强酸性电解水复用透析器对透析膜透析效率的影响

目的 观察强酸性电解水消毒复用三醋酸纤维透析器对小分子溶质尿素清除指数(KT/V)利尿素清除率(urea removal ratio,URR)的影响,以及扫描电镜下不同复用次数透析膜内纤维蛋白假膜的形成和变化,探讨强酸性电解水复用透析器对尿素清除效率的影响.方法 14例规律血液透析病人随机分为2组,每组7例,A组为强酸性电解水复用实验组,B组为过氧乙酸复用对照组.两组分别于复用的0、1、3、5次观察各指标.结果 两组间不同复用次数的KT/V、URR相比无显著性差异.扫描电镜下过氧乙酸复用第4次可见少量纤维蛋白沉积,两种消毒剂复用第5次透析膜内均见纤维蛋白假膜形成,强酸性电解水复用者纤维蛋白假膜沉积累及的纤维束数量明显少于过氧乙酸复用者,且假膜的厚度薄得多.结论 强酸性电解水消毒复用5次透析器对尿素的透析效率无影响.

Influence of Reprocessing Dialysers with Electrolyzed Strong Acid Aqueous Solution on Dialysis Efficiency

Objective To investigate the dialysis efficiency of reprocessing cellulose triacetate dialysers with electrolyzed strong acid aqueous solution. Methods 14 patients with chronic renal failure on regular hemodialysis treatment were randomly allocated to two groups. The dialyzers of Group A (n=7) was reprocessed with electrolyzed strong acid aqueous solution and Group B (n=7) with peracetic acid as a control. Urea removal (expressed as KT/V, urea reduction ratio-URR) were observed on various reuse. The scanning electrono-graphs of various reprocessed membranes were also observed. Results There was no difference among the values of KT/V and URR on various reuses with the both disinfectants. Under the scanning electron microscope deposited layers of proteins were seen on the dialysis membranes. The number of deposited layers of proteins involving the cellulose bundles in group A was less than group B. Conclusions There was no influence of reprocessing dialyzers with electrolyzed strong acid aqueous solution on dialysis efficiency of urea.