| 特集名 | 腎代行治療 (renal replacement therapy ; RRT) のイノベーション | |
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| 題名 | 在宅腹膜透析 -- 操作に必要な機器，薬剤，管理，支援体制 | |
| 発刊年月 | 2008年 06月 | |
| 著者 | 石田 真理 | 北彩都病院内科 |
| 【 要旨 】 | 腹膜透析 (PD) 療法は本来，在宅で行う透析であり，患者自身の自立した透析治療と生活の両立を可能とするものである．しかし，要介護高齢者を在宅で管理するには介護保険の限界があり，社会環境の整備が未熟であること，要介護状態のPD患者の入所できる施設がないことなどの医療制度の不備が挙げられる． 在宅PD管理には，基幹病院の患者管理のための院内体制の確立と，各種社会資源を投入した患者支援体制の確立が重要である．現状の介護保険制度では，PD患者の手技の第三者による維持継続には無理がある．積極的にPD手技援助できる地域密着型の施設の設立と，経済的・法的保護の確立が急務であろう． |
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| Theme | Innovation of Renal Replacement Therapy (RRT) -- What points should be changed ? | |
|---|---|---|
| Title | Home PD treatment | |
| Author | Mari Ishida | Kitasaito Hospital |
| [ Summary ] | Peritoneal dialysis (PD) makes it possible for elderly patients to live with dignity and to maintain their QOL with home medical treatment. Not only for younger patients who have jobs but also for the elderly who need care-givers to carry out their PD treatment, PD has many advantages. However, the number of patients receiving PD treatment is still low compared with the number of hemodialysis patients in Japan. To support home PD treatment for elderly patients, medical staffs must choose PD modalities. The use of double bag systems or APD (automated peritoneal dialysis) and low dose and low frequency dwell times, may help prevent exhaustion in patients and care-givers. The purpose of PD treatment is not only to maintain adequate QOL but to improve it. This is especially true for elderly patients. To provide patients with home PD treatment, integrated nursing care and, social care systems are required. The public health care insurance system for elderly PD patients continues to provide satisfactory help for home PD treatment. The proper social care environment for home PD treatment, as well as social welfare resources, including the public-care insurance system for patients and care-givers must be maintained. |
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