シャント流量と再循環率の関連 Correlation between vascular access and re-circulation rate

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Transonic Systems社製HD02血液透析モニタ(以下HD02)を用いて,シャント流量と再循環率,穿刺方向別の再循環率を測定し,穿刺間隔・穿刺方向と再循環率との相関ならびにシャント流量と再循環の発生について検討した.シャント流量700mL/min程度で,狭窄や分岐の少ない健全なシャントでは,穿刺方向にかかわらず穿刺針先端の間隔が30mm以上あれば再循環はおきないことが示された.また対向穿刺で,穿刺針先端間隔が50mm程度の場合,シャント流量300mL/min未満で再循環が出現しはじめ,血液流量(以下Q<SUB>B</SUB>)を調節しても再循環率に改善はみられなかった.

Adequacy of dialysis is very important for the dialysis patient. Vascular access is one of the most important factors influencing the quality of dialysis ; sufficient blood flow is needed and there must not be re-circulation. There are few reports investigating the concrete conditions under which re-circulation appears. Therefore, we investigated 1) the influence of distance between puncture sites and puncture direction on the appearance of re-circulation, 2) the relation between vascular access flow and re-circulation. Thirty-seven dialysis patients were selected for this study. Using a dialysis monitor, HD02<SUP>®</SUP>(Transonic Systems company, NY, USA), we measured vascular access flow and re-circulation rate, and examined the correlation among the re-circulation rate, puncture needle distance and puncture direction. We also examined minimum vascular access flow in the absence of re-circulationn. In this study, we demonstrated that re-circulation never appeared when the distance between the puncture sites was more than 30mm, but did not depend on puncture direction, when fair vascular access was achieved without stenosis and showed limited branching with a blood flow over 700mL/min. In addition, when distance between the puncture sites was 50mm in case of the opposite puncture, re-circulation appeared with vascular access flow less than 300mL/min. There was no improvement in the re-circulation rate even if blood flow was reduced by 20% (Q<SUB>B</SUB>250→200mL).

収録刊行物

  • 日本透析医学会雑誌 = Journal of Japanese Society for Dialysis Therapy  

    日本透析医学会雑誌 = Journal of Japanese Society for Dialysis Therapy 41(4), 245-249, 2008-04-28 

    The Japanese Society for Dialysis Therapy

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各種コード

  • NII論文ID(NAID)
    10021274411
  • NII書誌ID(NCID)
    AN10432053
  • 本文言語コード
    JPN
  • 資料種別
    ART
  • ISSN
    13403451
  • NDL 記事登録ID
    9500046
  • NDL 雑誌分類
    ZS39(科学技術--医学--皮膚科学・泌尿器科学)
  • NDL 請求記号
    Z19-1413
  • データ提供元
    CJP書誌  NDL  J-STAGE 
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