臨牀透析 Vol.15 No.8(5)


特集名 透析患者の骨折
題名 透析患者における骨折のプライマリーケア
発刊年月 1999年 07月
著者 服部 文忠 長尾病院透析室
【 要旨 】 慢性血液透析患者は骨折の危険性にさらされており,透析医療に携わる医師はふだんから透析患者の骨折のプライマリーケアを心掛けておくべきである.少しでも骨折が疑われたらX線撮影を行ったり,整形外科医にコンサルトする必要がある.急性期の合併症としてはショック,出血,コンパートメント症候群,脂肪塞栓に留意し,疑われるときはただちにセンター病院と連絡を取り,救急患者として治療を開始しなければならない.疼痛があれば,使い慣れた非ステロイド系消炎鎮痛薬を使用して,可能なかぎり痛みを軽減させることが重要で,必要があれば坐薬も使用する.今後は骨折というリスクを管理する必要を認識し,環境整備にも留意すべきである.
Theme Bone Fracture in Patients with Renal Replacement Therapy
Title Primary care of fracture of dialysis patients
Author Fumitada Hattori Dialysis Unit, Nagao Hospital
[ Summary ] Patients receiving dialysis therapy are facing with the danger of bone fractures. Physicians, who participate in dialysis treatment, should always keep in mind primary care concerning fractures. The sooner, the physician finds the fracture, the better. They should perform X-ray photography, or should consult with an orthopedist about the state of the patient. What the physicians, in charge of such patients, should keep in mind is the complications in the acute stage, which are shock, hemorrhage, compartment syndrome,and fat embolism. If the physicians suspects such conditions, they should immediately contact the related hospital-center, and initiate therapy as an emergency case. It is also important that if the patients have a pain, the physicians prescribe a trusted non-steroidal antiinflammatory drug, to reduce pain as much as possible. If needed, suppositories are also available. The physicians, in charge of the patients on chronic dialysis, must recognize the importance of risk control for fractures in dialysis patients, and keep in mind the environmental adjustments necessary concerning such patients.
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