Kaiser W, Biesenbach G, Kramer E, Dunzinger I, Zazgornik J
II. Medizinische Abteilung, Allgemeines öffentliches Krankenhaus, Linz.
Wien Klin Wochenschr. 1988 Nov 18;100(22):733-6.
Haemodialysis with bicarbonate dialysate is well established in the treatment of chronic renal failure. The costs of bicarbonate haemodialysis are higher than acetate haemodialysis. Commercially available bicarbonate solutions are sold from AS 129.- to AS 189.- per 8 litre canister (December 1987). The self-prepared solution contains 650 g bicarbonate (for AS 8.-) in 8 litres of deionized water. In 10 patients on regular dialysis treatment haemodialysis were performed with both commercially available and self-prepared solutions for a 3 week period. Blood and dialysate samples were obtained before and 10 minutes, 1 h, 2 h, 3 h and 4 h after starting haemodialysis. Osmolality, Na+, K+, Cl-, pO2, pCO2 and pH were measured in the dialysate and in the serum, as well as serum lactate levels. There were no significant differences and the biochemical changes were similar with both preparations. In our centre with about 4000 bicarbonate dialyses yearly, AS 500,000.- to AS 700,000.- could be saved by self preparation of the dialysate.
使用碳酸氢盐透析液进行血液透析在慢性肾衰竭治疗中已得到广泛应用。碳酸氢盐血液透析的成本高于醋酸盐血液透析。市售碳酸氢盐溶液每8升罐售价为129瑞士法郎至189瑞士法郎(1987年12月)。自制溶液在8升去离子水中含有650克碳酸氢盐(成本8瑞士法郎)。对10例接受常规透析治疗的患者,分别使用市售溶液和自制溶液进行为期3周的血液透析。在血液透析开始前以及开始后10分钟、1小时、2小时、3小时和4小时采集血液和透析液样本。测量透析液和血清中的渗透压、钠、钾、氯、氧分压、二氧化碳分压和pH值,以及血清乳酸水平。两种制剂之间无显著差异,生化变化相似。在我们中心,每年约有4000例碳酸氢盐透析,通过自制透析液可节省50万瑞士法郎至70万瑞士法郎。