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題名:慢性腎病病人使用暫時性導管啟動長期透析之影響因素
書刊名:榮總護理
作者:賴孟婕周哲毅呂淑華 引用關係
作者(外文):Lai, Meng-jieChou, Che-yiLu, Shu-hua
出版日期:2018
卷期:35:3
頁次:頁278-288
主題關鍵詞:慢性腎病暫時性導管透析Chronic kidney diseaseTemporary catheterDialysis
原始連結:連回原系統網址new window
相關次數:
  • 被引用次數被引用次數:期刊(1) 博士論文(0) 專書(0) 專書論文(0)
  • 排除自我引用排除自我引用:1
  • 共同引用共同引用:8
  • 點閱點閱:3
慢性腎病病人非計畫性置入暫時性導管,進行緊急血液透析是增加臨床醫療風險之處置。為瞭解其影響因素,進而能有效衛教無法避免長期透析的慢性腎病病人,計畫性的建置長期通路,以降低醫療風險與耗費。本研究以次級資料分析2006年至2014年間,中部某醫學中心「慢性腎臟疾病共同照護網」中,篩選以長期透析結案的末期腎病前期(Pre-ESRD)病人資料,採回溯性世代研究設計,利用描述性統計、卡方檢定及複邏輯斯迴歸進行統計。結果在464位首次透析病人中,297人(64.0%)使用暫時性導管,發現慢性腎病病人使用暫時性導管啟動長期透析之重要影響因素包括:年紀輕(OR= 0.96, p< .001)、腎絲球過濾率低(OR= 0.88, p= .004)、血清白蛋白高(OR= 1.86, p= .017) 與透析前接受衛教(含主動諮詢)次數多(OR= 1.12, p= .023)。本研究結果期提供慢性腎病照護團隊設計預建透析通路相關衛教方案之參考。
Admitting patients with chronic kidney disease (CKD) for unplanned double-lumen catheter treatment as a temporary treatment measure for hemodialysis is a risky clinical practice. To gain insight into the factors that control or affect the temporary use of a catheter and to provide further effective health education for patients with CKD that could not avoid use of a catheter, this study employed descriptive statistics, the chi-squared test, and a multivariate logistic regression retrospective cohort design to perform secondary data analysis on 464 patients that underwent dialysis for the first time. The result revealed that 297 (64%) of these patients had used a temporary catheter. Younger age (OR = 0.96, p < .001), lower basal estimated glomerular filtration rate (OR = 0.88, p = .004), higher serum albumin (OR = 1.86, p = .017), and more education sessions (OR = 1.12, p = .023) were identified as influential factors. The results of this study are expected to serve as reference to CKD care teams for the design and establishment of plans and to advance dialysis paths and relevant educational programs.
期刊論文
1.許智揚(20080500)。透析病患血管通路的建立及維護。腎臟與透析,20(2),63-67。  延伸查詢new window
2.林燕琴、謝炯昭(20070200)。慢性腎衰竭病人血管通路的手術前評估及術後照護。腎臟與透析,19(1),40-44。  延伸查詢new window
3.潘美妃、何延鑫、王美華、陳梅麗(20060600)。推動門診慢性腎臟疾病個案管理專案。臺灣腎臟護理學會雜誌,5(1),40-53。  延伸查詢new window
4.邱怡文、黃尚志、陳鴻鈞(20070200)。階段式開始腹膜透析(Stepwise Initiation of Peritoneal Dialysis)之可行性。腎臟與透析,19(1),36-39。  延伸查詢new window
5.陳秋月、陳瑞忻、陳思嘉、周明瑾、李素珠、黃麗利、麥秀琴、張哲銘(20120300)。探討早期腎臟科轉介對血液透析病人在透析前照護、血管通路建立及死亡率的影響。臺灣腎臟護理學會雜誌,11(1),26-33。  延伸查詢new window
6.陳泰瑜、林麗玫(20170900)。慢性腎臟病病人接受透析的時機。腎臟與透析,29(3),132-135。  延伸查詢new window
7.裘苕莙、陳育弘、陳佩盈、蘇逸玲(2009)。暫時性血液透析導管血流感染相關因素探討。榮總護理,27(2),127-135。  延伸查詢new window
8.Buck, J.、Baker, R.、Cannaby, A. M.、Nicholson, S.、Peters, J.、Warwick, G.(2007)。Why do patients known to renal services still undergo urgent dialysis initiation? A cross-sectional survey。Nephrology Dialysis Transplantation,22(11),3240-3245。  new window
9.Evans, M.、Tettamanti, G.、Nyrén, O.、Bellocco, R.、Fored, C.、Elinder, C. G.(2011)。No survival benefit from early-start dialysis in a population-based, inception cohort study of Swedish patients with chronic kidney disease。Journal of Internal Medicine,269(3),289-298。  new window
10.Kukita, K.(2015)。Practice and education of the vascular access。The Journal of Vascular Access,16(Suppl 10),2-4。  new window
11.Perl, J.、Wald, R.、McFarlane, P.、Bargman, J. M.、Vonesh, E.、Na, Y.、Moist, L.(2011)。Hemodialysis vascular access modifies the association between dialysis modality and survival。Journal of the American Society of Nephrology,22(6),1113-1121。  new window
12.You, J. H.、Ming, W. K.、Lin, W. A.、Tarn, Y. H.(2015)。Early supplemented low-protein diet restriction for chronic kidney disease patients in Taiwan--A cost-effectiveness analysis。Clinical Nephrology,84(4),189-196。  new window
13.洪燕妮、吳肖琪、吳義勇、柯博仁(20090400)。採用動靜脈瘻管或人工血管之血液透析病人住院醫療利用之分析。臺灣公共衛生雜誌,28(2),144-154。new window  延伸查詢new window
圖書
1.黃志強(2006)。血液透析學。臺北:合記圖書出版社。  延伸查詢new window
2.台灣腎臟醫學會(2010)。慢性腎臟病防治手冊。台北市:行政院衛生署國民健康局。  延伸查詢new window
3.許志成、熊昭、陳鴻鈞、黃秋錦、黃尚志、吳麥斯、高治圻(2015)。2015台灣腎病年報。臺北市:衛生福利部國家衛生研究院。  延伸查詢new window
4.許志成、熊昭、盧國城、吳麥斯、高治圻、林彥仲、黃尚志(2017)。2016台灣腎病年報。臺北市:衛生福利部國家衛生研究院。  延伸查詢new window
其他
1.衛生福利部中央健康保險署(2018)。96年度門診透析服務品質保證保留款實施方案,https://www.nhi.gov.tw/Advanced_Search.aspx?q=96年門診透析服務品質保證。  延伸查詢new window
 
 
 
 
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