血液透析机操作.pptVIP

一：相关医学和技术基础二：血透机组成及作用三 ：相关报警及处理 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 Diffusion is a consequence of the random movementof all molecules (Brownian Movement). 弥散是微分子物质随机的运动可导致均匀分布的结果 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 Osmosis渗透作用 Time Contrary to diffusion the dissolved particles cannot pass through the membrane, nevertheless the concentrations tend to equal out, thus water passes through the membrane. 与弥散作用相反，当溶质不能通过膜孔时发生的水由溶质密度小的一侧渗透到溶质密度大的一侧的情况而使两侧密度趋于相同的情况叫做水的渗透作用。 Reverse Osmosis反渗透作用 Time Pressure时间和压力 Similar to ultrafiltration pressure is applied to one side of the membrane. Reverse osmosis is especially important for the purification of water for the production of dialysate.类似于超滤靠压力作用于膜的一侧，反渗是生产透析用的纯净水的重要方法。 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 Diffusive metabolic transport through semi-permeable membranes with balance of a concentration difference between blood and dialysis fluid. 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 Small molecular substances will essentially more effective. 小分子物质可有效的被清除 Hemofiltration血液透析滤过 Soluble substances are swept along in a fluid stream through high permeable membranes (convection). The convection depends on the transmembrane pressure and on membrane features like size, density, and quality of the pores (?cut-off- value“). 可溶物质随着通过高通透性半透膜的液体流动而被清除（对流）。对流依靠跨膜压和膜的物理性质（面积、密度、质量、孔径）来实现。 High moleculare substances, as long as they are below the ?cut-off-value“, will be eliminated in a better way. 清除高分子量物质（只要是低于膜孔的筛选值的物质）的有效方法 B mmHg D B D high-flux Hemodialysis血液透析and Hemofiltration血液透析滤过 HDF – Hemodiafiltration