血液透析患者血管通路的管理與教育

Vascular Access Management and Education for Hemodialysis Patients

良好的血管通路是血液透析治療的基石，一個功能運作良好且合併症少的血管通路，除能滿足患者血液透析需求外，同時也可使患者重新找回生命的希望。血管通路的維護需醫護人員與患者共同合作，患者若能以所知血管通路自我照顧知識，運用於日常生活中，將可提升全面照顧的成效。本文概述血液透析患者的血管通路可能產生合併症的內在與外在因素，護理人員在管理上應加強施行身體檢查與評估、以及適當穿刺技巧等面向，並提供心理支持協助患者調適慢性病所面臨的衝擊，同時增加患者日常生活中避免血管通路阻塞技巧、保護與預防感染的自我照顧能力，才能共同保護血管通路以延長通路的壽命。

Appropriate management and care of vascular access are very important to hemodialysis patient care. Access is the cornerstone of hemodialysis therapy. Vascular access with good function and few complications not only promotes hemodialysis therapy success but also facilitates the ability of patients to restore normalcy to life. Proper vascular access maintenance requires good cooperation between medical care personnel and patients. Nurses are responsible to apply their professional knowledge and technology in clinical practice and educate and encourage patients to take care of themselves. Patients are responsible to apply learned self-care knowledge to their daily life. Such cooperation is essential to enhancing the effectiveness of comprehensive care. This article provides an overview of vascular access issues in hemodialysis therapy, including related nursing assessment, management, and proper cannulation procedures. Enhancing patient self-care abilities and working together with patients on proper vascular access care can prolong vascular access site viability.