臨牀透析 Vol.26 No.11(2-1)


特集名 透析看護の実践 (1)透析中のケアとその有用性
題名 症状別ケアとその効果 (1) 血管痛
発刊年月 2010年 10月
著者 許斐 眞弓 三井島内科クリニック・看護師
【 要旨 】 血液透析中における血管痛は,穿刺して透析を開始した直後,あるいは2~3時間透析をした後から発生してくることが多く,透析が終了するまで持続し,なかには強い苦痛を訴える患者もいる.原因は局所的な刺激によるもの,心因によるもの,身体拘束や緊張による筋肉の凝りなどが考えられ,複数の原因が重なり慢性疼痛となりやすい.穿刺方法の検討などで効果が低いときは,痛みの閾値を上げる緩和技術として,マッサージ,加温,筋緊張を和らげる気分転換法,リラクゼーション,ポジショニングなどが効果的である.また痛みを否定しない支持的な接し方をするとともに透析患者を理解し,チームで継続的に関わっていくことが痛みの閾値を上げることに繋がる.
Theme Nursing Care During Dialysis Treatment and Its Usefulnessy
Title Nursing intervention for alleviation of pain during hemodialysis : Management of venous pain
Author Mayumi Konomi Department of Nursing, Miishima Internal Medicine Clinic
[ Summary ] Venous pain which develops during hemodialysis usually occurs immediately or shortly after treatment begins. This pain continues until hemodialysis is complete. Some patients suffer from severe pain during hemodialysis. The causes of such pain vary from local stimuli, such as sudden changes in blood flow or a patient’s mental stress, to muscle strains included by the physical restraint which prevent patients from moving freely. A variety of factors can result in chronic pain. If changing the puncture method does not reduce pain, then pain alleviation techniques such as massage, heat applications, diversion activities that allow patients to mitigate muscle strain, relaxation techniques, or posture repositioning may be effective in reducing pain. From a nursing standpoint, we should acknowledge patients pain and try to interpret it. Furthermore, it is essential to support patients from the perspective of increasing their pain thresholds. In order to increase patient pain tolerance it is essential for the medical team to continually build supportive relations.
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