课件：CRR原理.ppt

最常用的导管 11-12 Fr. Bloodflow 主血管血流方向 锁骨下静脉 CRRT治疗常用双腔配套导管 成人：11.5F-13.5F 婴幼儿：4F-9F 颈静脉 操作简单 并发症少 不适合气管切开病人使用 导管选择： 左侧：＜20cm 右侧：＜15cm 锁骨下静脉 置管技术要求高 易出现并发症 导管选择： 同颈静脉 股静脉 操作简单 血流量充分 并发症少 适用于气管切开病人 导管的选择： ＞20cm CRRT基本原理 模拟肾小球的滤过原理。以对流为基础的血液净化技术。利用血泵或不用血泵，将血液引入具有高通透性的半透膜滤过器，依靠半透膜两侧的压力梯度（跨膜压力）达到清除水分及溶质的目的。小于滤过膜孔的物质被滤出（包括机体需要的物质与不需要的物质），同时又以置换液的形式将机体需要的物质输入体内，以维持内环境的稳定 THANK YOU SUCCESS * * 可编辑 * The goal of a Hemofilter is to mimic (copy) some of the functions of the kidneys particularly the excretory functions, i.e. remove waste products, like urea and creatinine, and excess fluid from the blood to maintain homeostasis in the body. This is essential for the regulation of the water and electrolyte (dissolved salts) balance and for the body to maintain normal acid-base balance. At the same time, while removing some of the metabolic wastes I have just mentioned, the kidneys do not allow the removal of essential compounds such as albumin and haemoglobin. * To illustrate the principle of diffusion, picture a cup of water as seen here on the slide. In the cup on the left, a quantity of salt is poured. The salt gradually diffuses through the water from the high salt concentration area to the low salt concentration area until it is evenly distributed. A uniformly salty solution is created as seen in the cup on the right. * To illustrate convection, we go back to the use of the cups. The cup now has a concentrated solution on one side of the semipermeable membrane. As fluid moves (by ultrafiltration), solutes small enough to pass through the pores of the membrane move along with the fluid. Change in blood concentration of a specific solute is dependent on the fluid volume removed. * Are there any questions before I move forward? The next section of the program discusses the transport mechanisms involved in CRRT’s different therapies. Let’s start by describing the filter that is used as our “temporary kidney”. The filter is constructed of an outer casing tha