혈액투석 환자에서 혈액투석 중 항색전 스타킹 착용이 혈역동학 변수들에 미치는 영향 = Effect of Anti-embolism Stocking on Intrasession Hemodynamic Variables in Hemodialysis Patients

국문 초록 (Abstract)

목적: 저자 등은 말기신부전 환자에서 혈액투석 중 항색전 스타킹 착용의 혈역동학적 효과에 대하여 조사하였다. 방법: 11명의 혈액투석 환자에 대하여 혈액투석을 2회 시행하였다. 첫 번째에는 평소대로 혈액투석을 하였고 (SN)두 번째에는 항색전 스타킹 착용한 후 혈액투석을 하였다. (SP). 각 연구시 혈액투석 시작 후 1시간째와 3시간째에 혈역동학에 대한 변수들을 측정하여 비교하였다. 결과: CBV는 투석 시간에 각각 0.85±0.32 L와 0.93±0.32 L로 SP시에 의미 있게 많았고 (p=0.003), 투석 3시간에는 0.78±0.25 L와 0.83±0.33 L로 차이가 없었다. 0.25 CO는 투석 1시간에 각각 5.14±1.35L/min과 5.56±1.22L/min로 SP시에 높은 경향을 보였고, 투석 3시간에는 각각 4.65±1.50ml/min과 4.75±1.66ml/min으로 차이가 없었다. PR은 투석 1시간째와 투석 3시간째에 차이가 없었다. 결론: 혈액투석 시 항색전 스타킹을 착용하는 것은 투석 초기에 일시적으로 중심혈류량을 증가시키며 시간이 더 지나면 이러한 효과는 사라지는 것으로 보인다.

다국어 초록 (Multilingual Abstract)

Purpose: There is no data about the effect of anti-embolism stockings on intrasession hemodynamics in end stage renal disease patients on hemodialysis (HD). We investigated whether it affects the hemodynamic changes during HD or not. Methods: We performed 2 HD sessions, before (stocking negative, SN) and after (stocking positive, SP) putting on thigh-high anti-embolism stockings in 11 ESRD patients on HD. In each session, cardiac output (CO), stroke volume (SV), central blood volume (CBV), and peripheral resistance (PR) were measured by ultrasound velocity dilution method at 1 and 3 hours of HD. Ultrafiltration (UF) amount was matched during study. Hemodynamic variables were compared between SN and SP. Results: Mean ages were 51±14 years, female was 8, diabetes mellitus was 4, and duration of HD was 56.9±28.9 months. There were no differences in pre- and post-HD SBP and DBP, UF amount at 1 hr and 3 hr of HD, and total UF amount between SN and SP. At 1 hr of HD, CBV was greater in SP than in SN (0.85±0.32 L vs. 0.93±0.32 L, p=0.003). CO (5.56±1.22 L/min vs. 5.14±1.35 L/min, p= 0.075) and SV (73.77±19.11 mL vs. 68.95±22.21 mL, p=0.05) tended to be increased in SP than in SN. However, there were no differences in TPR between 2 groups. At 3 hr of HD, there were no differences in all hemodynamic variables bewteen SP and SN. Conclusion: At early phase of HD, anti-embolism stockings seem to increase CBV, but this effect seems to be attenuated at later phase.