血液透析机实际透析液总流量的测定

Determination of total actual dialysate flow for hemodialysis machines

目的探讨血液透析机的实际透析液流量与设定流量是否存在差异。方法清华大学第一附属医院肾脏科血液透析机共37台,3种不同品牌分为A、B、C组。选择常规血液透析时间4h病情稳定的维持性血液透析患者。通过透析废液收集器装置收集血液透析模式开始至4h结束的全部透析废液量。实际透析液总流量=全部透析废液量-超滤总量。比较实际流量与设定值（120L）的差异。结果全部机器实际总透析液流量平均（117.784±5.970）L,小于120L者25台占67.4%,大于120L者共12台占32.4%。A组18台机器平均透析液总流量[120.333±6.598（110-133）]L,B组13台机器平均透析液总流量[116.131±3.938（111-123）]L,C组6台机器平均透析液总流量[113.717±4.598（105-117）]L。单因素方差分析3组间存在明显统计学差异（F=4.150,P=0.024）。C组调试后实际透析液总流量为[120.075±0.529（119.4-121）]L。结论血液透析机实际透析液总流量普遍存在偏离,其中以负偏离居多。不同厂家透析机实际透析液总流量存在差异,通过调试可以达到设定目标。

Objective To investigate whether there is a difference between actual dialysate flow and set dialysate flow ofhemodialysis machines. Methods There are 37 hemodialysis machines in our center. We divided the three brands of machines into A, B and C groups. We selected stable patients on conventional hemodialysis. Total waste dialysate during a 4-hour hemodialysis session was collected. The actual total dialysate flow is equal to the total waste dialysate minus the total ultrafiltration volume. We compared the difference between the actual total dialysate flow and the set dialysis flow （120L）. Result The actual total dialysate flow was 117.78±5.97L for all machines, less than 120L in 25 hemodialysis machines （67.6%） and more than 120L in 12 machines （32.4%）. There was a significant difference between the 3 groups （ANOVA, F=4.150, P= 0.024）. After debugging, the total dialysate flow in Group C improved significantly [120.075±0.529L （119.4- 121.0L） vs. 113.717±4.588 L（105-117L）]. Conclusion Deviation of actual total dialysate flow existed among hemodialysis machines, and most of them had negative deviation. There were differences in the actual total dialysate flow among machines of different manufactures, and the set dialysate flow can be achieved after debugging