腹膜透析分析报告.ppt

腹膜透析的临床优越性 第一代头孢菌素（头孢唑啉）或万古霉素；联用第三代头孢菌素或氨基糖甙类药物， 氨曲南，喹喏酮类 肝素500－1000U/L留腹以防止纤维蛋白凝块形成 单药治疗：亚胺培南、西司他丁500mg留腹6h，继以100mg/2L；头孢吡肟2g留腹6h，继以1g/d连用9天。 经验疗法 ISPD Guidelines/ Recommendations. Perit Dial Int 25:107-131,2005 * * * * ‘Hemo’, of course, means blood. The word ‘dialysis’ comes from a Greek root that means a loosening of something. When you think about it, that is what the goal of hemodialysis is: to loosen and remove unwanted substances such as toxins and excess electrolytes and water from the blood. * Affecting Diffusion: The direction of blood and dialysate flow is very important to maintaining a concentration gradient that will promote maximum removal of solute through the entire dialyzer flow path. The flow pattern in the slide is known as COUNTER CURRENT… Meaning blood flows in one direction and dialysate flows in the opposite direction. If both were flowing in the same direction (CO-CURRENT), studies have shown that the efficiency of solute removal is reduced by about 25%. * * * * * * * * * * * Confidential – Not for distribution * Confidential – Not for distribution 腹 膜 透 析 六安市中医院肾病二科 郑昌志 终末期肾病治疗方式的选择 血液透析 腹膜透析 肾移植 Transplantation移植 Advantages Most like your own kidney No dialysis needed No access needed Normal Diet (-sodium) More “normal” life style 优点 与自己的肾脏功能相似 不需透析 不需要通路 正常饮食（钠） 生活方式更接近正常 Disadvantage Risks of major surgery Risk of body rejecting kidney Possible side effects of drugs Lower resistance to illness Body image changes. 缺点 手术风险 排异反应 药物的副作用 抵抗力低下 体形改变 P a t i e n t s K i d n e y T r a n s p l a n t K i d n e y ( e x t r a - p e r i t o n e a l l y ) B l a d d e r 病肾 移植肾 膀胱 Who cannot donate a kidney?哪些人不可捐献肾？ HIV or AIDS-related infection Hepatitis B or C infection Major heart or breathing problems Diabetes Extreme obesity Significant kidney disease Most cancers IV drug abuse Pregnancy High BP Having only one kidney Evidence of financial or non-financial coercion Inability to give informed consent/psychiatric disorde