臨牀透析 Vol.16 No.14(4)


特集名 今日のCAPD療法
題名 周辺機器(接続補助具,APD機器)
発刊年月 2000年 12月
著者 鈴木 一之 仙台社会保険病院腎センター
【 要旨 】 腹膜透析において透析回路の閉鎖性を形成するためにいくつかの透析液交換システムが開発されたが,もっとも重要なものはY-setとdouble bag systemであり,現在主流のtwin bag systemの基礎となった.さらに接続補助具として,回路の接続部分に紫外線照射や加熱滅菌を行う機器などが開発され,経カテーテル感染による腹膜炎は減少した.一方,透析液を機械によって交換する自動腹膜灌流装置は,CCPD/NIPD/TPDなどの透析処方を実施するために必要となった.近年のコンピュータ技術の発達に伴い,複雑な処方にも対応し,かつ種々の付加機能をもった装置に発展した.また夜間に1回だけ透析液の交換をする簡便なnight exchange deviceも開発された.これらの装置をうまく用いることで,尿毒素の除去量や除水量の増加が期待できる.
Theme CAPD Up-to-date 2000
Title CAPD related instruments -- connection devices and APD machines
Author Kazuyuki Suzuki Kidney Center, Sendai Shakaihoken Hospital
[ Summary ] In order to establish the closed system of CAPD, many connection methods and devices have been developed. Among these, the Y-set and double bag systems were of most importance. These have developed into the modern twin bag systems. To sterilize the connection site, an ultraviolet apparatus and a heat sterile connection device have also been introduced. Because of progress in connection technology, the incidence of peritonitis, due to contact contamination has decreased.
Automated peritoneal dialysis machines (cyclers) are required to perform CCPD/NIPD/TPD prescriptions. Recent advancements in computer technology have made it possible to prescribe these flow techniques, and have also led to many optional functions for cyclers. For an additional exchange while a patient sleeps, a night exchange device (NED) has also been developed. With these hightech machines, patients can have a higher uremic toxin clearance and a higher ultrafiltration volume without decreasing their quality of life.
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