臨牀透析 Vol.18 No.13(2-7)


特集名 栄養障害に陥った腎不全患者のケア -- 医師・栄養士・看護師の連携
題名 ケース・スタディ VII. 感覚障害
発刊年月 2002年 12月
著者 田部井 薫 自治医科大学附属大宮医療センター腎臓科
【 要旨 】 透析患者では，味覚異常，視覚異常（色覚異常，視野異常，視力障害），聴覚異常（聴力障害，耳鳴り），知覚異常（知覚鈍麻，しびれ感），嗅覚異常などさまざまな感覚障害を伴うことが多い．しかし，多くの場合，透析導入期に発生し，透析導入という人生最大の出来事に気を取られ，かなり重症でないと，あまり感覚障害については訴えないことが多い．また，徐々に症状が増悪するため，患者が積極的に訴えないことも多い．多くの場合には，適正な透析療法により改善してしまうが，時に薬剤性，透析合併症として感覚障害が発生することもあり，患者のQOLを考えると，感覚異常はもっと注目されてよい病態と思われる．
Theme Care of Patients with Chronic Renal Failure under Malnutrition -- The Teamplay of Physicians, Nutritionists, and Nurses
Title Nutritional management for sensory disturbances in uremia
Author Kaoru Tabei Devision of Nephrology, Jichi Medical School, Omiya Medical Center
[ Summary ] In hemodialysis patients, various sensory disturbances, such as those associated with taste, vision, hearing, touch, and smell are frequently encountered. These sensory disturbances occur frequently in the early phases of hemodialysis induction. However, even though the psychological states of patients are in the up-set, and they do not complain about minor problems, such as sensory disturbances. Moreover, these sensory disturbances progress slowly, and patients do not notice them. Although most patients recover from sensory disturbances immediately by appropriate hemodialysis therapy, drugs may play some role in sensory disturbances. Considering the quality of life for hemodialysis patients, sensory disturbances should be recognized more often in clinical situations.
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