Puas Siv Tau Lub Tshuab Dialyzer Rov Qab Rau Kev Kho Mob Hemodialysis?

Lub tshuab lim ntshav, yog ib yam khoom siv tseem ceeb rau kev kho mob raum dialysis, siv lub hauv paus ntsiab lus ntawm daim nyias nyias semi-permeable los tso cov ntshav los ntawm cov neeg mob uas ua tsis tau haujlwm raum thiab dialysate rau hauv lub tshuab lim ntshav tib lub sijhawm, thiab ua rau ob qho dej ntws mus rau hauv kev taw qhia sib txawv ntawm ob sab ntawm daim nyias nyias dialysis, nrog kev pab los ntawm ob sab solute gradient, osmotic gradient, thiab hydraulic pressure gradient. Cov txheej txheem dispersion no tuaj yeem tshem tawm cov tshuaj lom thiab dej ntau dhau ntawm lub cev thaum rov ua kom lub cev cov khoom xav tau thiab tswj qhov sib npaug ntawm electrolytes thiab acid-base.

Cov tshuab lim ntshav feem ntau yog ua los ntawm cov qauv txhawb nqa thiab cov ntaub so dialysis. Cov hom fiber hollow feem ntau siv hauv kev kho mob. Qee cov tshuab lim ntshav tau tsim los kom siv tau dua, nrog rau kev tsim tshwj xeeb thiab cov ntaub ntawv uas tuaj yeem tiv taus ntau zaus ntxuav thiab tua kab mob. Lub caij no, cov tshuab lim ntshav pov tseg yuav tsum tau muab pov tseg tom qab siv thiab tsis tuaj yeem siv dua. Txawm li cas los xij, muaj kev tsis sib haum xeeb thiab kev tsis meej pem txog seb puas yuav tsum siv cov tshuab lim ntshav dua. Peb yuav tshawb nrhiav cov lus nug no thiab muab qee cov lus piav qhia hauv qab no.

Cov txiaj ntsig thiab qhov tsis zoo ntawm kev siv cov dialysis rov qab siv dua

(1) Tshem tawm cov tsos mob siv thawj zaug.
Txawm hais tias muaj ntau yam ua rau muaj tus mob siv thawj zaug, xws li cov tshuaj tua kab mob ntawm ethylene oxide, cov khoom siv membrane, cov cytokines tsim los ntawm kev sib cuag ntshav ntawm daim nyias nyias dialysis, thiab lwm yam, tsis hais qhov ua rau dab tsi los xij, qhov tshwm sim yuav txo qis vim yog kev siv dialyzer ntau zaus.

(2) Txhim kho qhov bio-compatibility ntawm lub dialyzer thiab txo qhov ua haujlwm ntawm lub cev tiv thaiv kab mob.
Tom qab siv lub dialyzer, ib txheej ntawm cov protein zaj duab xis raug txuas rau sab hauv ntawm daim nyias nyias, uas tuaj yeem txo cov tshuaj tiv thaiv zaj duab xis ntshav los ntawm kev ntxuav dialysis tom ntej, thiab txo qhov kev ua haujlwm ntawm cov khoom sib xyaw, neutrophil degranulation, lymphocyte activation, microglobulin ntau lawm, thiab cytokine tso tawm.

(3) Kev cuam tshuam ntawm qhov nrawm ntawm kev tshem tawm.
Tus nqi tshem tawm ntawm creatinine thiab urea tsis txo qis. Cov tshuaj dialyzers rov siv dua uas tau tua kab mob nrog formalin thiab sodium hypochlorite ntxiv tuaj yeem ua kom ntseeg tau tias tus nqi tshem tawm ntawm cov khoom nruab nrab thiab loj (Vital12 thiab inulin) tseem tsis hloov pauv.

(4) Txo cov nqi hemodialysis.
Tsis muaj ib qho kev tsis ntseeg tias kev siv lub tshuab lim ntshav rov qab tuaj yeem txo cov nqi kho mob rau cov neeg mob uas ua rau lub raum tsis ua haujlwm thiab muab kev nkag mus rau cov tshuab lim ntshav zoo dua tab sis kim dua.
Tib lub sijhawm, qhov tsis zoo ntawm kev siv dialyzer rov qab kuj pom tseeb.

(1) Cov kev tsis haum tshuaj rau cov tshuaj tua kab mob
Kev tua kab mob Peracetic acid yuav ua rau lub dialysis membrane denaturation thiab decompose, thiab tseem tshem tawm cov protein uas khaws cia rau hauv lub membrane vim yog siv ntau zaus, ua rau muaj feem ntau ntawm kev ua kom tiav. Kev tua kab mob formalin tuaj yeem ua rau Anti-N-antibody thiab tawv nqaij ua xua rau cov neeg mob.

(2) Ua kom muaj feem ntau ntawm cov kab mob thiab endotoxin kis tau ntawm lub dialyzer thiab ua rau muaj kev pheej hmoo ntawm kev sib kis kab mob

(3) Kev ua haujlwm ntawm lub dialyzer raug cuam tshuam.
Tom qab siv lub tshuab dialyzer ntau zaus, vim muaj cov protein thiab cov ntshav txhaws thaiv cov fiber bundles, thaj chaw ua haujlwm tau txo qis, thiab qhov nrawm thiab qhov nrawm ultrafiltration yuav maj mam txo qis. Txoj kev ntsuas feem ntau los ntsuas qhov ntim fiber bundle ntawm lub tshuab dialyzer yog xam tag nrho qhov ntim ntawm tag nrho cov fiber bundle lumens hauv lub tshuab dialyzer. Yog tias qhov piv ntawm tag nrho lub peev xwm rau lub tshuab dialyzer tshiab tsawg dua 80%, lub tshuab dialyzer siv tsis tau.

(4) Ua kom cov neeg mob thiab cov neeg ua haujlwm kho mob muaj feem raug tshuaj lom neeg ntau dua.
Raws li kev tshuaj xyuas saum toj no, kev ntxuav thiab tua kab mob tuaj yeem ua rau muaj qhov tsis zoo ntawm kev siv cov tshuaj dialyzer rov qab siv dua rau qee qhov. Lub dialyzer tsuas yog siv tau dua tom qab kev ntxuav thiab tua kab mob nruj thiab dhau qhov kev sim kom ntseeg tau tias tsis muaj daim nyias nyias tawg lossis thaiv sab hauv. Txawv ntawm kev rov ua dua tes ib txwm muaj, kev siv cov tshuab rov ua dua tes tsis siv neeg qhia txog cov txheej txheem txheem rau hauv kev rov ua dua tes dialyzer kom txo qhov yuam kev hauv kev ua haujlwm tes. Lub tshuab tuaj yeem ntxuav, tua kab mob, sim, thiab ntxiv, raws li cov txheej txheem teeb tsa thiab cov kev teeb tsa, los txhim kho cov txiaj ntsig ntawm kev kho mob dialyzer, thaum ua kom ntseeg tau tias tus neeg mob muaj kev nyab xeeb thiab huv si.