血液透析のための動静脈シャントの研究 第2報: 慢性血液透析患者の過去2年間のQuinton Scribnerシャントの成績・合併症について

Abstract

Twenty-six patients were treated by intermittent hemodialysis with Kiil dialyser for past two years, April, 1968 to March 1970. All the patients were equipped with the arteriovenous shunt of Quinton-Scribner type, 16 in the forearm and 10 in the leg. Average shunt survival in the patients dialyzed more than three months was 11 to 12 months on the arterial side and 8 to 9 months on the venous side both in the forearm and leg shunts. If the cases dialyzed more than one year were taken, the shunt survival was 14 to 17 months on the arterial side and 10 to 12 months on the venous side with a little longer survival in the leg shunt. These results are never inferior to those in the western countries. Complications associated with shunt consisted of clotting (48.3 %), mechanical imperfection (26.7 %), infection (15 %) and bleeding (10 %). These were predominantly seen on the venous side, therefore, recannulation required was mostly that of the venous cannula. Frequency of the complications was a little higher in the forearm shunts, but that of recannulation was almost same in both groups. Angiography is important for diagnosis of the complications. It is often helpful for recannulation to know about the state of the vessel where the vessel tip is inserted as well as about the collateral circulation.