臨牀透析 Vol.15 No.5(4-2)


特集名 透析とモニタリング技術 -- 透析の自動化と今後の展開
題名 血圧モニター (2) 間接法
発刊年月 1999年 05月
著者 八木 さゆり 前田記念腎研究所・看護婦
著者 山本 浩靖 前田記念腎研究所・臨床工学技士
著者 前田 貞亮 前田記念腎研究所内科
著者 福内 史子 前田記念腎研究所内科
【 要旨 】 血圧は内的・外的環境の変化により非常に変動しやすい生体情報である.測定される血圧には,外来随時血圧,家庭血圧,24時間自由行動下血圧がありそれぞれ重要な情報をもたらす.測定には従来よりコロトコフ音を聴取する聴診法が広く用いられてきたが,近年振動法に基づいた自動血圧計が普及してきた.われわれの施設でも透析集中監視システムに接続した自動血圧計および48時間自由行動下の自動血圧計を用い,透析患者における血圧値の水分貯留との関連,降圧薬の使用方法,透析終了後の低血圧とその防止などに役立てており,長時間モニタリングの意義は大きい.
Theme Monitoring Technologies in Dialysis Therapy
Title Blood pressure monitor ; indirect method
Author Sayuri Yagi Department of Nursing, Maeda Insutitute of Renal Research
Author Hiroyasu Yamamoto Department of Clinical Engineering, Maeda Insutitute of Renal Research
Author Teiryo Maeda Department of Internal Medicine, Maeda Insutitute of Renal Research
Author Fumiko Fukuuchi Department of Internal Medicine, Maeda Insutitute of Renal Research
[ Summary ] Blood pressure (BP)is extremely variable, depending on the situation in response to intrinsic as well as extrintic factors, BP was classfied according to the patients situation. The categories were casual BP, home BP and ambulatory BP over a 24-hours period.
The continued monitoring of these different types of BP provides important information. In the measurement method, auscultion of Kortokow sounds has been widely used. Recently, however, automatic sphygmomanometers using the vibration method have become quite popular. We have been using automatic sphygmomanometers connected to an intensive monitoring system for dialysis units and forty eight hours BP monitors. With these results, we evaluated water balance and the dry weight of dialysis patients, and considered the appropriate medication for hypertention and to prevent hypotention after dialysis. Forty eight hours monitoring is especially useful for dialysis patients, in whom the average BP of the second twenty four hours after the dialysis therapy is higher than that of the first twenty four hours after dialysis. Thus, an extended period of monitoring of BP in different situation is important for patients of dialysis treatment.
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