžèª¿ã«ã€ãªãããŸãããŸããç»é¢ãèŠç¶ããããšã§çŒç²Ÿç²åŽãåŒãèµ·ããããããè©ãèäžã®ããã°ãã«ã€ãªããããšããããŸãã
2.4 ç«è
ç«èã¯ãè©ç²éªšãå€åŽã«åºãããèäžã®çèãåžžã«äŒžã°ãããç¶æ ã«ãªããŸãããã®ç¶æ ãç¶ããšãè©ç²éªšåšãã®çèã®ãã©ã³ã¹ã厩ããçã¿ãäžèª¿ã«ã€ãªããããããªããŸãããŸããç«èã«ãã£ãŠèžéãå§è¿«ããããšãåŒåžãæµ ããªããé žçŽ äŸçµŠãäžè¶³ããããšã§ãçèã®ç²åŽå埩ãé ããçã¿ãå¢åŒ·ãããå¯èœæ§ããããŸãã
2.5 ã¹ãã¬ã¹
ã¹ãã¬ã¹ã¯ãèªåŸç¥çµã®ãã©ã³ã¹ã厩ããçèã®ç·åŒµãé«ããŸããè©ãèäžã®çèãç·åŒµãããšãè¡è¡ãæªããªããè©ç²éªšåšãã®çèã硬ããªããŸãããã®çµæãè©ç²éªšã®åããæªããªããçã¿ãäžèª¿ã«ã€ãªãããŸãããŸããã¹ãã¬ã¹ã¯ç¡ç ã®è³ªãäœäžãããããšããããçèã®ç²åŽå埩ã劚ããçã¿ãæ ¢æ§åãããå¯èœæ§ããããŸãã
2.6 å èçŸæ£
ãŸãã«ãå èçŸæ£ãåå ã§èäžã®çã¿ãè©ç²éªšã®äžèª¿ãçŸããããšããããŸããäŸãã°ãå¿èãèºãèå¢ãªã©ã®çŸæ£ããèäžã«é¢é£çãåŒãèµ·ããããšããããŸãããããã®çã¿ã¯ãå§¿å¢ãéåãšã¯é¢ä¿ãªãçºçããæç¶çãªçã¿ããç¹å®ã®åäœã§æªåããçã¿ãªã©ãç¹åŸŽã§ãã以äžã«ãå èçŸæ£ãšé¢é£çã®äŸãæããŸãã
| å è | é¢é£çã®éšäœ |
| å¿è | å·Šè©ãå·Šè ãèäž |
| èº | èäžãè© |
| èå¢ | å³è©ç²éªšã®äžãèäž |
èªå·±å€æãããå»çæ©é¢ãžã®å蚺ãããããããŸãã
3. èäžã®çã¿ãšè©ç²éªšã®äžèª¿ãã§ãã¯ãªã¹ã
以äžã®ãã§ãã¯ãªã¹ãã§ããèªèº«ã®èäžã®çã¿ãšè©ç²éªšã®äžèª¿ã®çšåºŠã確èªããŠã¿ãŸããããåœãŠã¯ãŸãé ç®ãå€ãã»ã©ãã»ã«ãã±ã¢ã ãã§ãªãå°éå®¶ãžã®çžè«ãæ€èšããå¿ èŠããããããããŸããã
| çç¶ | é »åºŠ |
| è©ç²éªšåšèŸºãåãåºãŸã£ãŠãããšæãã | ã»ãšãã©ãªã æã é »ç¹ã« åžžã« |
| è©ç²éªšãåãã«ããããŸãã¯éåæããã | ã»ãšãã©ãªã æã é »ç¹ã« åžžã« |
| èäžã«çã¿ãæãã | ã»ãšãã©ãªã æã é »ç¹ã« åžžã« |
| åŒåžãæµ ããšæãã | ã»ãšãã©ãªã æã é »ç¹ã« åžžã« |
| è©ãéŠã®ãããæãã | ã»ãšãã©ãªã æã é »ç¹ã« åžžã« |
| é çããã | ã»ãšãã©ãªã æã é »ç¹ã« åžžã« |
| è ããã³ããããŸãã¯ã ãã | ã»ãšãã©ãªã æã é »ç¹ã« åžžã« |
ãããã®çç¶ã¯ãè©ç²éªšã®åãã®æªããåšå²ã®çèã®ç·åŒµãå§¿å¢ã®æªããªã©ãåå ã§èµ·ããããšããããŸããã»ã«ãã±ã¢ã§æ¹åããããšããããŸãããçç¶ã匷ãå Žåãé·åŒãå Žåã¯ãå°éå®¶ãžã®çžè«ãããããããŸãã
3.1 èäžã®çã¿ãšè©ç²éªšã®äžèª¿ã«é¢ãããã®ä»ã®ãã§ãã¯é ç®
以äžã®é ç®ã«ã€ããŠã確èªããŠã¿ãŸãããã
3.1.1 æ¥åžžç掻
- ãã¹ã¯ã¯ãŒã¯äžå¿ã®ç掻ãéã£ãŠãã
- é·æéåãå§¿å¢ã§äœæ¥ããããšãå€ã
- éåäžè¶³ã§ãã
- éãè·ç©ãé »ç¹ã«æã€
- ç¡ç äžè¶³ã§ãã
- ã¹ãã¬ã¹ãæããããšãå€ã
3.1.2 æ¢åŸæŽ
- éå»ã«è©ãèäžã«ã±ã¬ãããããšããã
- ä»ã®ç æ°ã§æ²»çãåããŠãã
ãããã®é ç®ããèäžã®çã¿ãè©ç²éªšã®äžèª¿ã«é¢é£ããŠããå¯èœæ§ããããŸãããã§ãã¯ãªã¹ãã®çµæãšåãããŠããèªèº«ã®ç¶æ ãææ¡ããããã«ããŸãããã
4. èäžã®çã¿ãšè©ç²éªšã®äžèª¿ãåãããã»ã«ãã±ã¢
èäžã®çã¿ãè©ç²éªšã®äžèª¿ãåãããããã«ã¯ãã»ã«ãã±ã¢ãæå¹ã§ããããã§ã¯ãã¹ãã¬ããããããµãŒãžãçãã¬ã®3ã€ã®ã¢ãããŒããã玹ä»ããŸãããèªèº«ã®äœã®ç¶æ ã«åãããŠãç¡çã®ãªãç¯å²ã§è¡ã£ãŠãã ããã
4.1 ã¹ãã¬ãã
è©ç²éªšåšãã®çèãæãããããããšã§ãèäžã®çã¿ãè©ç²éªšã®äžèª¿ãåãããããšãã§ããŸããåŒåžãæ¢ããã«ããã£ãããšè¡ãããšããã€ã³ãã§ãã
4.1.1 è©ç²éªšã¯ããã¹ãã¬ãã
äž¡è ãåã«äŒžã°ããæã®ã²ããåãããŸãããã®ãŸãŸè ãäžã«æã¡äžããé ã®äžã§æã®ã²ããè¿ããŠãèãæ²ããŸããè©ç²éªšãæèããªãããèãã§ããéãåŸãã«åŒããŸãããã®å§¿å¢ã10ç§éããŒããããã£ãããšå ã®å§¿å¢ã«æ»ããŸããããã5åç¹°ãè¿ããŸãã
4.1.2 è©ç²éªšåãã¹ãã¬ãã
äž¡è ãè©ã®é«ãã«äžããŠãèã90åºŠã«æ²ããŸããè©ç²éªšãæèããªãããèã§å€§ããªåãæãããã«ååŸã«åããŸããååãã10åãåŸãåãã10åè¡ããŸãã
4.1.3 èžãéãã¹ãã¬ãã
äž¡æãåŸãã§çµã¿ãèžã匵ããŸããè©ç²éªšãäžå€®ã«å¯ããããã«æèããªããããã®å§¿å¢ã10ç§éããŒãããŸããããã5åç¹°ãè¿ããŸãã
4.2 ãããµãŒãž
ãããµãŒãžã¯ãè¡è¡ãä¿é²ããçèã®ç·åŒµãã»ãã广ããããŸããçæ°æã¡ãããšæããçšåºŠã®åŒ·ãã§è¡ããŸãããã
4.2.1 è©ç²éªšåšãã®ãããµãŒãž
è©ç²éªšã®å åŽãå€åŽãäžäžãããããæã®è ¹ã§åªãããããµãŒãžããŸããåãæãããã«ããããã¯äžäžã«æ«ã§ãããã«è¡ããŸããå·Šå³ãããã5åçšåºŠè¡ããŸãã
4.2.2 èäžã®ãããµãŒãž
ããã¹ããŒã«ããã©ãŒã ããŒã©ãŒã䜿ã£ãŠãèäžã®çèãã»ãããŸããåºã«å¯è»¢ãããããŒã«ãããŒã©ãŒãèäžã«åœãŠãäœéããããŠãã£ãããšäžäžã«åãããŸããç¹ã«çã¿ãã³ãªãæããéšåãäžå¿ã«ã5åçšåºŠè¡ããŸãã
4.3 çãã¬
è©ç²éªšåšãã®çèãèçãéããããšã§ãå§¿å¢ãæ¹åãããèäžã®çã¿ãè©ç²éªšã®äžèª¿ãäºé²ããããšãã§ããŸããæ£ãããã©ãŒã ã§è¡ãããšã倧åã§ãã
4.3.1 è©ç²éªšåšãã®çãã¬
| çãã¬å | ããæ¹ | åæ° |
| ãã¥ãŒãããŒã€ã³ã° | ãã¥ãŒããåºå®ããè©ç²éªšãå¯ããããã«åŒã£åŒµãã | 10ïœ15åÃ3ã»ãã |
| ããã·ã¥ã¢ãããã©ã¹ | è ç«ãŠäŒãã®å§¿å¢ãããããã«è©ç²éªšãå¯ããã | 10ïœ15åÃ3ã»ãã |
4.3.2 èçã®çãã¬
| çãã¬å | ããæ¹ | åæ° |
| ããã¯ãšã¯ã¹ãã³ã·ã§ã³ | ãã€äŒãã«ãªããäžå身ãåããã | 10ïœ15åÃ3ã»ãã |
| ãã©ã³ã¯ | ãã€äŒãã®å§¿å¢ãç¶æããã | 30ç§ïœ1åÃ3ã»ãã |
ãããã®ã»ã«ãã±ã¢ã¯ãèäžã®çã¿ãè©ç²éªšã®äžèª¿ãåãããã®ã«åœ¹ç«ã¡ãŸããããããçç¶ãæ¹åããªãå Žåãæªåããå Žåã¯ãå°éå®¶ãžã®çžè«ãããããããŸãã
5. æ¥åžžçæŽ»ã§æ°ãä»ããã¹ããã€ã³ã
èäžã®çã¿ãè©ç²éªšã®äžèª¿ãæ¹åããããã«ã¯ãã»ã«ãã±ã¢ã ãã§ãªããæ¥åžžçæŽ»ã§ã®æ³šæç¹ã«ãæ°ãé ãããšã倧åã§ããæ¥ã ã®ç©ã¿éãããå¥ãããªèäžãšè©ç²éªšãžãšç¹ãããŸãã ããã§ã¯ãæ¥åžžçæŽ»ã§æèããããã€ã³ãã詳ãã解説ããŸãã
5.1 æ£ããå§¿å¢ãä¿ã€
æ£ããå§¿å¢ã¯ãè骚ãè©ç²éªšãžã®è² æ ã軜æžããçã¿ãäžèª¿ã®äºé²ã«ç¹ãããŸãã ç«ã£ãŠãããšãã¯ãè³ãè©ãè °ãããã¶ããäžçŽç·ã«ãªãããã«æèããŸãããã座ã£ãŠãããšãã¯ãæ·±ã座ããèçã䌞ã°ããé¡ãåŒããŸããããœã³ã³äœæ¥äžã¯ãã¢ãã¿ãŒã®äœçœ®ãç®ã®é«ãã«åãããããŒããŒããšããŠã¹ã¯äœã«è¿ãäœçœ®ã«çœ®ãããšã§ãç«èã«ãªãã«ãããªããŸãã
5.1.1 ç«ã£ãŠããæã®å§¿å¢
- è³ãè©ãè °ãããã¶ããäžçŽç·ã«ãªãããã«æèãã
- ãè ¹ã«è»œãåãå ¥ãã
- é¡ãåŒã
5.1.2 座ã£ãŠããæã®å§¿å¢
- æ€ åã«æ·±ã座ããèãããã«å¯ãããã
- èçã䌞ã°ããé¡ãåŒã
- è¶³ãçµãŸãªã
- æºãšäœã®è·é¢ãé©åã«ä¿ã€
5.1.3 ããœã³ã³äœæ¥æã®å§¿å¢
| é ç® | ãã€ã³ã |
| ã¢ãã¿ãŒã®äœçœ® | ç®ã®é«ãã«åããã |
| ããŒããŒããšããŠã¹ã®äœçœ® | äœã«è¿ãäœçœ®ã«çœ®ã |
| èã®è§åºŠ | 90床以äžã«ãã |
5.2 é©åãªäŒæ©ããšã
é·æéåãå§¿å¢ãç¶ãããšãçèãç·åŒµããè¡è¡ãæªããªããçã¿ãäžèª¿ã®åå ãšãªããŸãã 1æéã«1åã¯ç«ã¡äžããã軜ãã¹ãã¬ãããæ£æ©ããããªã©ãäœãåããæéãèšããŸããããäœæ¥ã«éäžãããããšäŒæ©ãå¿ããã¡ã«ãªãã®ã§ãã¿ã€ããŒãªã©ã掻çšãããšå¹æçã§ããäŒæ©æéã«ã¯ãæž©ãã飲ã¿ç©ã飲ãã ãããªã©ãã¯ã¹ã§ãã鳿¥œãèŽãããããã®ãããããã§ãã
- 1æéã«1åã¯äŒæ©ãåã
- 軜ãã¹ãã¬ãããæ£æ©ããã
- æž©ãã飲ã¿ç©ã飲ã
- ãªã©ãã¯ã¹ã§ãã鳿¥œãèŽã
- ã¿ã€ããŒã掻çšãã
5.3 èªåã«åã£ãå¯å ·ãéžã¶
ç¡ç äžã¯ãäœã®æªã¿ãæŽããçèããªã©ãã¯ã¹ããã倧åãªæéã§ãã èªåã«åã£ãå¯å ·ãéžã¶ããšã§ã質ã®é«ãç¡ç ãåŸãããšãã§ããèäžã®çã¿ãè©ç²éªšã®äžèª¿ã®æ¹åã«ç¹ãããŸãããããã¬ã¹ã¯ã硬ãããæãããããªããã®ãéžã³ãæã¯ãéŠãè©ã«è² æ ãããããªãé«ããéžã³ãŸããããå¯è¿ããããããããšãéèŠãªãã€ã³ãã§ããæ·åžå£ãæã«ããŒãªã©ã®çŽ æã«ããã ãããå¿«é©ãªç¡ç ç°å¢ãæŽããŸãããã
5.3.1 ãããã¬ã¹
- 硬ãããæãããããªããã®ãéžã¶
- äœå§åæ£æ§ã«åªãããã®ãéžã¶
- éæ°æ§ã®è¯ããã®ãéžã¶
5.3.2 æ
- éŠãè©ã«è² æ ãããããªãé«ããéžã¶
- å¯è¿ããæã¡ããããã®ãéžã¶
- çŽ æã«ãã ãã£ãŠéžã¶
ãããã®ãã€ã³ããæèããããšã§ãæ¥åžžç掻ã®äžã§èäžã®çã¿ãè©ç²éªšã®äžèª¿ãäºé²ã»æ¹åããå¿«é©ãªæ¯æ¥ãéãããšãã§ããã§ãããã
6. ãŸãšã
èäžã®çã¿ãšè©ç²éªšã®äžèª¿ã¯ãå§¿å¢ã®æªããéåäžè¶³ãé·æéã®ãã¹ã¯ã¯ãŒã¯ãã¹ãã¬ã¹ãªã©ãæ§ã ãªèŠå ãè€éã«çµ¡ã¿åã£ãŠåŒãèµ·ããããŸãããããã®äžèª¿ãæ¹åããããã«ã¯ãåå ã«åãããé©åãªã»ã«ãã±ã¢ãéèŠã§ããè©ç²éªšã¯ãããè©åããªã©ã®ã¹ãã¬ãããè©ç²éªšåšããèäžã®ãããµãŒãžããããŠçãã¬ã¯ã广çãªã»ã«ãã±ã¢ã®æ¹æ³ã§ããã¹ãã¬ããã¯çèã®æè»æ§ãé«ãããããµãŒãžã¯è¡è¡ãä¿é²ããçãã¬ã¯åšå²ã®çèã匷åããããšã§ãè©ç²éªšã®åããã¹ã ãŒãºã«ããèäžã®çã¿ã軜æžããŸããããã«ãæ¥åžžç掻ã§ã¯æ£ããå§¿å¢ãæèããé©åãªäŒæ©ãåããèªåã«åã£ãå¯å ·ãéžã¶ããšã§ãäžèª¿ã®äºé²ãšæ¹åã«ç¹ãããŸããã»ã«ãã±ã¢ãè¡ã£ãŠãæ¹åãèŠãããªãå Žåã¯ãå°éå®¶ãžã®çžè«ãæ€èšããŸããããã玹ä»ããã»ã«ãã±ã¢ãšæ¥åžžçæŽ»ã®æ¹åçãå®è·µããããšã§ããã£ãšå¿«é©ãªæ¯æ¥ãéããããã«ãªãã§ãããã