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Vpliv arteriovenske fistule kot žilnega pristopa za hemodializo na prekrvljenost distalnih struktur - dlani in prstov (ocena treh parametrov)Maša Knehtl,
Mitja Krajnc, 2004, original scientific article
Abstract: Hemodialysis is the most widely used method of renal replacement therapy in end-stage renal disease. It requires a reliable permanent vascular access and arteriovenous fistule (AVF) is the most commonly used method. Among other complications, it may cause hand (palm and fingers) ischemia (incidence 1-10%)as a result of altered hemodynamic circumstances in the area. Hand ischemia is manifested by typical signs and symptoms, especially in patients wich preexisting factors. The objective was to estimace the clinical significance of the measured parameters (skin temperature between the thumb and forefinger, skin temperature between the thumb and middle finger, skin temperature in the palm crease, pulse oxymetry, dynamometry) in dealing with apatient who has hand perfusion problems as a consequcnce of AVP. The significance of dynamometry and skin temperature is yet to be established. There is not a definite answer about the value of pulse oxymetry. Perspective measurements of the above-mentioned parameters were performed on 78 randomly selected end-stage renal disease patients who at the time of measurement did not have any manifest signs/symptoms of hand ischemia, on both hands. The first measurement was dune just before AVF creation (n=18), the second one in the first 24 hours following AVF creation (n=18), the third between the 2nd and the 5th month following AVF creation (n=9), the fourth between the 6th andthe 9th month (n=7) and the last one (fifth) was done between the 10th and the 13th month following AVF creation. The average vulues of the chosen parameters on the fistular hand were lower (with a few exceptions) then on thenonfistular hand (measurements 2-5). For measurements 2-5, the average values on the fistular hand were Iower than the values obtained during the first measurement on a fistular hand. (Abstract truncated at 2000 characters).
Published in DKUM: 21.12.2015; Views: 1222; Downloads: 73
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