以尿素清除率为依据对透析器复用次数和清除效果的初步探讨

多景华; 王凯; 张淑艳; 曾春艳; 李华颖; 赵桂芝; 李长杰; 刘文霞

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中国血液净化 ›› 2005, Vol. 4 ›› Issue (7) : 369-371.

论著

以尿素清除率为依据对透析器复用次数和清除效果的初步探讨

多景华王凯张淑艳曾春艳李华颖赵桂芝李长杰刘文霞

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摘要

目的探讨高通量F50透析器和F6透析器的复用次数及其溶质清除效果。方法通过在线尿素清除率监测（OCM）测定60例患者，在其使用F50和F6透析器第1次及其复用第3、6、9次时Kt/V值的变化及透析器血室容积（Tcv）的数值。并对部分患者检测了透析前后血清尿素水平计算了 Kt/V值。结果 60例使用F50透析器的患者在第1次使用及其复用中，Kt/V值相互间比较均差异无显著。复用的F50透析器质量检测也全部合乎要求。使用F6透析器的患者在第1次使用及其复用中，Kt/V值相互间比较也均无显著下降。但F6透析器在复用至第9次时约90%的Tcv下降≥20%。检测的Kt/ V值与OCM监测的Kt/V值比较无明显差别。结论 F50透析器复用至第9次时，其质量和清除效果无明显改变。F6透析器复用至第9次时Kt/V值与第1次使用时比较下降无统计学差异，但大多透析器Tcv下降≥20%，故F6透析器复用不应用超过9次。

Abstract

Objective To explore reused dialyzer efficiency of high flux dialyzer F50 and standard dialyzer F6 through on-line clearance measurement (OCM). Methods Kt/V value was measured by OCM in sixty hemodilysis patients. Total column volume (Tcv) and pressure were measured after the dialyzers were used for the first, third, sixth and ninth time. Results Kt/V value measured by OCM had no significant difference using reused F50 and F6 dialyzers compared with new F50 and F6 dialyzers.There was no significant difference of Kt/V value measured by OCM or by urea kinetic model. However, Tcv of 90% of the ninth time reused F6 dialyzer decreased more than 20%. Conclusions Both clearance efficiency and hollow fiber quality of the ninth time reused F50 dialyzer do not markedly change compared to its first time using in hemodialysis, but Tcv of 90% the ninth time reused F6 dialyzer decrease more than 20% though their Kt/V value does not decrease compared with new dialyzers.