CN102768653B - A kind of CRRT replacement liquid prescription counter - Google Patents
A kind of CRRT replacement liquid prescription counter Download PDFInfo
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- CN102768653B CN102768653B CN201210242428.8A CN201210242428A CN102768653B CN 102768653 B CN102768653 B CN 102768653B CN 201210242428 A CN201210242428 A CN 201210242428A CN 102768653 B CN102768653 B CN 102768653B
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Abstract
The invention discloses a kind of CRRT replacement liquid prescription counter, comprise housing, input block, output unit, internal element and power supply unit; Input block comprises is located at calculator keyboard on housing and information points out LCD lamp; Output unit comprises LCD display and USB communication interface unit; LCD display is embedded on housing, for showing operational data.The present invention fast, accurately can calculate each component ion concentration of CRRT displacement liquid, and can predict this displacement liquid over the course for the treatment of to the influence degree of each electrolyte of blood and soda acid, predicts the changing value of each electrolyte of blood per hour and soda acid simultaneously; For continuation blood purification clinical treatment provides reference, optimize the scheme for the treatment of, improve the effect for the treatment of.
Description
Technical field
The present invention relates to clinical continuation blood purification treatment technical field, particularly a kind of CRRT replacement liquid prescription counter.
Background technology
Continuation blood purification, being called for short CRRT, is the one of blood purification technology, conventional in intensive care unit especially.Utilize the principle of semi-permeable diaphragm, by convection action by patient body, small-molecule substance leaches, the macromolecular substances be not filtered across and blood in circuit system defeated time patient body, thus reach the object of blood purification together with displacement liquid.
This by convection current remove moisture and in, small-molecule substance is simulation detection of glomeruli filtration function, supplementing displacement liquid is then the heavy absorption function of analogue kidney tubule.
Current CRRT replacement liquid prescription has multiple, as Kaplan formula, Port formula, Nanjing General Hospital, Nanjing Military Area Command, PLA's formula (Ji Shi formula), the online production displacement liquid of citrate solution, consonance formula, on-line hemodialysis filter and other formulas etc.Because displacement liquid composition is more, ion concentration calculates complicated, clinical medical and nursing worker is each component ion concentration of less calculating each bag of displacement liquid in routine duties, and the empirical evaluation method of more employings, adjust the amount of each composition of displacement liquid according to blood samples of patients electrolyte and soda acid situation of change, often error is larger.The ion concentration of each composition of displacement liquid directly affects the change of blood samples of patients electrolyte and soda acid, determines the final effect for the treatment of.Therefore, exactly, calculate adjustment CRRT replacement liquid prescription in time rapidly and become requirement the most basic in continuation blood purification treatment.
The empirical evaluation method that the adjustment of current CRRT displacement liquid adopts, can not calculate the exact ionic concentration of each composition in time, can not predict the amplitude of blood samples of patients electrolyte and soda acid change; And often cause blood samples of patients electrolyte and soda acid significantly to change, in the treatments such as hypernatremia, hyponatremia, hypopotassaemia, complication is more especially, has a strong impact on patient's prognosis.
In sum, the configuration of current CRRT displacement liquid and the not enough major reason of adjustment aspect thereof are can not the ion concentration of the various composition of calculating each bag of displacement liquid promptly and accurately, this displacement liquid unpredictable, to the influence degree of electrolyte each in blood samples of patients and soda acid, can not predict its changing value per hour.
Summary of the invention
Goal of the invention of the present invention be for existing cannot the technical deficiency of accurate CRRT replacement liquid prescription concentration, a kind of CRRT replacement liquid prescription counter is provided.
For achieving the above object, the technical solution used in the present invention is:
A kind of CRRT replacement liquid prescription counter is provided, comprises housing, input block, output unit, internal element and power supply unit; Described input block comprises is located at calculator keyboard on housing and information points out LCD lamp; Described output unit comprises LCD display and USB communication interface unit; Described LCD display is embedded on housing, for showing operational data; Described USB communication interface unit is arranged on housing, for connecting host computer; Described internal element is arranged in housing, and this internal element comprises the internal arithmetic unit that main circuit trigger is located at CPU center-control on main circuit board and logical process, and described internal element is connected with described input block and described power supply unit respectively; And described internal element is connected with LCD display and USB communication interface unit respectively.
Preferably, described computer keyboard comprises on & off switch, numerical key, reset key, returns delete key, the transfer of storage key, cursor key, cursor, determines OK key and calculation keys.
Preferably, described information prompting LCD lamp comprises parameter LCD lamp, and for pointing out input CRRT to treat parameter, described CRRT treats parameter and comprises: volume of blood flow, displacement liquid speed, periphery fluid infusion composition and weight in patients.
Preferably, described information prompting LCD lamp also comprises the biochemical LCD lamp of vim and vigour, for pointing out the data vim and vigour machine biochemistry detection result of input.
Preferably, described information prompting LCD lamp also comprises the biochemical LCD lamp of vim and vigour, is vim and vigour machine biochemistry detection result for pointing out the data of input.
Preferably, described information prompting LCD lamp also comprises formula composition LCD lamp, and for pointing out the data of input to be CRRT formula and composition, described CRRT formula and composition comprise A liquid and B liquid;
Wherein, A liquid comprises (ml): 0.9% sodium chloride solution, sterile water for injection, 10% Klorvess Liquid, 5% calcium chloride solution, 25% Adlerika, 50% Adlerika, 10% sodium chloride solution, 10% calcium gluconate solution, 5% glucose solution, 50% glucose solution; And get rid of 5% sodium bicarbonate solution in A liquid;
B liquid comprises (ml/h): 5% sodium bicarbonate solution; And get rid of calcium chloride solution or calcium gluconate solution in B liquid.
Preferably, described information prompting LCD lamp also comprises periphery fluid infusion LCD lamp, is periphery fluid infusion and composition for pointing out the data of input.
Preferably, described information prompting LCD lamp also comprises formula ion concentration LCD lamp, is the ion concentration of various constituent in CRRT formula for pointing out the data of output.
Preferably, described information prompting LCD lamp also comprises prediction concentrations LCD lamp, is the prediction ion concentration of various constituent in CRRT formula in 1-6 hour of prediction for pointing out the data of output.
Preferably, described information prompting LCD lamp also comprises historical query LCD lamp, error analysis LCD lamp, returns LCD lamp, determines LCD lamp, stores LCD lamp, re-enters LCD lamp.
In addition, this auxiliary product has replacement liquid prescription automatically calculate Microsoft Excel, replacement liquid prescription quick checking three-dimensional table and can install the application software being applied to bedside blood filter, computer and mobile phone, according to the testing result of electrolyte each in blood samples of patients and soda acid, predict the impact of this displacement liquid on each electrolyte of blood and soda acid, predict its changing value hourly.
The present invention, relative to prior art, has following beneficial effect: the present invention fast, in time, accurately calculate the ion concentration of each bag of each composition of displacement liquid, can reduce the trouble that written calculation brings.The present invention can treat the adjustment of parameter according to CRRT, the formula of synchronous adjustment CRRT displacement liquid; And analyze and biochemical eight according to patient blood gas in time, personalization adjusts CRRT replacement liquid prescription exactly, and minimizing electrolyte balance and soda acid significantly change, and reduces complication.The present invention can predict each electrolyte of blood and soda acid changing value hourly, improves quality of medical care, ensures the life security of patient to greatest extent.The present invention can predict that periphery amount infused, periphery fluid infusion velocity, patient's discrepancy amount and CRRT ultrafiltration volume are to each electrolyte of blood and soda acid changing value hourly, for the management of critical patient body fluid provides foundation.
Accompanying drawing explanation
Fig. 1 is the structural drawing of CRRT replacement liquid prescription counter of the present invention;
Fig. 2 is Microsoft Excel figure matching used with CRRT replacement liquid prescription counter;
Fig. 3 checks three-dimensional table trrellis diagram quickly with the matching used replacement liquid prescription of CRRT replacement liquid prescription counter;
Fig. 4, for when displacement liquid speed is 3000ml/h, water for injection 1000ml, 5% sodium bicarbonate 140ml/h, checks the schematic diagram of na concn and the bicarbonate concentration found three-dimensional table quickly from replacement liquid prescription;
Fig. 5, for when displacement liquid speed is 2000ml/h, water for injection 1000ml, 5% sodium bicarbonate 140ml/h, checks the schematic diagram of na concn and the bicarbonate concentration found three-dimensional table quickly from replacement liquid prescription;
Fig. 6, for as displacement liquid speed 3000ml/h, 5% calcium chloride solution 23ml, water for injection 1000ml, checks the schematic diagram of calcium concentration and the bicarbonate concentration found three-dimensional table quickly from replacement liquid prescription;
Fig. 7, for as displacement liquid speed 3000ml/h, 5% calcium chloride solution 23ml, water for injection 1000ml, checks the schematic diagram of calcium concentration and the bicarbonate concentration found three-dimensional table quickly from replacement liquid prescription;
Fig. 8 is for working as displacement liquid speed 3000ml/h, 10% Klorvess Liquid 12ml, and water for injection 1000ml, 5% sodium bicarbonate 140ml/h constantly, check the schematic diagram of potassium concn and the bicarbonate concentration found three-dimensional table quickly from replacement liquid prescription;
Fig. 9 is for working as displacement liquid speed 3000ml/h, 10% Klorvess Liquid 12ml, and water for injection 1000ml, 5% sodium bicarbonate 140ml/h constantly, check the schematic diagram of potassium concn and the bicarbonate concentration found three-dimensional table quickly from replacement liquid prescription;
Figure 10 is the schematic diagram drawing corresponding vim and vigour and biochemistry detection result parameter according to Microsoft Excel;
Figure 11 is the schematic diagram determining sodium bicarbonate solution input speed in periphery 5% according to Microsoft Excel;
Figure 12 is the schematic diagram according to the Microsoft Excel determination injection water yield;
Figure 13 is the schematic diagram determining 5% calcium carbonate soln consumption according to Microsoft Excel;
Figure 14 is the schematic diagram determining 10% potassium chloride dosage according to Microsoft Excel.
Embodiment
Be described in further detail goal of the invention of the present invention below in conjunction with the drawings and specific embodiments, embodiment can not repeat one by one at this, but therefore embodiments of the present invention are not defined in following examples.Unless stated otherwise, the present invention adopt material and job operation be the art conventional material and job operation.
As shown in Figure 1, a kind of CRRT replacement liquid prescription counter, comprises housing 2, input block, output unit, internal element and power supply unit; Described input block comprises the calculator keyboard 3 be located on housing and points out LCD lamp with information; Described output unit comprises LCD display 1 and USB communication interface unit; Described LCD display 1 is embedded on housing 2, for showing operational data; Described USB communication interface unit is arranged on housing 2, for connecting host computer; Described internal element is arranged in housing 2, and this internal element comprises the internal arithmetic unit that main circuit trigger is located at CPU center-control on main circuit board and logical process, and described internal element is connected with described input block and described power supply unit respectively; And described internal element is connected with LCD display and USB communication interface unit respectively.
Computer keyboard 3 comprises on & off switch, numerical key, reset key, returns delete key, the transfer of storage key, cursor key, cursor, determine OK key and calculation keys.
Information prompting LCD lamp comprises parameter LCD lamp, and for pointing out input CRRT to treat parameter, described CRRT treats parameter and comprises: volume of blood flow, displacement liquid speed, periphery fluid infusion composition and weight in patients.
Information prompting LCD lamp also comprises the biochemical LCD lamp of vim and vigour, for pointing out the data vim and vigour machine biochemistry detection result of input.
Information prompting LCD lamp also comprises the biochemical LCD lamp of vim and vigour, is vim and vigour machine biochemistry detection result for pointing out the data of input.
Information prompting LCD lamp also comprises formula composition LCD lamp, is CRRT formula and composition for pointing out the data of input; Described CRRT formula and composition comprise A liquid and B liquid;
Wherein, A liquid comprises (ml): 0.9% sodium chloride solution, sterile water for injection, 10% Klorvess Liquid, 5% calcium chloride solution, 25% Adlerika, 50% Adlerika, 10% sodium chloride solution, 10% calcium gluconate solution, 5% glucose solution, 50% glucose solution; And get rid of 5% sodium bicarbonate solution in A liquid;
B liquid comprises (ml/h): 5% sodium bicarbonate solution; And get rid of calcium chloride solution or calcium gluconate solution in B liquid.
Information prompting LCD lamp also comprises periphery fluid infusion LCD lamp, is periphery fluid infusion and composition for pointing out the data of input.
Information prompting LCD lamp also comprises formula ion concentration LCD lamp, is the ion concentration of various constituent in CRRT formula for pointing out the data of output.
Information prompting LCD lamp also comprises prediction concentrations LCD lamp, is the prediction ion concentration of various constituent in CRRT formula in 1-6 hour of prediction for pointing out the data of output.
Information prompting LCD lamp also comprises historical query LCD lamp, error analysis LCD lamp, returns LCD lamp, determines LCD lamp, stores LCD lamp, re-enters LCD lamp.
Calculate the molecular mass of material used during ion concentration: sodium chloride: 58.44; Sodium bicarbonate: 84.01; Glucose: 198.17; Calcium gluconate: 448.4; Magnesium sulfate: 246.48; Lime chloride: 147.02.(Data Source: blood purification displacement liquid concentration is calculated and the query of expression way. fourth is supported the army, Wang Xiujuan. Chinese blood purification .2005, (5) and medicine instructions)
Used computing formula:
Displacement liquid therapeutic dose (ml/h.kg)=displacement liquid speed (ml/h)/weight in patients (kg);
Formula HCO
3 -ion concentration (mmol/L)=0.05 × 5% sodium bicarbonate solution speed (ml/h) ÷ 84.01 × 1000 ÷ (displacement liquid speed (ml/h)+5% sodium bicarbonate solution speed (ml/h)) × 1000;
Formula Na < sup TranNum = "141" > + < / sup > ion concentration (tendency for L) = ((0.009 x 0.9% sodium chloride solution (ml) + 0.1 x 10% sodium chloride solution (ml)) present 58.44 x velocity (ml/h) present fluid replacement (0.9% sodium chloride solution (ml) + sterile injection water quantity (ml) + 5% calcium chloride solution (ml) + 25% magnesium sulfate solution (ml) + 50% magnesium sulfate solution (ml) + 10% KCL solution (ml) + 10% calcium gluconate solution (ml) + 5% glucose solution (ml) + 10% sodium chloride solution (ml) + 50% glucose solution (ml)) x 1000000 + 0.05 x 5% sodium bicarbonate solution speed (ml/h) present 84.01 x 1000000) present (displacement fluid speed rate (ml/h) + 5% sodium bicarbonate solution (ml/h));
Formula Ca < sup TranNum = "143" > 2 + < / sup > ion concentration (tendency for L) = (0.05 x 5% calcium chloride solution (ml) present 147.02 + 0.1 x 10% calcium gluconate solution (ml) present) 448.4 x 1000000 x velocity (ml/h) present fluid replacement (0.9% sodium chloride solution (ml) + sterile injection water quantity (ml) + 5% calcium chloride solution (ml) + 25% magnesium sulfate solution (ml) + 50% magnesium sulfate solution (ml) + 10% KCL solution (ml) + 10% calcium gluconate solution (ml) + 5% glucose solution (ml) + 10% sodium chloride solution (ml) + 50% glucose solution (ml)) present (displacement fluid speed rate (ml/h) + 5% sodium bicarbonate solution (ml/h));
Formula K
+ion concentration (mmol/L)=0.1 × 10% Klorvess Liquid amount (ml) ÷ 74.55 × 1000000 × displacement liquid speed (ml/h) ÷ (0.9% sodium chloride solution amount (ml)+sterile water for injection amount (ml)+5% calcium chloride solution amount (ml)+25% Adlerika amount (ml)+50% Adlerika amount (ml)+10% Klorvess Liquid amount (ml)+10% calcium gluconate solution amount (ml)+5% glucose solution amount (ml)+10% sodium chloride solution amount (ml)+50% glucose solution amount (ml)) ÷ (displacement liquid speed (ml/h)+5% sodium bicarbonate solution speed (ml/h));
Formula Mg < sup TranNum = "147" > 2 + < / sup > ion concentration (tendency for L) = (0.25 x 25% magnesium sulfate solution (ml) + 0.5 x 50% magnesium sulfate solution (ml)) present 246.48 x 1000000 x velocity (ml/h) present fluid replacement (0.9% sodium chloride solution (ml) + sterile injection water quantity (ml) + 5% calcium chloride solution (ml) + 25% magnesium sulfate solution (ml) + 50% magnesium sulfate solution (ml) + 10% KCL solution (ml) + 10% calcium gluconate solution (ml) + 5% glucose solution (ml) + 10% sodium chloride solution (ml) + 50% glucose solution (ml)) present (displacement fluid speed rate (ml/h) + 5% sodium bicarbonate solution (ml/h));
Formula GLU ion concentration (tendency for L) = (0.5 x 50% glucose solution (ml) present 198.17 + 198.17 x 10% calcium gluconate solution (ml) present 448.4 * 2 + 0.05 * 5% glucose solution (ml) present 198.17) x 1000000 x velocity (ml/h) present fluid replacement (0.9% sodium chloride solution (ml) + sterile injection water quantity (ml) + 5% calcium chloride solution (ml) + 25% magnesium sulfate solution (ml) + 50% magnesium sulfate solution (ml) + 10% KCL solution (ml) + 10% calcium gluconate solution (ml) + 5% glucose solution (ml) + 10% sodium chloride solution (ml) + 50% glucose solution (ml)) present (displacement fluid speed rate (ml/h) + 5% sodium bicarbonate solution (ml/h));
Formula Cl
-ion concentration (mmol/L)=(formula Na
+ion concentration (mmol/L)-formula HCO
3 -ion concentration (mmol/L)+formula K
+ion concentration (mmol/L)+formula Ca
2+ion concentration (mmol/L) ÷ 2 × 3+ fills a prescription Mg
2+ion concentration (mmol/L)) × 2+ formula GLU ion concentration (mmol/L));
Formula HCO
3 -ion per hour enter amount (mmol/h)=formula HCO
3 -ion concentration (mmol/L) × (displacement liquid speed (ml/h) ÷ 1000;
Formula Na
+ion per hour enter amount (mmol/h)=formula Na
+ion concentration (mmol/L) × displacement liquid speed (ml/h) ÷ 1000;
Formula Ca
2+ion per hour enter amount (mmol/h)=formula Ca
2+ion concentration (mmol/L) × displacement liquid speed (ml/h) ÷ 1000;
Formula K
+ion per hour enter amount (mmol/h)=formula K
+ion concentration (mmol/L) × displacement liquid speed (ml/h) ÷ 1000;
Formula Mg
2+ion per hour enter amount (mmol/h)=formula Mg
2+ion concentration (mmol/L) × displacement liquid speed (ml/h) ÷ 1000;
Formula GLU ion per hour enter amount (mmol/h)=formula GLU ion concentration (mmol/L) × displacement liquid speed (ml/h) ÷ 1000;
Formula Cl
-ion per hour enter amount (mmol/h)=formula Cl
-ion concentration (mmol/L) × displacement liquid speed (ml/h) ÷ 1000;
Plasma osmolarity (mOsm/kgH
2o)=(concentration of serum sodium (mmol/h)+blood Ca
2+ion concentration (mmol/L) × 3/2+ blood K
+ion concentration (mmol/L)) × 2+ blood GLU ion concentration (mmol/L)+blood BUN(mmol/L);
A+B total osmotic pressure (mOsm/kgH
2o)=(formula Na
+ion concentration (mmol/L)+formula Ca
2+ion concentration (mmol/L)+formula K
+ion concentration (mmol/L)+formula Mg
2+ion concentration (mmol/L)) × 2+ formula GLU ion concentration (mmol/L);
A liquid osmotic pressure (mOsm/kgH
2o)=(formula Na
+ion concentration (mmol/L)+formula Ca
2+ion concentration (mmol/L)+formula K
+ion concentration (mmol/L)+formula Mg
2+ion concentration (mmol/L)-formula HCO
3 -ion concentration (mmol/L)) × 2+ formula GLU ion concentration (mmol/L);
Estimate ion concentration changing value per hour=(blood ion concentration (mmol/L) × 60 × volume of blood flow (ml/h) ÷ 1000+ formula ion concentration (mmol/L) × displacement liquid speed (ml/h) ÷ 1000) ÷ (60 × volume of blood flow (ml/h) ÷ 1000+ displacement liquid speed (ml/h) ÷ 1000);
Estimate periphery per hour fluid infusion impact=(blood ion concentration (mmol/L) × 60 × volume of blood flow (ml/h) ÷ 1000+ formula ion concentration (mmol/L) × displacement liquid speed (ml/h) ÷ 1000+ periphery fluid infusion ion concentration (mmol/L) × periphery fluid infusion velocity (ml/h) ÷ 1000) ÷ (60 × volume of blood flow (ml/h) ÷ 1000+ displacement liquid speed (ml/h) ÷ 1000+ periphery fluid infusion velocity (ml/h) ÷ 1000) on blood ion concentration;
AG (AG)=blood Na
+concentration (mmol/h)-blood HCO
3 -ion concentration (mmol/L)-blood Cl
-ion concentration (mmol/L).
This auxiliary product has replacement liquid prescription automatically calculate Microsoft Excel, replacement liquid prescription quick checking three-dimensional table and can install the application software being applied to bedside blood filter, computer and mobile phone, according to the testing result of electrolyte each in blood samples of patients and soda acid, predict the impact of this displacement liquid on each electrolyte of blood and soda acid, predict its changing value hourly.
The application of replacement liquid prescription quick checking three-dimensional table:
1. increased progressively with 100 by 1000ml/h to 3500ml/h(according to displacement liquid speed) time, along with the various combination of 5% sodium bicarbonate solution speed (ml/h) and sterile water for injection amount (ml), formula Na
+the situation of change of ion concentration (mmol/L).For 3000ml/h and 2000ml/h:
As shown in Figure 4, as displacement liquid speed 3000ml/h, water for injection 1000ml, during 5% sodium bicarbonate 140ml/h, tables look-up and obtains na concn 136.9mmol/L, bicarbonate concentration 26.54mmol/L.
As shown in Figure 5, as displacement liquid speed 2000ml/h, water for injection 1000ml, during 5% sodium bicarbonate 140ml/h, tables look-up and obtains na concn 146.9mmol/L, bicarbonate concentration 38.94mmol/L.
2. increased progressively with 100 by 1000ml/h to 3500ml/h(according to displacement liquid speed), 5% calcium chloride solution amount is increased progressively with 1ml by 15ml to 40ml() time, along with the various combination of 5% sodium bicarbonate solution speed (ml/h) and sterile water for injection amount (ml), the situation of change of formula Ca2+ ion concentration (mmol/L).For 3000ml/h and 2000ml/h:
As shown in Figure 6, as displacement liquid speed 3000ml/h, 5% calcium chloride solution 23ml, water for injection 1000ml, during 5% sodium bicarbonate 140ml/h, table look-up and obtain calcium ion concentration 2.46mmol/L, bicarbonate ion concentration 26.54mmol/L.
As shown in Figure 7, as displacement liquid speed 2000ml/h, 5% calcium chloride solution 23ml, water for injection 1000ml, during 5% sodium bicarbonate 140ml/h, table look-up and obtain calcium ion concentration 2.407mmol/L, bicarbonate concentration 38.94mmol/L.
3. increased progressively with 100 by 1000ml/h to 3500ml/h(according to displacement liquid speed), 10% Klorvess Liquid amount is increased progressively with 1ml by 1ml to 30ml() time, along with the various combination of 5% sodium bicarbonate solution speed (ml/h) and sterile water for injection amount (ml), the situation of change of formula K+ ion concentration (mmol/L).For 3000ml/h and 2000ml/h:
As shown in Figure 8, as displacement liquid speed 3000ml/h, 10% Klorvess Liquid 12ml, water for injection 1000ml, during 5% sodium bicarbonate 140ml/h, table look-up and obtain potassium concentration mmol/L, bicarbonate ion concentration 26.54mmol/L.
As shown in Figure 9, as displacement liquid speed 2000ml/h, 10% Klorvess Liquid 12ml, water for injection 1000ml, during 5% sodium bicarbonate 140ml/h, table look-up and obtain potassium concentration mmol/L, bicarbonate concentration 38.94mmol/L.
Form is applied:
Weight in patients 55kg, vim and vigour chemical result: PH:7.32PCO
2: 44.4mmHgBEb:-3.6HCO
3 -: 20.8mmol/hHCT:35LAC:0.4mmol/hHGb119g/LNA
+: 134mmol/hK
+: 5.18mmol/hCa
2 +2.24mmol/hCL
-: 95mmol/hBUN:25.6mmol/hCr:379umol/hGLU10.3mmol/h
CRRT volume of blood flow 200ml/min, treatment 6h, dehydration 1200ml, doctor's advice requires displacement liquid metering 45ml/h.kg, and thoroughly, electrolyte adjusts to normal range.
The first step: determine displacement liquid speed;
Weight in patients, CRRT volume of blood flow are input to treatment parameter correspondence position, and when changing displacement liquid speed, displacement liquid dosage calculates automatically, so when displacement liquid speed is 2500ml/h, replaces dosage closest to doctor's advice 45ml/h.kg, as shown in Figure 10.
Second step: input vim and vigour chemical result;
3rd step: the replacement liquid prescription determining every bag, physiological saline 3000ml;
1. according to HCO in vim and vigour
3 -ion concentration (mmol/L) adjusts periphery 5% sodium bicarbonate solution input speed (ml/h).
When periphery 5% sodium bicarbonate solution input speed is 120ml/h, HCO in formula
3 -ion concentration 27.26mmol/L and 6 hours blood HCO
3 -ion concentration is estimated to become 25.28HCO
3 -mmol/L meets doctor's advice requirement, as shown in figure 11.
2. according to blood Na in biochemistry
+concentration (mmol/h) adjusts the amount (ml) of water for injection.When water for injection is 800ml, formula blood Na
+concentration 142.35mmol/h, and 6 hours blood Na
+concentration estimates that becoming 139.8mmol/h meets doctor's advice requirement.When patient blood glucose is low, 5% glucose solution, 50% glucose solution can be added to increase sugared concentration in formula, prevent dialysis from increasing the weight of hypoglycemia mass formed by blood stasis, as shown in figure 12.
3. according to Ca in biochemistry
2+ion concentration (mmol/L) determines 5% calcium chloride solution or 10% calcium gluconate solution consumption (ml) in formula.When 5% calcium chloride solution is 23ml, formula Ca
2+ion concentration is 2.22mmol/L, and 6 hours blood Ca
2+ion concentration estimates that becoming 2.22mmol/L meets doctor's advice requirement.When patient blood glucose is low or occur hyperchloremia, available 10% calcium gluconate solution replaces 5% calcium chloride solution, as shown in figure 13.
4. according to K in biochemistry
+ion concentration (mmol/L), GLU ion concentration (mmol/L) determine formula 10% Klorvess Liquid, 10% calcium gluconate solution, 5% glucose solution, 50% glucose solution consumption (ml).Method is the same.
5. when periphery amount infused is comparatively large or when having potassium, calcium, sugar, sodium composition to input, correct in units of per hour, estimate that periphery fluid infusion is to blood HCO
3 -ion concentration (mmol/L), Na
+concentration (mmol/h), Ca
2+ion concentration (mmol/L), K
+the impact of ion concentration (mmol/L), GLU ion concentration (mmol/L).CRRT dehydrating amount per hour and urine volume also have impact to blood soda acid and each change of electrolyte.When periphery supplementary physiological saline 100ml per hour, 5% glucose solution 100ml, CRRT dewater 200ml, urine volume 10ml, wherein 10% potassium chloride 5ml is mended in periphery, as shown in figure 14.
Above-described embodiment is only preferred embodiment of the present invention, is not used for limiting practical range of the present invention.Namely all equalizations done according to content of the present invention change and modify, all by the claims in the present invention scope required for protection is contained.
Claims (1)
1. a CRRT replacement liquid prescription counter, comprises housing, input block, output unit, internal element and power supply unit; It is characterized in that: described input block comprises is located at calculator keyboard on housing and information points out LCD lamp; Described output unit comprises LCD display and USB communication interface unit; Described LCD display is embedded on housing, for showing operational data; Described USB communication interface unit is arranged on housing, for connecting host computer; Described internal element is arranged in housing, and this internal element comprises the internal arithmetic unit that main circuit trigger is located at CPU center-control on main circuit board and logical process, and described internal element is connected with described input block and described power supply unit respectively; And described internal element is connected with LCD display and USB communication interface unit respectively; Described calculator keyboard comprises on & off switch, numerical key, reset key, returns delete key, the transfer of storage key, cursor key, cursor, determine OK key and calculation keys; Described information prompting LCD lamp comprises parameter LCD lamp, and for pointing out input CRRT to treat parameter, described CRRT treats parameter and comprises: volume of blood flow, displacement liquid speed, periphery fluid infusion composition and weight in patients; Described information prompting LCD lamp also comprises the biochemical LCD lamp of vim and vigour, for pointing out the data vim and vigour machine biochemistry detection result of input; Described information prompting LCD lamp also comprises the biochemical LCD lamp of vim and vigour, is vim and vigour machine biochemistry detection result for pointing out the data of input; Described information prompting LCD lamp also comprises formula composition LCD lamp, is CRRT formula and composition for pointing out the data of input; Described CRRT formula and composition comprise A liquid and B liquid; Wherein, A liquid comprises: 0.9% sodium chloride solution, sterile water for injection, 10% Klorvess Liquid, 5% calcium chloride solution, 25% Adlerika, 50% Adlerika, 10% sodium chloride solution, 10% calcium gluconate solution, 5% glucose solution, 50% glucose solution; And get rid of 5% sodium bicarbonate solution in A liquid; B liquid comprises: 5% sodium bicarbonate solution; And get rid of calcium chloride solution or calcium gluconate solution in B liquid; Described information prompting LCD lamp also comprises periphery fluid infusion LCD lamp, is periphery fluid infusion and composition for pointing out the data of input; Described information prompting LCD lamp also comprises formula ion concentration LCD lamp, is the ion concentration of various constituent in CRRT formula for pointing out the data of output; Described information prompting LCD lamp also comprises prediction concentrations LCD lamp, is the prediction ion concentration of various constituent in CRRT formula in 1-6 hour of prediction for pointing out the data of output; Described information prompting LCD lamp also comprises historical query LCD lamp, error analysis LCD lamp, returns LCD lamp, determines LCD lamp, stores LCD lamp and re-enter LCD lamp.
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|---|---|---|---|---|
| CN206518724U (en) * | 2016-08-30 | 2017-09-26 | 上海交通大学医学院附属第九人民医院 | Citrate anticoagulation device |
| CN106975114A (en) * | 2017-03-01 | 2017-07-25 | 李振翮 | A kind of CRRT replacement liquid prescriptions computing device |
| CN106964009B (en) * | 2017-04-05 | 2020-01-03 | 广东省人民医院(广东省医学科学院) | Preparation and adjustment method of CRRT (continuous reverse transcription) local citric acid anticoagulation displacement solution |
| CN113012785A (en) * | 2021-04-07 | 2021-06-22 | 闵东 | Liquid configuration device, system and method and related components |
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| CN2484595Y (en) * | 2001-06-04 | 2002-04-03 | 杭州宏软计算机通信技术有限公司 | Special insurance cauculator |
| US8372025B2 (en) * | 2005-09-22 | 2013-02-12 | Baxter International Inc. | Automation and optimization of CRRT treatment using regional citrate anticoagulation |
| CN2893788Y (en) * | 2006-01-23 | 2007-04-25 | 杜庭琼 | Computing device with checking calculating and automatic recomputing function |
| JP5341906B2 (en) * | 2008-10-17 | 2013-11-13 | シスメックス株式会社 | Biological monitoring device |
| US8298167B2 (en) * | 2008-11-03 | 2012-10-30 | B. Braun Avitum Ag | Modular hemofiltration apparatus with interactive operator instructions and control system |
| EP2459269B1 (en) * | 2009-07-27 | 2019-05-01 | B. Braun Avitum AG | Modular hemofiltration apparatus for carrying out neonatal and pediatric crrt |
| CN102053943B (en) * | 2010-12-01 | 2012-05-23 | 中国检验检疫科学研究院 | Calculator for calculating dosage of fumigation agentia |
| CN202736040U (en) * | 2012-07-12 | 2013-02-13 | 广东省人民医院 | CRRT displacement fluid formula calculator |
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