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<blockquote style="padding-top: 0px; padding-right: 0px; padding-bottom: 0px; max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;"><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; max-width: 100%; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important; word-wrap: break-word !important;">众所周知．肾脏是人体的一个重要器官，具有生成尿液，排除代谢终末产物、毒物和药物．调节体内水、电解质、渗透压和酸碱平衡、血压，分泌肾素、促红细胞生成素和前列腺素等功能。慢性肾功能衰竭尿毒症期的主要临床治疗方法之一就是使用透析机进行血液透析治疗。</p><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; max-width: 100%; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important; word-wrap: break-word !important;"><br style="margin: 0px; padding: 0px; max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;" /></p></blockquote><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; max-width: 100%; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important; word-wrap: break-word !important;"><br style="margin: 0px; padding: 0px; max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;" /></p><fieldset data-id="126" class="135editor" style="margin: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; min-width: 0px; border: 0px none; font-size: 14px; font-family: 微软雅黑; word-wrap: break-word !important;"><fieldset style="margin: 5px 0px; padding: 0px; max-width: 100%; box-sizing: border-box; min-width: 0px; border: 0px; word-wrap: break-word !important;"><section style="margin: -0.8em 0.1em -0.8em 0.2em; padding: 0.8em; max-width: 100%; box-sizing: border-box; border: 1px solid rgb(249, 110, 87); border-top-left-radius: 0.3em; border-top-right-radius: 0.3em; border-bottom-right-radius: 0.3em; border-bottom-left-radius: 0.3em; word-wrap: break-word !important;"><section style="margin: -0.8em 0.1em -0.8em 0.2em; padding: 0.8em; max-width: 100%; box-sizing: border-box; border: 1px solid rgb(249, 110, 87); border-top-left-radius: 0.3em; border-top-right-radius: 0.3em; border-bottom-right-radius: 0.3em; border-bottom-left-radius: 0.3em; word-wrap: break-word !important;"><section placeholder="四角宽边框的样式" class="135brush" style="margin: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; word-wrap: break-word; color: rgb(51, 51, 51); line-height: 1.4; word-break: break-all;"><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; min-height: 1em; white-space: pre-wrap; word-wrap: break-word !important;"><span style="margin: 0px; padding: 0px; max-width: 100%; font-size: 18px; background-color: rgb(146, 205, 220); box-sizing: border-box !important; word-wrap: break-word !important;">1、血液透析原理</span></p><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; min-height: 1em; white-space: pre-wrap; word-wrap: break-word !important;"><span style="margin: 0px; padding: 0px; max-width: 100%; line-height: 1.4; box-sizing: border-box !important; word-wrap: break-word !important;"> 血液透析的作用是清除体内的毒素、纠正酸碱平衡紊乱、清除体内过多水分以及纠正电解质失衡。血液透析的原理是利用透析器中透析膜的半透性，通过对流、弥散、超滤等物理现象，来对血液和透析液中的离子成分进行选择性滤过，从而达到透析的目的。</span><br style="margin: 0px; padding: 0px; max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;" /></p><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; min-height: 1em; white-space: pre-wrap; word-wrap: break-word !important;">透析膜是一种中空纤维，可以由铜铵膜、醋酸膜、血仿膜、聚砜膜等材料制成，它可以全通过水分子、透析液中的钾、钠、钙、镁等离子，单向通过血液中的尿酸、尿素、肌酐等小分子。对于分子量大的如血细胞、蛋白质、脂肪分子等则完全阻断。</p><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; min-height: 1em; white-space: pre-wrap; word-wrap: break-word !important;">血液透析所需要配置的设备及材料有水处理机、血液透析机、透析器、穿刺针、血路管、生理盐水、肝素、消毒液等。</p></section></section><section style="margin: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; height: 1em; word-wrap: break-word !important;"><section data-width="1.5em" style="margin: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; height: 14px; width: 1.5em; float: left; border-bottom-width: 0.4em; border-bottom-style: solid; border-color: rgb(249, 110, 87); border-left-width: 0.4em; border-left-style: solid; word-wrap: break-word !important;"></section></section><section data-width="1.5em" style="margin: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; height: 5px; width: 1.5em; float: right; border-bottom-width: 0.4em; border-bottom-style: solid; border-color: rgb(249, 110, 87); border-right-width: 0.4em; border-right-style: solid; word-wrap: break-word !important;"></section></section></fieldset></fieldset><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; min-height: 1em; white-space: pre-wrap; word-wrap: break-word !important;"><br style="margin: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; word-wrap: break-word !important;" /></p><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; min-height: 1em; white-space: pre-wrap; word-wrap: break-word !important;"><br style="margin: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; word-wrap: break-word !important;" /></p><fieldset data-id="126" class="135editor" style="margin: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; min-width: 0px; border: 0px none; font-size: 14px; font-family: 微软雅黑; word-wrap: break-word !important;"><fieldset style="margin: 5px 0px; padding: 0px; max-width: 100%; box-sizing: border-box; min-width: 0px; border: 0px; word-wrap: break-word !important;"><section style="margin: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; height: 1em; word-wrap: break-word !important;"><section data-width="1.5em" style="margin: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; height: 14px; width: 1.5em; float: left; border-top-width: 0.4em; border-top-style: solid; border-color: rgb(249, 110, 87); border-left-width: 0.4em; border-left-style: solid; word-wrap: break-word !important;"></section><section data-width="1.5em" style="margin: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; height: 14px; width: 1.5em; float: right; border-top-width: 0.4em; border-top-style: solid; border-color: rgb(249, 110, 87); border-right-width: 0.4em; border-right-style: solid; word-wrap: break-word !important;"></section><section style="margin: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; display: inline-block; color: transparent; clear: both; word-wrap: break-word !important;"></section></section><section style="margin: -0.8em 0.1em -0.8em 0.2em; padding: 0.8em; max-width: 100%; box-sizing: border-box; border: 1px solid rgb(249, 110, 87); border-top-left-radius: 0.3em; border-top-right-radius: 0.3em; border-bottom-right-radius: 0.3em; border-bottom-left-radius: 0.3em; word-wrap: break-word !important;"><section placeholder="四角宽边框的样式" class="135brush" style="margin: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; word-wrap: break-word; color: rgb(51, 51, 51); font-size: 1em; line-height: 1.4; word-break: break-all;"></section><section style="margin: -0.8em 0.1em -0.8em 0.2em; padding: 0.8em; max-width: 100%; box-sizing: border-box; border: 1px solid rgb(249, 110, 87); border-top-left-radius: 0.3em; border-top-right-radius: 0.3em; border-bottom-right-radius: 0.3em; border-bottom-left-radius: 0.3em; word-wrap: break-word !important;"><section placeholder="四角宽边框的样式" class="135brush" style="margin: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; word-wrap: break-word; color: rgb(51, 51, 51); line-height: 1.4; word-break: break-all;"><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; min-height: 1em; white-space: pre-wrap; line-height: 21px; word-wrap: break-word !important;"><span style="margin: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; line-height: 27px; font-family: 宋体; background-color: rgb(146, 205, 220); font-size: 18px; word-wrap: break-word !important;">2、血液透析机结构组成</span></p><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; min-height: 1em; white-space: pre-wrap; text-indent: 40px; line-height: 21px; word-wrap: break-word !important;"><span style="margin: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; font-family: 宋体; word-wrap: break-word !important;">血液透析机又称人工肾机。是血液透析的丰要设备，主要由以下几个部分组成：①液供给系统。②监护报警系统：血路报警(动脉压、静脉压、空气报警)、透析液路报警(温度、电导度、漏血、跨膜压)。③操作控制系统：超滤、钠曲线、B液、温度、透析液流量。④显示系统。⑤辅助装置：血泵、肝素泵、动静脉管路、透析器。⑥清洗消毒系统。</span></p><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; min-height: 1em; white-space: pre-wrap; line-height: 21px; word-wrap: break-word !important;"><br style="margin: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; word-wrap: break-word !important;" /></p><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; min-height: 1em; white-space: pre-wrap; word-wrap: break-word !important;"><br style="margin: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; word-wrap: break-word !important;" /></p></section></section><section style="margin: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; height: 1em; word-wrap: break-word !important;"><section data-width="1.5em" style="margin: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; height: 14px; width: 1.5em; float: left; border-bottom-width: 0.4em; border-bottom-style: solid; border-color: rgb(249, 110, 87); border-left-width: 0.4em; border-left-style: solid; word-wrap: break-word !important;"></section></section><section data-width="1.5em" style="margin: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; height: 5px; width: 1.5em; float: right; border-bottom-width: 0.4em; border-bottom-style: solid; border-color: rgb(249, 110, 87); border-right-width: 0.4em; border-right-style: solid; word-wrap: break-word !important;"></section></section></fieldset></fieldset><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; min-height: 1em; white-space: pre-wrap; word-wrap: break-word !important;"><br style="margin: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; word-wrap: break-word !important;" /></p><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; min-height: 1em; white-space: pre-wrap; word-wrap: break-word !important;"><br style="margin: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; word-wrap: break-word !important;" /></p><fieldset data-id="126" class="135editor" style="margin: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; min-width: 0px; border: 0px none; font-size: 14px; font-family: 微软雅黑; word-wrap: break-word !important;"><fieldset style="margin: 5px 0px; padding: 0px; max-width: 100%; box-sizing: border-box; min-width: 0px; color: rgb(62, 62, 62); white-space: normal; line-height: 22px; background-color: rgb(255, 255, 255); border: 0px; word-wrap: break-word !important;"><section style="margin: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; height: 1em; word-wrap: break-word !important;"><section data-width="1.5em" style="margin: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; height: 14px; width: 1.5em; float: left; border-top-width: 0.4em; border-top-style: solid; border-color: rgb(249, 110, 87); border-left-width: 0.4em; border-left-style: solid; word-wrap: break-word !important;"></section><section data-width="1.5em" style="margin: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; height: 14px; width: 1.5em; float: right; border-top-width: 0.4em; border-top-style: solid; border-color: rgb(249, 110, 87); border-right-width: 0.4em; border-right-style: solid; word-wrap: break-word !important;"></section><section style="margin: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; display: inline-block; color: transparent; clear: both; word-wrap: break-word !important;"></section></section><section style="margin: -0.8em 0.1em -0.8em 0.2em; padding: 0.8em; max-width: 100%; box-sizing: border-box; border: 1px solid rgb(249, 110, 87); border-top-left-radius: 0.3em; border-top-right-radius: 0.3em; border-bottom-right-radius: 0.3em; border-bottom-left-radius: 0.3em; word-wrap: break-word !important;"><section placeholder="四角宽边框的样式" class="135brush" style="margin: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; word-wrap: break-word; color: rgb(51, 51, 51); font-size: 1em; line-height: 1.4; word-break: break-all;"></section></section></fieldset><fieldset data-id="126" class="135editor" style="margin: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; min-width: 0px; color: rgb(62, 62, 62); white-space: normal; line-height: 22px; background-color: rgb(255, 255, 255); border: 0px none; word-wrap: break-word !important;"><fieldset style="margin: 5px 0px; padding: 0px; max-width: 100%; box-sizing: border-box; min-width: 0px; border: 0px; word-wrap: break-word !important;"><section style="margin: -0.8em 0.1em -0.8em 0.2em; padding: 0.8em; max-width: 100%; box-sizing: border-box; border: 1px solid rgb(249, 110, 87); border-top-left-radius: 0.3em; border-top-right-radius: 0.3em; border-bottom-right-radius: 0.3em; border-bottom-left-radius: 0.3em; word-wrap: break-word !important;"><section placeholder="四角宽边框的样式" style="margin: 0px; padding: 0px; max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;"><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; min-height: 1em; white-space: pre-wrap; word-wrap: break-word !important;"><span style="margin: 0px; padding: 0px; max-width: 100%; background-color: rgb(146, 205, 220); font-size: 18px; box-sizing: border-box !important; word-wrap: break-word !important;">3、血液透析机常见故障处理</span></p><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; min-height: 1em; white-space: pre-wrap; word-wrap: break-word !important;">在治疗的过程中，参数的设置，操作失误，机器故障等原因都会引起报警，这是保证治疗的绝对安全所必须的。它可以分成提示性警报和机器故障警报，同时会通过各种不同的现象和表现形式反映出来。提示性警报往往由外界相关因素引发，正确处理后警报即刻消失，而机器故障警报则是机器自身出了问题，需要专业人员进行维修维护后才能恢复正常。</p><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; min-height: 1em; white-space: pre-wrap; word-wrap: break-word !important;"><span style="margin: 0px; padding: 0px; max-width: 100%; font-size: 16px; background-color: rgb(195, 214, 155); box-sizing: border-box !important; word-wrap: break-word !important;">3．1电导度报警</span></p><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; min-height: 1em; white-space: pre-wrap; word-wrap: break-word !important;">电导度实际上是测量导体导电能力的一个参数。应用在血液透析机上的透析液是导体，通过电导度传感器间接地测量透析液的离子浓度。而电导度测量装置(传感器+温度补偿)与旁路循环的设计，用来防止错误的透析液成份通过透析器。</p><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; min-height: 1em; white-space: pre-wrap; word-wrap: break-word !important;">影响电导度的因素有以下几点：透析液配比是否正确、透析液流量是否稳定、传感器灵敏度漂移及显示误差、零部件损坏。</p><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; min-height: 1em; white-space: pre-wrap; word-wrap: break-word !important;">电导度报警常见故障现象：</p><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; min-height: 1em; white-space: pre-wrap; word-wrap: break-word !important;">①电导度高或低警报。排查线索：A、B液桶的标号是否正确、A、B液管滤网及安放位置是否正确、温度补偿是否异常。</p><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; min-height: 1em; white-space: pre-wrap; word-wrap: break-word !important;">②电导度间歇式警报。排查线索：A、B液管接口处漏气、O型圈磨损、机器轻微堵塞。</p><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; min-height: 1em; white-space: pre-wrap; word-wrap: break-word !important;">③多台机器同时电导警报或伴随水或流量警报。排查线索：检查浓缩液配制是否准确、检查反渗水供水压力。</p><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; min-height: 1em; white-space: pre-wrap; word-wrap: break-word !important;">④电导度没有警报但病人表现有口渴．血压升高或降低，头疼恶心等失衡症状。排查线索：报管窗口设置错误、校准电导度传感器及显示、检查透析液电解质。</p><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; min-height: 1em; white-space: pre-wrap; word-wrap: break-word !important;"><span style="margin: 0px; padding: 0px; max-width: 100%; background-color: rgb(195, 214, 155); font-size: 16px; box-sizing: border-box !important; word-wrap: break-word !important;">3．2温度报警</span></p><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; min-height: 1em; white-space: pre-wrap; word-wrap: break-word !important;">几乎所有型号的机器都是用加热器来为透析液加温的。原理相当于我们经常用的热得快，但血透机的加热器更精确，用温度传感器来控制使之保持恒温。透析液温度设置一般为35—39℃之间可调整。</p><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; min-height: 1em; white-space: pre-wrap; word-wrap: break-word !important;">影响温度的因素：进水温度、供水不足或透析液流量不瑟、加热器损坏、传感器工作点漂移。温度报警常见故障现象：①多台机器同时出现高低温警报。排查线索：检查进水温度。②除温度警报外还伴有电导，水，流量等警报。排查线索：供水不足、流量不稳。③病人主诉冷热感受程度与机器温度设置不符。排查线索：传感器灵敏度失灵。</p><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; min-height: 1em; white-space: pre-wrap; word-wrap: break-word !important;"><span style="margin: 0px; padding: 0px; max-width: 100%; background-color: rgb(195, 214, 155); font-size: 16px; box-sizing: border-box !important; word-wrap: break-word !important;">3．3透析液流量报警</span></p><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; min-height: 1em; white-space: pre-wrap; word-wrap: break-word !important;">透析液流量是血液透析治疗中的一个重要的参数。常规选择500mL／min，还可以根据不同体重，不同病情等因素进行个体化选择，降低或提高。流量警报的相关因素：水处理供水不足或压力降低，透析机排水不畅，透析机需要清洗除钙，硬件故障。</p><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; min-height: 1em; white-space: pre-wrap; word-wrap: break-word !important;"><span style="margin: 0px; padding: 0px; max-width: 100%; background-color: rgb(195, 214, 155); font-size: 16px; box-sizing: border-box !important; word-wrap: break-word !important;">3．4漏血报警</span></p><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; min-height: 1em; white-space: pre-wrap; word-wrap: break-word !important;">漏血检测是利用测量透析液管路里的透光强度来实现的。光束穿过透析废液照射到光敏管上。如果废液罩混有血液。则透光减弱，光电效应改变后引发报警，实现监测目的。</p><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; min-height: 1em; white-space: pre-wrap; word-wrap: break-word !important;">造成漏血报警的因素：透析器膜破，透析液中有空气。废液管路污染，元件损坏或电路工作点漂移。</p><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; min-height: 1em; white-space: pre-wrap; word-wrap: break-word !important;">漏血报警常见故障现象：①透析器膜外出口处见到少量血液，按复位键不能消除。排查线索：透析器膜破。②间歇式报警，按复位键可以消除。排查线索：是否是单超状态、透析器连接头密封圈磨损、除气泵效率降低或管路污染。③机器自检时漏血项不能通过或治疗时无故报警且按复位键不能消除警报。排查线索：发光二极管坏、控制电路需校准、废液回路管断。</p><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; min-height: 1em; white-space: pre-wrap; word-wrap: break-word !important;"><span style="margin: 0px; padding: 0px; max-width: 100%; background-color: rgb(195, 214, 155); font-size: 16px; box-sizing: border-box !important; word-wrap: break-word !important;">3．5血泵故障</span></p><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; min-height: 1em; white-space: pre-wrap; word-wrap: break-word !important;">血泵的工作是提供一个体外循环的动力。所有型号的血透机几乎都是通过泵头的转动带动滚轮挤压泵管，推动动脉血流向透析器，实现体外循环。</p><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; min-height: 1em; white-space: pre-wrap; word-wrap: break-word !important;">影响血泵工作的因素：体外循环系统警报、血泵门未关严或泵管移动导致泵卡死、滚轮污染后相对运动受阻、血泵间隙过大或过小、零部件损坏。</p><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; min-height: 1em; white-space: pre-wrap; word-wrap: break-word !important;"><span style="margin: 0px; padding: 0px; max-width: 100%; background-color: rgb(195, 214, 155); font-size: 16px; box-sizing: border-box !important; word-wrap: break-word !important;">3．6空气监测故障</span></p><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; min-height: 1em; white-space: pre-wrap; word-wrap: break-word !important;">防止空气进入血液的防护系统是建立在超声波传递原理基础上。超声波在液体和固体内的传播速度比在气体内快，因此在静脉血液管路的两侧分别装上超声波发射器和接收器来捕捉经过静脉管路的气泡。影响空气监测的因素：血路管安装位置不妥或变形、透析器内部除气不足、血流提速过快或高血流速使动脉压过低、动脉穿刺针的位置欠佳、透析器血液腔室和透析液腔室有残余空气进入静脉血路管，形成微小气泡。消除这些气泡预冲透析器的规范操作极为重要，必须确保将膜内膜外的空气除掉。</p><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; min-height: 1em; white-space: pre-wrap; word-wrap: break-word !important;"><span style="margin: 0px; padding: 0px; max-width: 100%; background-color: rgb(195, 214, 155); font-size: 16px; box-sizing: border-box !important; word-wrap: break-word !important;">3．7跨膜压报警</span></p><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; min-height: 1em; white-space: pre-wrap; word-wrap: break-word !important;">跨膜压是指透析器半透膜血液侧和透析液侧的压力差。是用压力传感器测量静脉压力和透析压力的方法经过计算而来。TMP=(Bi+Bo)/2-(Di+Do)/2</p><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; min-height: 1em; white-space: pre-wrap; word-wrap: break-word !important;">在实际应用当中近似地认为：</p><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; min-height: 1em; white-space: pre-wrap; word-wrap: break-word !important;">TMP=Bo-Do+补偿值</p><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; min-height: 1em; white-space: pre-wrap; word-wrap: break-word !important;">其中：Bo=透析器血液出口处压力，Bi=透析器血液入口处压力，Do=透析液出口处压力，Di=透析液人口处压力。</p><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; min-height: 1em; white-space: pre-wrap; word-wrap: break-word !important;">影响跨膜压的因素：静脉压、透析器的选择、超滤率及时间的设置、透析器内产生气阻现象、抗凝不足、透析液侧压力传感器损坏。<br style="margin: 0px; padding: 0px; max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;" /></p><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; min-height: 1em; white-space: pre-wrap; word-wrap: break-word !important;"><span style="margin: 0px; padding: 0px; max-width: 100%; background-color: rgb(195, 214, 155); font-size: 16px; box-sizing: border-box !important; word-wrap: break-word !important;">3．8静脉压报警</span></p><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; min-height: 1em; white-space: pre-wrap; word-wrap: break-word !important;">静脉压通常在静脉血路的除泡器处通过压力监测器进行测量，该点在血泵后面因此为正压。静脉压最低下限设置必须大于O，常规为10mmHg。</p><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; min-height: 1em; white-space: pre-wrap; word-wrap: break-word !important;">影响静脉压的因素：血泵的速度，穿刺针的位置，回流血液在透析器、静脉针及血管内所受阻力的大小，压力监测器故障或保护罩损坏。静脉压报警常见故障现象：</p><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; min-height: 1em; white-space: pre-wrap; word-wrap: break-word !important;">①静脉压缓慢降低。排查线索：常见于静脉穿刺针处微少渗漏。</p><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; min-height: 1em; white-space: pre-wrap; word-wrap: break-word !important;">②静脉压突然降低。排查线索：动脉血流减少或阻断，静脉针脱落。</p><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; min-height: 1em; white-space: pre-wrap; word-wrap: break-word !important;">③静脉压缓慢升高。排查线索：肝素化不足、穿刺针位置需调整</p><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; min-height: 1em; white-space: pre-wrap; word-wrap: break-word !important;">④静脉压突然升高。排查线索：静脉血路受压或扭曲。</p><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; min-height: 1em; white-space: pre-wrap; word-wrap: break-word !important;">⑤静脉压忽高忽低，上下漂动不稳定。排查线索：压力监测器保护罩进了盐水或被血污染，个别情况为监测器损坏。</p><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; min-height: 1em; white-space: pre-wrap; word-wrap: break-word !important;"><span style="margin: 0px; padding: 0px; max-width: 100%; background-color: rgb(195, 214, 155); font-size: 16px; box-sizing: border-box !important; word-wrap: break-word !important;">3．9动脉压报警</span></p><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; min-height: 1em; white-space: pre-wrap; word-wrap: break-word !important;">动脉压同样是通过连接在动脉血路中的压力监测器进行测跫的。动脉压通常是在血泵前测量，因此是负压。该负压应尽可能小，以避免将血管壁抽进穿刺针管腔内，并且避免空气进入管道系统。</p><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; min-height: 1em; white-space: pre-wrap; word-wrap: break-word !important;">影响动脉压的因素：血泵速度、动静脉瘘血流量、动脉针在血管内的位置、长度和内径、压力监测器及保护罩损坏。</p><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; min-height: 1em; white-space: pre-wrap; word-wrap: break-word !important;"><span style="margin: 0px; padding: 0px; max-width: 100%; background-color: rgb(195, 214, 155); font-size: 16px; box-sizing: border-box !important; word-wrap: break-word !important;">3．10超滤报警</span></p><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; max-width: 100%; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important; word-wrap: break-word !important;">超滤的目的是透析后体重减少量与预期相一致，由容量控制原理来实现。血透机都具备平衡系统，尽管采用的方法各不相同，但最终实现了进出透析器的新鲜透析液和废液的量是相等的，这就是平衡的概念。而病人体内多余的水则是通过超滤的作用而另行计算的。大部分机器是用超滤泵来实现超滤的，也有平衡腔式的。</p><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; max-width: 100%; min-height: 1em; white-space: pre-wrap; box-sizing: border-box !important; word-wrap: break-word !important;">影响准确超滤的因素：透析前体重及治疗中摄入的水、食物以及排泄物等，预冲量，回水量，治疗中的补液量等，透析回路中较多的空气，计量器具的精度，超滤控制系统元件或超滤泵损坏。</p>以上对透析机主要的故障进行了分析，在实际工作中还要根据具体的情况灵活处理。故障原因是不确定的，但是解决故障的方法却是有章可循的，只要我们认真分析、全面考虑。这些问题就会迎刃而解。</section></section><section style="margin: 0px; padding: 0px; max-width: 100%; box-sizing: border-box; height: 1em; word-wrap: break-word !important;"><p><strong style="font-size: 16px; color: rgb(51, 51, 51); font-family: Verdana, Arial, Helvetica, sans-serif; line-height: 2em; text-align: center; text-indent: 2em; widows: 1; 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line-height: 1.75em;"><strong style="font-size: 14px; line-height: 21px; color: rgb(255, 255, 255); font-family: arial, helvetica, sans-serif; margin: 0px; padding: 0px; max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;"><span class="bkcolor" style="margin: 0px 8px 0px 0px; padding: 4px 10px; max-width: 100%; border-top-left-radius: 5px; border-top-right-radius: 5px; border-bottom-left-radius: 5px; border-bottom-right-radius: 5px; background-color: rgb(191, 0, 0); box-sizing: border-box !important; word-wrap: break-word !important;"></span></strong><br /></p><p style="white-space: normal; text-align: center; line-height: 1.75em;"><strong><span style="line-height: 2em; color: rgb(255, 0, 0);">ID: </span></strong></p><p style="white-space: normal; text-align: center; line-height: 1.75em;"><span style="font-size: 14px;">最具人气的医疗器械维修新媒体平台</span></p><p style="white-space: normal; text-align: center; line-height: 1.75em;"><span style="font-size: 11px;"><span style="font-size: 14px;">分享医疗器械前沿动态、医疗器械维修经验</span> </span></p><p style="white-space: normal; 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发表于 2020-10-21 13:25:29