Szepietowski T, Uzar J
Katedra i Klinika Nefrologii Akademii Medycznej we Wrocławiu.
Polim Med. 1989;19(3-4):107-18.
The possibility of multiple use of Cuprophan capillary dialyzers reutilized with our own method with a help of an automatic apparatus produced according to our own constructive assumptions was evaluated. The experiments were carried out using capillary dialyzers of the Organon Technika firm, Andante H.F. type with 8 mu thickness of a Cuprophan capillary++ membrane and a dysfusion surface of 0.8 m2. Complete sterility of the regeneration process and full wash of the disinfectant (formaldehyde extract) were observed before reusing of the dialyzer. The clearance of creatinine did not lower when the regenerated dialyzers were used. During the first use of the dialyzer it was 105.8 +/- 8.9 ml/min, and during the sixth one--105.5 +/- 9.8 ml/min. In a group of 24 patients first dialyzed using dialyzers only once and then after 4 months' dialyzing with dialyzers used at least 6 times and again after 4 months' of further dialyzing using a dialyzer only once, remarkable changes of the concentration of urea, creatinine, hydrogen carbonates, fibrinogen, the hematocrit indicator, the amount of hemoglobulin, the number of hematocytes, blood platelets and the weights of the patients in blood serum were not observed. Differences in the before-mentioned indicators between the group of patients dialyzed with a multiple used dialyzer and group of 7 persons dialyzed at the same time with a dialyzer used only once were not observed. During 1075 dialyses made using reutilized dialyzers negative phenomena which might be connected with multiple use of dialyzers were not observed in patients. The authors come to the conclusion that the automatic reutilization of their own method does not lower the efficiency of hemodialysis, lowers the risk of the first use syndrome and is well tolerated by patients which with simultaneous lowering the costs of dialysis as is much for multiple use of dialyzers.
对采用我们自己的方法、借助根据我们自己的结构设想制造的自动装置重复使用铜仿膜毛细管透析器的可能性进行了评估。实验使用的是欧加农技术公司的Andante H.F.型毛细管透析器,其铜仿膜毛细管厚度为8微米,透析面积为0.8平方米。在透析器重复使用前,观察到再生过程完全无菌且消毒剂(甲醛提取物)被完全冲洗掉。使用再生透析器时,肌酐清除率并未降低。透析器首次使用时肌酐清除率为105.8±8.9毫升/分钟,第六次使用时为105.5±9.8毫升/分钟。在一组24名患者中,先使用仅用过一次的透析器进行首次透析,4个月后使用至少用过6次的透析器进行透析,再过4个月后又使用仅用过一次的透析器进行进一步透析,未观察到尿素、肌酐、碳酸氢盐、纤维蛋白原浓度、血细胞比容指标、血红蛋白量、血细胞数量、血小板数量以及患者血清重量有明显变化。在使用多次使用的透析器进行透析的患者组与同时使用仅用过一次的透析器进行透析的7人组之间,未观察到上述指标存在差异。在使用重复使用的透析器进行的1075次透析过程中,未在患者身上观察到可能与透析器多次使用相关的负面现象。作者得出结论,他们自己方法的自动重复使用不会降低血液透析效率,降低了首次使用综合征的风险,患者耐受性良好,同时降低了透析成本,因为透析器多次使用可节省大量费用。