特集名 | 透析患者の栄養障害とNSTの可能性 | |
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題名 | 規模別NST活動の展開 (6) 各種特殊な病態を有する患者 1. リハビリ | |
発刊年月 | 2013年 07月 | |
著者 | 秋山 恭子 | 創和会しげい病院栄養管理部・管理栄養士 |
著者 | 山西 あさみ | 創和会しげい病院内科 |
著者 | 有元 克彦 | 創和会しげい病院内科 |
【 要旨 】 | 透析患者は,筋力低下や骨代謝異常などにより骨折しやすく,脳血管障害は死因の第4位を占める重要な合併症である.骨折も脳血管障害も病状が安定し始めた回復期に集中的なリハビリを行うことが,ADLやQOLの向上にもっとも効果的であるが,これまで透析患者は,さまざまな理由から回復期リハビリテーション(回リハ)病棟への受け入れが難しいといった現状があった.しかし,平成24年度診療報酬改定により,人工腎臓の手技料が当病棟の包括範囲から外れ,当院は透析患者中心の回リハ病棟を開設した.NST(nutrition support team)は,リハビリ効率向上のために栄養管理は重要と考え,栄養面から透析患者のリハビリを支援するために回リハ栄養カンファレンスを実施し,積極的介入を行っている. |
Theme | Protein-energy wasting and potentiality of NST in dialysis patients | |
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Title | NST efforts to dialysis patients in convalescence rehabilitation ward | |
Author | Kyoko Akiyama | Department of Nutrition, Shigei Hospital |
Author | Asami Yamanishi | Department of Internal Medicine, Shigei Hospital |
Author | Katsuhiko Arimoto | Department of Internal Medicine, Shigei Hospital |
[ Summary ] | Dialysis patients may easily experience fractures due to losses of muscle strength and abnormalities in skeletal metabolism. Cerebrovascular disorders are important complications which are the 4th most common cause of death in these patients. After patients have fractures or experience cerebrovascular disorders, intensive rehabilitation and convalescence is the most effective methed to achieve improvements in ADL and QOL. Dialysis patients may be accepted into convalescent wards, which has been difficult until now due to various complications. However, changes in medical treatment fees in the last year, including technical fees for artificial kidneys, have separated them from average patients in convalescent wards. Our hospital established a convalescent rehabilitation ward for dialysis patients. Nutritional management is considered important by the NST for improving rehabilitation efficiency. It is also important to support dialysis patients' rehabilitation in term of nutrition. Rehabilitation nutrition conferences are being conducted to help us provide positive intervention. |