伦拿连灭菌剂在透析器复用中灭菌效果观察

目的观察伦拿连灭菌剂复用透析器的灭菌效果.方法使用0.5%过氧乙酸(A组)、2%甲醛(B组)和3.5%伦拿连(C组)复用透析器,观察3组热原反应和透析器破膜发生率.结果随机抽取3组血路管、透析器进行细菌学监测,无细菌生长;C组、B组和A组热原反应发生率分别为0.12%、2.54%和1.82%,提示3组间热原反应发生率差异有非常显著性(χ2=82.5,P<0.05);透析器破膜发生率分别为0.053%、0.46%和2.92%(χ2=107.1,P<0.05),提示3组间透析器破膜发生率差异有非常显著性.结论选用伦拿连灭菌剂对透析器进行复用灭菌,热原反应及透析器破膜发生率明显低于过氧乙酸和甲醛.     

The Current Status and Future of the Artificial Kidney

The use of the artificial kidney can presently be extended to almost all patients with end-stage renal failure. To reduce the cost of treatment, technological choices have to be made. These are always a compromise between cost and adequacy. The liberty obtained by technical improvements to perform a dialysis "à la carte," depending on patient and doctor wishes, is one of the main characteristics of the present status of hemodialysis.     

透析器复用对补体及单个核细胞激活的影响

目的：了解透析器复用对补体和单个核细胞激活的影响。方法：比较透析器第四次复用与首次使用时,血浆补体终末复合物（SC5b-9）浓度及分离的单个核细胞（PBMC）在体外培养产生IL－1β、TNF-α和IL－6量的差异。结果：血仿膜透析器用过氧乙酸和福尔马林消毒后第四次复用时,血浆SC5b-9浓度变化幅度较首次使用明显降低;PBMC在LPS刺激下体培养产生IL－1β、TNF-α和IL－6的量与首次使用相比差异无显著性。结论：血仿膜透析器用过氧乙酸和福民林消毒复用,可在一定程度上降低其补体激活能力,但不影响PBMC产生细胞因子。     

血液透析对游离肉碱的清除及影响因素的研究

目的　研究维持性血液透析 (MHD)患者血浆游离肉碱 (FC)水平以及透析对FC清除的影响。方法　应用酶法检测MHD组血浆和透析液中FC水平及对照组尿中FC水平。结果　MHD患者透前血浆FC水平明显低于正常人 (P <0 .0 1)。透析后 ,血浆FC水平较透析前下降 70 %。每周MHD患者透析所致的FC丢失量远远超过对照组尿液排出量 (P <0 .0 1)。透析过程中 ,FC在第 1小时清除最多。透析中FC的清除量与血浆FC浓度呈正相关 (R =0 .5 1,P =0 .0 1)。应用不同透析器及其复用对FC的清除无显著差异。结论　透析中丢失是MHD患者肉碱缺乏的重要原因。应用不同透析器及其复用对FC清除无明显影响。     

联机尿素清除率动态监测KT/V及相关因素分析

目的通过联机尿素监测器(OCM)实时动态监测KT/V,并对影响KT/V的相关因素进行分析。方法采用德国Fresenius4008S透析机及随机附带OCM组件,实时动态监测31例维持性血液透析患者,共308人次KT/V,同时记录透析器类型、透析时间、单超时间、血液流量,透析开始时尿素清除率(K1),透析两小时尿素清除率(K2),透析结束时尿素清除率(K3)。结果KT/V值与透析时间和血液流量成正相关,与尿素分布容积成负相关;尿素清除率和透析时间呈直线负相关,透析液流量由500ml/min调节到800ml/min,透析器的尿素清除率约提高15%。结论提高KT/V的有效方法是增加血流量、延长透析时间、提高透析液流量和使用高效率透析器;复用透析器不宜超过4次。     

D101吸附树脂再生工艺实验研究二:再生液流量、用量及温度对再生效果的影响

目的研究D101吸附树脂的再生活化工艺.方法采用正交试验法,以树脂比吸附量作为参考指标,考察酸、碱两种再生液的流量(A)、用量(B)、温度(C)三个因素对再生效果的影响.结果两种再生液的流量、用量、温度经优化后提示为A1B3C3.结论 D101树脂再生活化时,当再生液的酸、碱、乙醇浓度选择0.05mol·L-1NaOH的75%乙醇溶液和0.1mol·L-1HCl的90%乙醇溶液时,其的流量、用量、温度应为1.0SV、5.0BV,30℃.     

分散式污水处理系统研究进展

介绍了分散式污水处理系统的概念、类型及特点.综述了近年来国内外分散式污水处理系统的研究现状,以德国DEUS 21系统为例着重介绍了分散式污水处理工艺、处理技术等方面的研究进展.     

A Quality and Cost-Benefit Analysis of Dialyzer Reuse in Hemodialysis Patients

Background. To evaluate the benefits of dialyzer reuse for hemodialysis (HD) patients, including the cost of HD treatment and patient's survival, a comparison was made regarding the standard practice of single-use dialysis. Methods. From January 1, 2005, to December 31, 2005, a total of 128,232 successive HD treatments in 822 patients in Chang Gung Memorial Hospital-Kaohsiung Medical Center were included in this study. Results. Approximately 54.25% (446/822) of patients reused dialyzers. The average times of dialyzer reuse was 2.54. The annual hollow fiber cost is reduced by $241,054.08 U.S. dollars (NT $7,834,257.60). The annual cost of hollow fiber was reduced by $540.48 U.S. dollars (NT $17,565.60) in one patient with dialyzer reuse. The mortality rates in dialyzer reuse and single use groups were 3.1% and 10.9% within one year (p < 0.0001). Multiple logistic regressions showed that single use compared with reuse was associated with higher mortality after adjusting co-morbid conditions including age, diabetes mellitus, etc. Conclusions. We concluded that the benefits of dialyzer reuse included safety in our center and reduction in cost during a 12-month period. Dialyzer reuse may be a safe alternative.