The Examination of a vascular access of home hemodialysis patients in our hospital
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- Sasaki Yusuke
- Division of ME Service, Saitama Medical Center, Saitama Medical University
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- Ogawa Tomonari
- Department of Nephrology and Bloodpurification, Saitama Medical Center, Saitama Medical University
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- Kanayama Yuki
- Division of ME Service, Saitama Medical Center, Saitama Medical University
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- Yamaguchi Yumiko
- Division of ME Service, Saitama Medical Center, Saitama Medical University
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- Nagamine Daisuke
- Division of ME Service, Saitama Medical Center, Saitama Medical University
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- Isa Yuya
- Division of ME Service, Saitama Medical Center, Saitama Medical University
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- Motozuka Akira
- Division of ME Service, Saitama Medical Center, Saitama Medical University
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- Seki Yosie
- Division of Nursing, Saitama Medical Center, Saitama Medical University
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- Ise Yasuo
- Division of Nursing, Saitama Medical Center, Saitama Medical University
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- Nagao Noriko
- Division of Nursing, Saitama Medical Center, Saitama Medical University
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- Tanabe Atsuko
- Division of Nursing, Saitama Medical Center, Saitama Medical University
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- Iwanaga Mizuki
- Department of Nephrology and Bloodpurification, Saitama Medical Center, Saitama Medical University
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- Kiba Touta
- Department of Nephrology and Bloodpurification, Saitama Medical Center, Saitama Medical University
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- Noiri Chie
- Department of Nephrology and Bloodpurification, Saitama Medical Center, Saitama Medical University
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- Matsuda Akihiko
- Department of Nephrology and Bloodpurification, Saitama Medical Center, Saitama Medical University
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- Mitarai Tetsuya
- Department of Nephrology and Bloodpurification, Saitama Medical Center, Saitama Medical University
Bibliographic Information
- Other Title
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- 当院在宅血液透析患者に対する自己穿刺への取り組みと合併症に関する検討
- トウ イン ザイタク ケツエキ トウセキ カンジャ ニ タイスル ジコ センシ エ ノ トリクミ ト ガッペイショウ ニ カンスル ケントウ
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Abstract
[Purpose] Recently, home hemodialysis (HHD) has become common in Japan. However, vascular access (VA) is difficult in some patients. To perform stable HHD, it is important to achieve favorable VA. With respect to VA for HHD patients in our hospital, we analyzed VA maintenance/control before and after the introduction of HHD. [Subjects/Methods] The subjects were 4 patients undergoing chronic maintenance dialysis in whom HHD management had been conducted in our hospital (42.8±7.1 years, male-to-female ratio: 2: 2, duration of HHD: 20.8±20.5 months) (mean±SD). We retrospectively examined VA orientation as guidance before HHD introduction and the management of puncture/problems after HHD introduction based on interviews on consultation at the outpatient clinic and reports/records regarding the treatment course on each session. [Results] The mean frequency of guidance before HHD introduction was 27.3±10.9 times (mean±SD). Of these, the frequency of guidance for puncture was 21.5±9.0 times. VA problems after HHD introduction consisted of mis-puncture-related internal hemorrhage (11 episodes), pain/swelling at the puncture site (6 episodes), puncture-position switching related to an increase in the venous pressure or pain at the puncture site (7 episodes), PTA selection (1 episode), and additional guidance for puncture (2 episodes). Sharp needle-related problems caused swelling/pain, markedly influencing the patients' stress. On the other hand, buttonhole (BH) puncture reduced stress. [Conclusion] As a specific interval is required to learn self-puncture, it may be necessary to start guidance for puncture in the early phase. BH puncture may lead to a decrease in the number of puncture-related problems, and should be utilized as a puncture method to put patients' mind at ease. However, guidance for puncture with a sharp needle must be performed in patients in whom BH puncture is difficult or as a strategy when it is impossible. For VA management in HHD patients, it is important to accurately acquire puncture methods matched to individual patients and continue regular observation with dialysis staff.
Journal
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- Nihon Toseki Igakkai Zasshi
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Nihon Toseki Igakkai Zasshi 46 (2), 185-191, 2013
The Japanese Society for Dialysis Therapy
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Details 詳細情報について
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- CRID
- 1390282679656196864
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- NII Article ID
- 10031161754
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- NII Book ID
- AN10432053
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- ISSN
- 1883082X
- 13403451
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- NDL BIB ID
- 024316602
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- Text Lang
- ja
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- Data Source
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- JaLC
- NDL
- Crossref
- CiNii Articles
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- Abstract License Flag
- Disallowed