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\u7de8\u8f2f\uff1a\u6c88\u71d5\u5a9a<\/p>\n

https:\/\/health2.mingpao.com\/ftp\/Health2\/20170828\/news\/_28YG001_.jpg\u4e8b\u524d\u8a13\u7df4\u2014\u2014\u75c5\u4eba\u9700\u8981\u63a5\u53d7\u8a13\u7df4\uff0c\u5b78\u7fd2\u64cd\u4f5c\u5100\u5668\u53ca\u61c9\u4ed8\u7dca\u6025\u60c5\u51b5\uff0c\u901a\u904e\u6e2c\u8a66\u624d\u53ef\u81ea\u884c\u5728\u5bb6\u4e2d\u6d17\u8840\u3002\uff08\u8cc7\u6599\u5716\u7247\uff09;https:\/\/health2.mingpao.com\/ftp\/Health2\/20170828\/news\/_28yg101.jpg\u597d\u8655\u591a\u2014\u2014\u5bb6\u4e2d\u63a5\u53d7\u6d17\u8840\uff0c\u4e0d\u4f46\u6210\u6548\u6bd4\u91ab\u9662\u6d17\u8840\u597d\uff0c\u4ea6\u514d\u9664\u821f\u8eca\u52de\u9813\u4e4b\u82e6\uff0c\u5c07\u65e5\u9593\u751f\u6d3b\u7684\u5f71\u97ff\u6e1b\u5230\u6700\u4f4e\u3002\uff08\u660e\u5831\u88fd\u5716\uff09;https:\/\/health2.mingpao.com\/ftp\/Health2\/20170828\/news\/_28yg102.jpg;https:\/\/health2.mingpao.com\/ftp\/Health2\/20170828\/news\/_28yg103.jpg;<\/inline><\/p>\n","protected":false},"excerpt":{"rendered":"

【明報專訊】腎臟是最特別的人體器官之一，既是「排毒能手」，又是「有事可以等多一等」的器官。<\/p>\n

腹膜透析（又稱洗肚）是醫管局提供給慢性腎衰竭的第一線治療，病人可以家中、工作時進行；血液透析（又稱洗血）則要病人到醫院接受治療。自從引入家居血液透析服務，病人又多一個選擇。近年研究顯示，家居洗血成效較醫院洗血高2.7倍，是否所有腎病病人都需要洗血？家居洗血的成本又是否高昂？<\/p>\n

腎臟主要透過製造尿液，為我們排出血液中的毒素和多餘水分；當腎臟出現毛病時，往往沒有明顯的病徵，出現病徵時可能已在晚期階段，必須接受透析治療或移植腎臟來保命。<\/p>\n

換腎是不少腎衰竭病人最渴望的事，但腎臟輪候時間長，不是想換就換。可幸的是，他們可以透過治療維持生命，換取時間來等待他人捐贈腎臟。本港現時有逾七千名末期腎衰竭病人，須長期接受腎臟透析治療，包括血液透析及腹膜透析。接受血液透析的病人每隔兩至三日便要到醫院接受治療，每次花上四至五個小時，每周花在洗血的時間接近十五小時，影響工作和日常生活，但也是沒有辦法中的辦法。<\/p>\n

比醫院洗血更徹底排毒<\/p>\n

可幸，自從十年前引入了家居血液透析服務後，病人可隔晚自行使用血液透析機（又稱洗血機），在睡覺時洗血，每晚洗血六至八小時，比到醫院洗血的時間長，毒素因此排得更清。這樣不但不影響日間的工作，病人的心理和生活質素更大大提升；最重要的是，有研究發現家居洗血的成效較醫院洗血高2.7倍，而且夜間洗血對健康帶來更正面的影響，是不少腎病病人的福音。<\/p>\n

減輕貧血骨折問題<\/p>\n

對腎病病人而言，家居洗血可改善血蛋白濃度和血清磷酸鹽的水平。《加拿大腎病健康及疾病期刊》去年發表一篇文章，比較病人使用家居夜間洗血與傳統洗血的成效。結果發現，家居洗血一年後，病人血液中的磷質平均減少了27%；傳統洗血者，一年後血磷反而上升了2.7%，意味着骨質流失較嚴重，骨折風險更高。其實，早於2011年已經另有本地資料顯示，九成病人可減少使用俗稱「補血針」的紅血球生成素補充劑，改善洗血病人的貧血問題。腎病病人的血液中磷濃度偏高，需藉藥物降低，但由於家居洗血清除廢物的成效高，九成病人可減少服藥降低血磷濃度。<\/p>\n

那麼是否所有腎病病人都需要洗血？成本又是否高昂？相信是很多病人關心的問題。其實，並不是所有腎病病人都有急切洗血的需要，當腎功能只剩15%或以下才需要。洗血是利用過濾網和洗血機進行透析，病人需將體內血液引流到外置的過濾網，利用透析液過濾血液中的廢物和多餘水分，之後再把淨化的血液輸回體內。<\/p>\n

可申請津貼 月花$2000<\/p>\n

至於成本，洗血費用的確比較高，是洗肚的三倍。不過，香港賽馬會慈善信託基金及香港腎臟基金會，分別贊助多部洗血機和提供津貼給末期腎病病人，讓他們可以較低成本在家中洗血，每月支付約二千元，大大改善生活質素。<\/p>\n

目前有208名病人受惠於上述計劃，不過家居洗血機並非人人合用，病人需要接受為期數月的訓練，學會操作儀器及應付緊急情况，通過測試後才可以自行在家中洗血；若病人家居環境狹窄或衛生欠佳，也不適合。<\/p>\n

■知多啲<\/p>\n

腎病徵狀難察 宜定期檢驗<\/p>\n

要避免洗腎甚至換腎，防患於未然最重要。糖尿病、腎小球炎、高血壓等是腎病的主要成因，當中有44%末期腎衰竭病人都是因糖尿病引致（即常常聽到的糖尿腎病）。此外，腎臟是個無法承受過高血流壓力的器官，高血壓會令血管收縮和硬化，破壞腎功能。而慢性腎衰竭可分為不同階段，大多數病人會在腎衰竭階段（腎功能只有15%至20%）才開始出現輕微病徵，直到末期腎衰竭（腎功能低於15%）才有明顯病徵，如疲倦、食慾不振、排尿量小、腳部腫脹、氣喘、臉色灰暗、貧血等。<\/p>\n

多飲水防腎石 少食高鈉質食物<\/p>\n

腎病病徵不明顯，看似「防不勝防」，所以預防腎病和定期檢查十分重要。高危人士如年長、肥胖、糖尿病，或有家族史的人，不論男女，應定期接受身體檢查及腎功能測試。常見的腎功能測試為常規尿液試紙檢查、血液檢查、24小時小便定量檢測。常規尿液試紙檢查能快速發現蛋白尿和顯微鏡血尿，血液檢查和24小時小便定量檢測則能發現變形紅血球、蛋白尿、血液中的肌酸酐濃度和蛋白質量。一旦發現異常，建議接受超聲波掃描檢查及腎活組織檢查，進一步確定病情。<\/p>\n

而於平日，市民亦應多喝清水以保持足夠尿量，以預防腎結石和尿道炎，減少進食高鈉質食物，切勿胡亂服用中西成藥，尤其非類固醇消炎止痛藥，避免增加腎臟負擔。即使患有腎病，亦應樂觀面對，積極與醫生探討治療的方法。<\/p>\n

文：唐國隆（腎科專科醫生）<\/p>\n

圖：資料圖片、明報製圖<\/p>\n

編輯：沈燕媚<\/p>\n

https:\/\/health2.mingpao.com\/ftp\/Health2\/20170828\/news\/_28YG001_.jpg事前訓練——病人需要接受訓練，學習操作儀器及應付緊急情况，通過測試才可自行在家中洗血。（資料圖片）;https:\/\/health2.mingpao.com\/ftp\/Health2\/20170828\/news\/_28yg101.jpg好處多——家中接受洗血，不但成效比醫院洗血好，亦免除舟車勞頓之苦，將日間生活的影響減到最低。（明報製圖）;https:\/\/health2.mingpao.com\/ftp\/Health2\/20170828\/news\/_28yg102.jpg;https:\/\/health2.mingpao.com\/ftp\/Health2\/20170828\/news\/_28yg103.jpg;<\/inline><\/p>\n","protected":false},"author":2,"featured_media":9234,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"rank_math_lock_modified_date":false,"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[3],"tags":[944,121,172,945,943],"class_list":["post-9144","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-3","tag-944","tag-121","tag-172","tag-945","tag-943"],"publishpress_future_action":{"enabled":false,"date":"2026-11-22 20:13:30","action":"change-status","newStatus":"draft","terms":[],"taxonomy":"category"},"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"_links":{"self":[{"href":"\/\/www.afterroberto.com\/wp-json\/wp\/v2\/posts\/9144"}],"collection":[{"href":"\/\/www.afterroberto.com\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"\/\/www.afterroberto.com\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"\/\/www.afterroberto.com\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"\/\/www.afterroberto.com\/wp-json\/wp\/v2\/comments?post=9144"}],"version-history":[{"count":0,"href":"\/\/www.afterroberto.com\/wp-json\/wp\/v2\/posts\/9144\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"\/\/www.afterroberto.com\/wp-json\/wp\/v2\/media\/9234"}],"wp:attachment":[{"href":"\/\/www.afterroberto.com\/wp-json\/wp\/v2\/media?parent=9144"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"\/\/www.afterroberto.com\/wp-json\/wp\/v2\/categories?post=9144"},{"taxonomy":"post_tag","embeddable":true,"href":"\/\/www.afterroberto.com\/wp-json\/wp\/v2\/tags?post=9144"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}