血液透析裝置糸統(tǒng)梅長(zhǎng)林解放軍腎臟病研究所第二軍醫(yī)大學(xué)長(zhǎng)征醫(yī)院腎內(nèi)科Evaluauononr.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2019-2019AsposePtyL血透條統(tǒng)的組成血透機(jī)水處理系統(tǒng)透析液透析器。Evaluauononr.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2019-2019AsposePtyL透析機(jī)血液透析機(jī)按其功能可劃分為三大部分透析液供給系統(tǒng)血循環(huán)控制系統(tǒng)超濾控制系統(tǒng)Evaluauononr.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2019-2019AsposePtyL透折液供給系統(tǒng)反滲水預(yù)處理微孔濾器熱交換器加熱器:一般為35~37℃←除氣室密透析液配比進(jìn)水泵和流量控制裝置調(diào)節(jié)透析液的流量般為500m/minEvaluauononr.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2019-2019AsposePtyL透析液供給系統(tǒng)透析液監(jiān)控電導(dǎo)度溫度:透析液溫度正常設(shè)置在365cpH值:受透析液成分及濃度的影響,正常范圍6.0-8.0漏血探測(cè)旁路閥Evaluauononr.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2019-2019AsposePtyL血循環(huán)控制系統(tǒng)血泵動(dòng)、靜脈壺及壓力監(jiān)測(cè)器一排出聚集在腔內(nèi)的空氣測(cè)定動(dòng)、靜脈壓力各種輸液、輸血的接口空氣探測(cè)部位空氣探測(cè)器和靜脈夾8肝素泵Evaluauononr.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2019-2019AsposePtyL超濾控制系統(tǒng)超濾液的產(chǎn)生總是通過跨膜壓來實(shí)現(xiàn)的,跨膜壓的調(diào)節(jié)有兩種基本方式定壓超濾:通過控制透析液的負(fù)壓,直接改變跨膜壓的大小,從而產(chǎn)生相應(yīng)的超濾量⑧定容超濾:通過獨(dú)立的超濾泵,直接從水路中抽取所需的超濾量,而跨膜壓的大小則隨透析液負(fù)壓的改變而變化Evaluauononr.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2019-2019AsposePtyL常見的報(bào)警原因和處理電導(dǎo)度低報(bào)警+原因二濃縮液錯(cuò)誤或用完濃縮液管阻塞或漏氣水流量不足或水壓過低報(bào)警限設(shè)置過高Evaluauononr.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2019-2019AsposePtyL+處理一檢查濃縮液是否正確提起濃縮液吸管,觀察濃縮液是否吸入一ˇ吸則檢査:透析液流量是否正確;報(bào)警限設(shè)置是否正確不吸則檢査:濃縮液管有否扭曲打結(jié);濾網(wǎng)是否堵塞;接頭是否漏氣以上如未見異常則請(qǐng)維修人員Evaluauononr.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2019-2019AsposePtyL靜脈壓髙報(bào)警+原因靜脈腔濾網(wǎng)凝血靜脈回路管道受阻患者靜脈狹窄、血栓形成患者側(cè)臥位,靜脈受壓Evaluauononr.chAsposeslidesforNET4od