Widerøe T E, Smeby L C, Dahl K, Jörstad S
Department of Nephrology, University of Trondheim, Norway.
Artif Organs. 1988 Jun;12(3):210-8. doi: 10.1111/j.1525-1594.1988.tb02756.x.
A survey is given comparing measurements of transperitoneal water transport in different clinical situations with analyses based on the so-called "pore theory." This model links the measured changes to physical alterations of the peritoneal membrane. The calculations include "equivalent pore radius," effective "membrane area" and diffusive length, the transport resistance of the unstirred dialysate layer, and the residual intraperitoneal volume after dialysate drainage. The clinical appearances include individual differences in transperitoneal transport characteristics, changes in transperitoneal transport over time on continuous ambulatory peritoneal dialysis (CAPD) and during peritonitis, the pharmacological effect on the transport properties, and the effect of peritoneal catheter dislocation on ultrafiltration capacity. The main conclusions are as follow: During CAPD treatment the measurement of intraperitoneal solute equilibration and "mass-transfer-area coefficients" for urea and creatinine is less sensitive than the measurement of ultrafiltration volume in revealing peritoneal membrane changes. Differences and changes found have mostly a combined physical explanation, but one is more or less dominant. Changes in peritoneal membrane area seem to be the most dominant cause of changes in transperitoneal transport during time on CAPD and when sodium nitroprusside was added to the peritoneal dialysate. Changes during peritonitis can be explained by changes in pore radius and depth. Individual differences can be explained by differences in "membrane" area and in resistance of the unstirred dialysate fluid. High residual dialysate volume can give rise to clinical problems and should be considered when placing the catheter in the peritoneal cavity.
开展了一项调查，将不同临床情况下经腹膜水转运的测量结果与基于所谓“孔隙理论”的分析进行比较。该模型将测量到的变化与腹膜的物理改变联系起来。计算内容包括“等效孔径半径”、有效“膜面积”和扩散长度、未搅动透析液层的转运阻力以及透析液引流后的残余腹腔容积。临床表现包括经腹膜转运特征的个体差异、持续非卧床腹膜透析（CAPD）期间及腹膜炎时经腹膜转运随时间的变化、药物对转运特性的影响以及腹膜导管移位对超滤能力的影响。主要结论如下：在CAPD治疗期间，测量腹腔内溶质平衡以及尿素和肌酐的“传质面积系数”，在揭示腹膜膜变化方面不如测量超滤量敏感。所发现的差异和变化大多有综合的物理解释，但其中一种或多或少占主导地位。腹膜膜面积的变化似乎是CAPD期间及向腹膜透析液中添加硝普钠时经腹膜转运变化的最主要原因。腹膜炎期间的变化可用孔径和深度的变化来解释。个体差异可用“膜”面积和未搅动透析液流体阻力的差异来解释。高残余透析液量可能引发临床问题，在将导管置入腹腔时应予以考虑。
