- 著者
- 羽賀 里御 浦辺 俊一郎 深澤 桃子 加藤 亜輝良 松沢 翔平 加藤 基子 檜山 英己 栗井 阿佐美 南雲 三重子 尾崎 美津子 古森 くみ子 清水 美智江 水品 伊津美 山本 茉梨恵 白鳥 恵 巽 亮子 倉田 康久 兵藤 透
- 出版者
- 一般社団法人 日本透析医学会
- 雑誌
- 日本透析医学会雑誌 (ISSN:13403451)
- 巻号頁・発行日
- vol.53, no.9, pp.465-470, 2020 (Released:2020-09-28)
- 参考文献数
- 13
当院はCOVID-19感染者の多い神奈川県にある無床外来維持血液透析クリニックである. 透析患者は学会指針のマスク着用, 手洗い等の標準予防策を遵守し通院している. 今回, 血液透析患者1例がCOVID-19に罹患していることが判明した. この普段からの標準予防策に加えて, 発生から2週間, 感染者が出た透析時間帯の患者は時間帯を固定, 同一メンバーとし, 不要不急の検査, 受診, 手術は延期し, 感染防御対策を行うこと (集団的隔離透析) を補完的に加えることで, 二次感染が防止できたと考えられる事例を経験した. 特にマスク, 手洗い等の普段からの学会指針の基本を遵守することが二次感染防止に非常に有効と考えられた.
- 著者
- 川上 純子 三上 憲子 飛田 美穂 倉田 康久 兵藤 透
- 出版者
- 相模女子大学
- 雑誌
- 相模女子大学紀要. B, 自然系 (ISSN:09167676)
- 巻号頁・発行日
- vol.76, pp.1-6, 2012
Objective : To investigate the limit of validity of assessment of nutritional risk by using serum albumin values, which is handily used for assessing nutrition risk of patients, and explore feasible tools for high risk patients, by comparing index of serum albumin values and other assessment tools : Mini Nutritional Assessment-Short Form (MNA-SF) as a well validated nutrition screening and assessment tool, Barthel Index (BI) as an index of activities of daily living, Karnofsky Performance Scale (KPS) as a tool for assessing patients functional impairment, and Geriatric Nutritional risk Index (GNRI) as based on serum albumin values and the discrepancy between real and ideal weight for the elderly. Subjects : Seventy outpatients at a dialysis institution in Kanagawa prefecture (40 male, 30 female) ; mean age 68.0 ± 10.4 (male 67.9 ± 10.1, female 68.4 ± 11.0). Methods : 1. Examined correlation among outcomes of MNA-SF, BI, KPS, GNRI tools, and also between these outcomes and serum albumin values as an index of Objective Dietary Assessment. 2. Examined outcomes (scores) of MNA-SF methods and GNRI methods with regards to patients of serum albumin values under 3.4 g/dl. Results : (N=70) Correlation between assessment tools; (1) between MNA-SF scores and KPS scores, r=0.4952, p<0.001, (2) between serum albumin values and KPS scores, r=0.3693, p<0.01, (3) between serum albumin values and BI scores, r=0.0819, p=0.5. For patients with albumin values under 3.4 g/dl ; four male : mean albumin value, 3.1± 0.5 g/dl, mean GNRI score, 81.4 ± 6.9 (classified as major risk), five female : mean albumin value, 3.2 ± 0.2 g/dl, mean GNRI score, 89.7 ± 8.2 (classified as moderate risk). Discussion and Conclusion : Based on MNA-SF, which is a well validated nutrition screening and assessment tool, its scores had the higher correlation with KPS scores than the other tool's scores, while weak correlation was found between serum albumin values and KPS scores. It was also found that there was a possibility that BI was not related with serum albumin values. Serum albumin value may be a feasible screening tool of nutritional risk of dialysis outpatients, as it may reflect disease prognosis and severity. However, it alone may not reflect ADL of these patients. Therefore, among these methods, MNA-SF method may have possibility of adequately assessing patients' overall physical condition, while BI method was suggested that it may have possibility for assessing specifically patients' ADL.