血液透析机超滤功能合理维护方法的探讨

Appropriate maintenance of ultrafiltration function for hemodialysis machines

目的 探讨血液透析机超滤功能合理的维护方法.方法 选取首都医科大学附属北京同仁医院血液透析中心2种进口品牌血液透析机.按其超滤泵的不同分为2组,A组17台（固定容量膜式泵）,B组11台（陶瓷柱塞泵）,测定其不同时间的超滤误差值,并进行比较;回顾性统计分析自2004年1月～2012年6月2组透析机超滤故障发生率及超滤故障原因,比较2组间超滤故障发生率、超滤故障原因的构成比.结果 ①2组透析机超滤误差值的比较,在校准9个月后（t=2.261,P=0.042）、校准12个月后（t=2.364,P=0.026）,差异有统计学意义.②2组超滤故障发生率的比较,组间无统计学意义（x2=0.635,P=0.425）.③2组超滤故障原因的比较,差异有统计学意义（x2=10.763,P=0.013）.结论 不同品牌血液透析机引起超滤故障的原因有差异,可以根据维修记录,统计分析透析机超滤故障的常见原因,采用合理的超滤功能维护方法.

Objective To find out suitable maintenance methods for ultrafiltration function of hemodialy- sis machines. Method We selected the hemodialysis machines in our hospital, and divided them by ultrafiltra- tion pump type into 2 groups： group A （17 machines with fixed capacity membrane pumps）, and group B （11 machines with ceramic piston pumps）. We measured ultrafiltration errors of the machines in the 2 groups at different situations. We also reviewed and analyzed the ultrafiltration malfunction rate and its causes in the period from Jan. 2004 to Jun. 2012. Result ①There were significant differences in ultrafiltration errors between the 2 groups after calibration for 9 months （t =2.261, P=0.042） and for 12 months （t =2.364, P=-0.026）. ②There was no significant difference in ultrafiltration malfunction rate between the 2 groups （χ2=0.635, P= 0.425）. ③There were significant differences in causes of ultrafiltration malfunction between the 2 groups （χ2= 10.763, P=0.013）. Conelusion The causes for ultrafiltration malfunction were significantly different between the 2 groups of hemodialysis machines. We could analyze these causes from the maintenance record, and use appropriate methods to maintain the ultrafiltration function.