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- バスキュラーアクセスの手技＆Tips［Web動画付］−腎臓内科医と形成外科医のコラボレーシ...
Vara #:
88013096
バスキュラーアクセスの手技＆Tips［Web動画付］−腎臓内科医と形成外科医のコラボレーション−改訂第2版
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Vara #:
88013096
ISK 8332
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Upplýsingar um vöru
- あの好評書に，140本超のフルハイビジョン動画がついてさらにパワーアップ！透析医療のプロである腎臓内科医と, 血管吻合と創傷治癒のプロである形成外科医がコラボレーションすることで, 個々の患者に合ったVA作製のノウハウを, わかりやすく解説。豊富な写真とイラストだけでなく, 140本超のフルハイビジョン動画がついているので, 知りたい場面を繰り返して再生して確認できる。改訂にあたっては, 前腕および上腕でVA作製の基本手技を充実させるとともに, マイクロ下での血管吻合についても詳述した。患者のための, 長持ち・穿刺のしやすいVA作製に本書を活かしてほしい。【目次】Ⅰ 著者が推奨する手術器具 Ⅱ 前腕でのバスキュラーアクセス手術 1-1 定型的左前腕遠位AVF 1-2 左前腕遠位AVF（側端吻合）（橈側皮静脈が橈骨動脈から離れている場合） 2 右前腕遠位AVF 3 かぎタバコ窩でのAVF 4-1 前腕中・近位でのAVF（総論） 4-2 正中皮静脈（MV）を用いたAVF 4-3 （参考）前腕中ほど〜遠位では，腕橈骨筋腱が邪魔になることがある例 4-4 橈骨動脈の伴行静脈を用いたAVF 4-5 前腕近位での橈骨動脈- 橈側皮静脈AVF（RCAVF） 5 尺骨動脈- 尺側皮静脈AVF Ⅲ 上腕でのバスキュラーアクセス手術 1 総論 2 上腕動脈表在化法 3 上腕動脈- 橈側皮静脈AVF 4-1 上腕動脈- 尺側皮静脈AVF（BBAVF） 4-2 （参考）高度の肥満がある患者における，上腕バスキュラーアクセスのアプローチ（BBAVF） Ⅳ 透析導入時の初回手術術式選択のまとめ Ⅴ 血管吻合に関する事項 1 総論 2 AVF作製の側々吻合を顕微鏡下で行う場合 3 石灰化を伴う硬化がある動脈に対する，8-0ナイロン糸による側々吻合 4 動脈の菲薄化があり石灰化が著しい再建症例における，7-0プロリン®糸を用いた側々吻合 Ⅵ 術前・術後管理と穿刺 Tips ① モノポーラ型電気メスよりバイポーラ型止血鑷子がよい理由 ② へパリン生食水用にはなぜ10mLシリンジと20Gサーフロー®針の組み合わせがよいか ③ 局所麻酔注射について（1％キシロカイン®E） ④ AとVが離れている場合の吻合位置 ⑤ 橈側皮静脈（CV）の枝（特に背側枝）の処理について ⑥ モスキートペアンで，7-0プロリン®糸のような細い糸を把持する場合のコツ ⑦ 血管吻合における形成外科的感覚 ー縫合糸の選択，連続縫合 vs. 結節縫合ー ⑧ 膜を破る前に局所麻酔の追加をする ⑨ 連続縫合は，針を無鈎鑷子でとるとリズミカルではやい ⑩ 皮膚切開の方向と術後瘢痕 ⑪ 動脈を側とした吻合は，破綻した場合に止血されにくい ⑫ 深部静脈の枝の結紮に関する注意点 ⑬ 真皮縫合と垂直マットレス縫合の功罪 ⑭ 白色血栓と赤色血栓 ⑮ ガーゼ・包帯の巻き方とシーネのあて方 ⑯ 誤って静脈に穴をあけたときの修復法 ⑰ 神経を栄養する血管 ⑱ 上腕動脈表在化の術後に創縁皮膚壊死が生じた場合 ⑲ 再手術の際の切開線について ⑳ 皮膚の構造と創傷治癒の大前提 ㉑創の管理と抜糸の時期 ㉒長期留置型カテーテルについて ㉓内シャント肢における血流量の変化 ㉔術中の組織検査 ㉕腎臓内科医からみたバスキュラーアクセスの評価 Coffee Break ① 手術手技は組織との対話 ② 顔にできた粉瘤を自分で摘出。何が難しい? ③ EBM のガイドラインは最強か? ④ 剥離できないにはわけがある～組織にも気持ちがある ⑤ 手術は一直線にしない ⑥ 単純作業のときは，頭と手を別に動かす ⑦ 三回やってもうまくいかないときは ⑧ 時間の無駄は小刻みにしないで，まとめて無駄にする ⑨ 少額の投資で時間の小刻みな無駄を減らす一法 ⑩ 英語を学んで海外にいくよりも ⑪ スマホ検索 vs. つり& 液晶広告 ⑫ あまのじゃく ⑬ 受け持ち患者さんとしてやっかいな人々 ⑭ 名医を尋ねられる ⑮ 鳩のフン ⑯ 頑固はNG 信念をもってやるのもほどほどに ⑰ 手術のビデオを撮るということ
| Publisher | メジカルビュー社 |
| Publication date | March 31, 2024 |
| Edition | Review 2 |
| Language | Japanese |
| Print length | 220 pages |
| ISBN-10 | 4758322406 |
| ISBN-13 | 978-4758322409 |
| Item Weight | 1 g |
| Dimensions | 11.69 x 9.13 x 0.43 inches (29.7 x 23.2 x 1.1 cm) |
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ISK 8332
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