肾透析医疗技术基础.ppt

Medical and Technical Basics相关医学和技术基础 肾脏生理 生成尿液，排除代谢终末产物、毒物和药物 调节体内水、电解质、渗透压和酸碱平衡 调节血压 分泌肾素、促红细胞生成素、1,25-(OH)2D3、前列腺素等 血液透析的作用 清除体内的毒素（弥散、对流、吸附） 纠正酸碱平衡紊乱（弥散） 清除体内过多的水份（超滤） 纠正电解质失衡（弥散） Electrolytes and Ions H2 O Na+ Cl- Na+ Cl- dissolvert Definition Electrolytes are substances where the electrical current is guided via ions ? Definition Ions are atoms with electron absence (cations) ? or electron excess (anions) ? For instance NaCl dissociate in water in Na+ cations and Cl- anions Conductivity电导率 The conductivity is based on electrolytes and temperature. The physical unit is mS/cm (mille Siemens per cm). This is an American notation for the electrical resistance and this is a reciprocal value to Europe with Ohm (?). Cl- Na+ current quell current measurement mS/cm Minus pole 负极 Plus pole 正极 * Autoren: Günter NissenHeiko Riemenschneider * Training document, no update service This document may not be copied, partly or whole, or made be accessible to third parties without our permission and remains the property of B. Braun Medizintechnologie GmbH with all rights. * Diffusion弥散 Start开始时: DifferentConcentrations 膜两侧浓度有差别 End结束时: EqualConcentrations 膜两侧浓度相同 time 弥散是微分子物质随机的运动可导致均匀分布的结果 Diffusion is a consequence of the random movementof all molecules (Brownian Movement). Ultrafiltration超滤 Time Pressure Start: End: Exertion of pressure on one side of the membrane produces filtration of water with solutes, as long as they can pass the membrane. 运用压力的作用将水份从膜一侧推到另一侧，膜孔够大时溶质也可以被挤出 Adsorption 吸附 after chemical disinfection? hollow fiver endotoxins 内毒素 - contact space接触空间 Virus病毒 H2O water soluble molecules F mmHg mmHg B B B D B D mmHg B mmHg D B D low-flux低通透析器 high-flux高通透析器 high-flux高通透析器 Therapy types治疗模式 Hemodialysis血液透析 Hemofiltration血液滤过 Hemodiafiltration血液透析滤过 弥散原理 对流 吸附 弥散 对流 吸附 Hemodialysis 血液透析 利用血液和透析液中溶质的浓度差别使溶质在弥散作用下通过半透膜随透析液排出Diffusive metabolic transport through semi-permeable membranes with b