野战机动式血液净化系统在野战环境下急性肾衰竭动物模型救治中的应用

Application of mobile blood purification system in the treatment of acute renal failure dog model in the field environment

目的观察野战机动式血液净化系统在野战环境下急性肾衰竭（ARF）动物模型救治过程中的稳定性、安全性和有效性。方法健康成年雄性犬4只，行双肾切除术后建立ARF模型，采用野战机动式血液净化系统进行透析治疗，评估该系统在野战环境下对动物犬行短时（2h）和常规（4h）透析治疗后的各项功能指标。结果野战机动式血液净化系统在野战环境下血液流量为1SO～180ml／min，透析液流速2000ml／h，置换液流速2000ml／h，超滤量100～200ml／h，上述指标在系统运行过程中始终保持稳定。超滤压静态上限报警（〉100mmHg）、动脉压动态上限报警（〉400mmHg）、静脉压动态上限报警（〉400mmHg）、血路气泡报警、进液气泡报警、补液泵管路压力报警、漏血报警等功能均正常。4只动物犬在治疗过程中生命指征平稳，治疗后血清尿素氮（BUN）、肌酐（Cr）、K^＋水平明显下降（Pco．05），Na^＋、C1^-水平无明显变化（P〉0．05），血清丙氨酸转氨酶（AST）、天冬氨酸转氨酶（ALT）、总胆红素（T-Bil）水平无明显变化（P〉0．05）。结论野战机动式血液净化系统在野战环境下运转正常，操作简便，安全性、稳定性、机动性好，对ARF动物透析治疗安全有效。

Objective To evaluate the stability, safety and efficacy of mobile blood purification system in the treatment of acute renal failure dog model in the field environment. Methods The acute renal failure model was established in 4 dogs by bilateral nephrectomy, which was thereafter treated with the mobile blood purification system. The evaluation of functional index of the mobile blood purification system was performed after a short-time （2 hours） and conventional （4 hours） dialysis treatment. Results The mobile blood purification system ran stably in the field environment at a blood flow of 150-180ml/min, a dialysate velocity of 2000ml/h, a replacement fluid velocity of 2000ml/h, and ultrafiltration rate of 100-200ml/h. All the functions of alarming system worked well, including static upper limit alarm of ultrafiltration pressure （〉 100 mmHg）, upper limit alarm of ambulatory arterial pressure （〉400mmHg）, upper limit alarm of ambulatory venous pressure （〉400mmHg）, bubble alarm of vascular access, bubble alarm during the infusion of solutions, pressure alarm at the substitution pump segment and blood leaking alarm. The vital signs of the 4 dogs with acute renal failure kept stable during the treatment. After the treatment, a remarkable decrease was seen in the levels of serum urea nitrogen, creatinine and serum potassium （P〈0.05）, while no significant change was observed in the level of serum sodium, chloride, alanine transaminase and aspartate transaminase and total bilirubin （P〉0.05）. Conclusions The mobile blood purification system runs normally even in a field environment. It is a flexible and portable device with a great performance in safety and stability in the treatment of acute renal failure.