臺灣長期以來冠有「洗腎王國」之稱，根據美國腎臟資料系統(USRDS)2014年的統計結果來看，在2001年至2012年這段期間，臺灣在末期腎臟病(ESRD)的發生率和盛行率都是高居世界第一的。而目前國人常見的三高(高血壓、高血糖及高血脂)不僅是造成慢性腎臟病的主要原因之一，同時也是慢性腎臟病的併發症。從101年健康署的統計結果中可以得知患有三高的個案罹患末期腎臟病的比例是將近無三高個案的三倍。由於目前患有三高的患者人數不斷地上升，連帶著罹患慢性腎臟病患者的比例也愈來愈多，在2017年時，臺灣洗腎人口已突破至八萬五千人。世界腎臟大會在2017年時發布了首次全球腎臟病健康報告，共包括125個國家，占世界人口的93%。數據顯示全世界每十人當中就有一位患有腎臟疾病！而從美國腎臟資料系統(USRDS)2017年報的資料中可以看出ESRD患者醫療保險的經費量也是年年攀升，在2015年時更是超過了三百億美金，占了全部醫療保險經費的7.1%。以上的資料都顯示慢性腎臟病是極需要備受重視的議題，而當患者病情惡化到末期腎臟病(ESRD)時就必須要依靠透析治療或是腎臟移植才有辦法存活，目前患者又以選擇做血液透析治療為大宗。然而進行血液透析後，可能會導致患者止血功能的異常，這是因為血液和人工表面間的交互作用可能使得血小板長期受活化而導致它們的功能異常。而且用來作全身性抗凝的肝素可能會誘發血小板的活化和血小板減少症，導致血液透析患者止血不易的情況。然而目前施加於出血部位的止血帶壓力是根據護理人員的經驗來作判斷，但每位患者的血壓都不盡相同，有的患者甚至患有高血壓，而廔管對於透析患者來說又是很重要的一條血管，過大的加壓力道可能會影響到廔管的功能，但過小的加壓力道卻又無法有效達到止血的功能，因此我們想建構出一套根據患者透析結束後當下的血壓值來作適應性調控加壓力道的止血裝置，使其能對透析患者作最適當的加壓止血力道，以確保止血時的安全及舒適性。

Taiwan has long been known as the “dialysis kingdom.” According to the 2014 US Renal Data System (USRDS) statistics, the incidence and the prevalence of end-stage renal disease (ESRD) in Taiwan is the highest in the world during the period from 2001 to 2012 rate. At present, the common three highs (hypertension, hyperglycemia and hyperlipidemia) are not only one of the main causes of chronic kidney disease, but also a complication of chronic kidney disease. From the 101-year statistics released by the Health Department, it can be concluded that the proportion of people with the end-stage renal disease of three high case is three times as high as that of the non-three-high case. The World Kidney Congress released its first global report on kidney disease health in 2017, which includes 125 countries and accounts for 93% of the world's population. The data shows that one out of every ten people in the world suffers from kidney disease! From the data of the USRDS 2017 annual report, it can be seen that the funding for Medicare costs for ESRD patients has also increased year by year. In 2015, it exceeded US$30 billion, accounting for 7.1 percent of all Medicare costs. The above data shows that chronic kidney disease is a subject that needs much attention. When a patient's condition deteriorates to end-stage renal disease (ESRD), it must rely on dialysis treatment or kidney transplantation to survive. Now the patient has chosen to do hemodialysis treatment for the bulk. However, after hemodialysis, it may lead to abnormal hemostatic function of the patient, because the interaction between the blood and the artificial surface may cause the platelets to be activated for a long time and cause their abnormal function. Moreover, heparin used for systemic anticoagulation may induce platelet activation and thrombocytopenia, leading to hemostasis in hemodialysis patients is not easy. However, the current tourniquet pressure applied to the bleeding site is judged based on the experience of the nursing staff, but each patient's blood pressure is not the same, and some patients even have high blood pressure. The fistula is also a very important blood vessel for dialysis patients. Excessive pressure may affect the function of the fistula, but too little pressure can’t effectively achieve hemostasis. Therefore, we want to construct a hemostasis device that can adjust the pressure value according to the current blood pressure value after the end of dialysis, so that it can give the most appropriate hemostatic force for dialysis patients to ensure the safety and comfort of hemostasis.

[1] "One in 10 People Worldwide Have Chronic Kidney Disease," Medscape, Apr 21 2017.
[2] (2017, 5 March). New global report highlights burden and neglect of kidney disease worldwide. Available: https://medicalxpress.com/news/2017-04-global-highlights-burdenneglect-kidney.html
[3] (2017). World Kidney Day: Chronic Kidney Disease. Available: http://www.worldkidneyday.org/faqs/chronic-kidney-disease
[4] R. R. Preston and T. E. Wilson, Lippincott's Illustrated Reviews: Physiology: Lippincott Williams & Wilkins, 2013.
[5] "Your Kidneys and How They Work," The National Institute of Diabetes and Digestive and Kidney Diseases of The National Institutes of Health, May 2014.
[6] "慢性腎臟病的分期," 行政院衛生署國民健康局2014.
[7] 留以堅, "高血壓, 高血糖及高血脂與慢性腎臟病防治," 北市醫學雜誌, vol. 9, pp. 293-300, 2012.
[8] "101年健康署成人預防保健服務檢查結果統計," 衛生福利部統計處2012.
[9] 呂嘉陞, 林建宇, and 邱顯邦, "透析治療臨床實證指引," 台北: 合記, p. 341, 2006.
[10] N. R. Hill, S. T. Fatoba, J. L. Oke, J. A. Hirst, C. A. O’Callaghan, D. S. Lasserson, et al., "Global prevalence of chronic kidney disease–a systematic review and meta-analysis," PloS one, vol. 11, p. e0158765, 2016.
[11] "Total ESRD costs obtained from USRDS ESRD Database; Reference Table K.1. Total Medicare expenditures obtained from Trustees Report, Table II.B1."
[12] "The 2017 USRDS Annual Data Report Reference Tables ( Includes glomerulonephritis and cystic kidney disease, among other causes.)," 2017.
[13] 林杰樑, 透析治療患者保健手冊. 宏欣, 2002.
[14] 呂嘉陞, 林建宇, and 邱顯邦, "透析治療臨床實證指引," 台北: 合記, p. 177, 2006.
[15] R. Sanders, "The tourniquet. Instrument or weapon?," Hand, vol. 5, pp. 119-123, 1973.
[16] D. Arenson and L. Weil, "The uses and abuses of tourniquets in bloodless field foot surgery," Journal of the American Podiatry Association, vol. 66, p. 854, 1976.
[17] J. A. McEwen and R. W. McGraw, "An adaptive tourniquet for improved safety in surgery," IEEE Transactions on Biomedical Engineering, pp. 122-128, 1982.
[18] E. Altintas, K. Takoh, Y. Ohno, K. Abe, T. Akagawa, T. Ariyama, et al., "Wearable and low-stress ambulatory blood pressure monitoring technology for hypertension diagnosis," in Engineering in Medicine and Biology Society (EMBC), 2015 37th Annual International Conference of the IEEE, 2015, pp. 4962-4965.
[19] STMicroelectronic, "STM32F103x8 datasheet," 2015.
[20] CFSensor, "Pressure Sensor Module," XGZP6847 datasheet, 2015.
[21] 倪继烈, 微型计算机原理与接口技术: 清华大学出版社有限公司, 2005.