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題名 | 如何透析才算足夠=What is Adequate Dialysis |
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作者 | 陳殷正; 蔡敦仁; | 書刊名 | 內科學誌 |
卷期 | 13:4 2002.08[民91.08] |
頁次 | 頁175-188 |
分類號 | 415.816 |
關鍵詞 | 足量透析; 血液透析; 腹膜透析; Dialysis adequacy; Hemodialysis; Peritoneal dialysis; |
語文 | 中文(Chinese) |
中文摘要 | 對於末期腎病(end-stage renal disease)的病人,腎臟替代療法(renal replacement therapy)有三種選擇:血液透析(hemodialysis),腹膜透析(peritoneal dialysis)及腎臟移植(kidney transplantation)。而其中血液透析及腹膜透析佔重要的角色。所以如何達到「足量的透析」(dialysis adequacy),是很重要的課題。「足量的透析」不應只侷限在尿毒毒素的清除,而應更廣泛且更完整地涵蓋更多的層面。包括透析方式的選擇、透析量、營養、水分及電解質的平衡、感染、貧血及生活品質等,本文中針對個別的項目做深入的討論。美國國家腎臟基金會(American National kidney Foundation)在2000年所訂定最新的透析療效品質指導(Dialysis Outcome Quality Initiative,DOQI)準則,國際腹膜透析學會(International Society of peritoneal Dialysis,ISPD)在2000年最新發表的「腹膜透析引起腹膜炎之治療建議」以及歐洲腎臟協會╱歐洲透析及移植協會(European Renal Association/European Dialysis and Transplantation Association,ERNEDTA)在1999 年所發表針對慢性腎衰竭病人貧血處理的最佳施行準則(best practice guidelines),皆針對這些問題提供了許多建議,在本文中皆有引述,相當值得參考,也可看出國際上對這些問題的重視。最後,我們也介紹臺大醫院在透析方面的經驗,並提出幾個病例作討論,期能拋磚引玉,增進大家對這方面的了解。 |
英文摘要 | For patients with end-stage renal disease, there are three choices of renal replacement therapy: hemodialysis, peritoneal dialysis, and kidney transplantation. Among them, hemodialysis and peritoneal dialysis are the main treatment modalities. Hence, how to reach "dialysis adequacy" is an important issue. "Dialysis adequacy" should not only be limited to the clearance of uremic toxins, but also includes many other aspects of dialysis, such as the choice of dialysis modalities, the delivery of dialysis dose, nutrition, water and electrolytes balance, infection, anemia, quality of life, and so on. "Dialysis Outcome Quality Initiative (DOQI) clinical practice guidelines" constructed by American National Kidney Foundation (NKF) in 1997, "Peritoneal dialysis-related peritonitis treatment recommendations" updated by International Society of Peritoneal Dialysis (ISPD) in 1996, and "European best practice guidelines for the treatment of anemia in patients with chronic renal failure" raised by European Renal Association/European Dialysis and Transplantation Association (ERA/EDTA) in 1999, are introduced. These provide a good guidance for treating dialysis patients. We also described some of our experience in dialysis center of National Taiwan University Hospital. Besides, several clinical examples were discussed, in the hope that dialysis adequacy being better understood. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。