CN110064086A - Ultrafiltration monitoring method in a kind of blood dialysis - Google Patents
Ultrafiltration monitoring method in a kind of blood dialysis Download PDFInfo
- Publication number
- CN110064086A CN110064086A CN201910319619.1A CN201910319619A CN110064086A CN 110064086 A CN110064086 A CN 110064086A CN 201910319619 A CN201910319619 A CN 201910319619A CN 110064086 A CN110064086 A CN 110064086A
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- China
- Prior art keywords
- ultrafiltration
- dialysis
- hematocrit
- patient
- blood
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Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
- A61M1/14—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
- A61M1/34—Filtering material out of the blood by passing it through a membrane, i.e. hemofiltration or diafiltration
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
- A61M1/34—Filtering material out of the blood by passing it through a membrane, i.e. hemofiltration or diafiltration
- A61M1/3403—Regulation parameters
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M2230/00—Measuring parameters of the user
- A61M2230/20—Blood composition characteristics
- A61M2230/207—Blood composition characteristics hematocrit
Abstract
The invention discloses the present invention relates to haemodialysis fields, more particularly to ultrafiltration monitoring method in a kind of blood dialysis.Comprising: which into database, the current weight data of typing patient and detection calculate hematocrit before dialysing；The history dialysis data of patient are extracted from database；Weight after the current weight of patient and last dialysis is made the difference, and the weight of patient's last time Before and after dialysis is made the difference, if the difference of two differences is located in difference domain value range, the set hematocrit thresholding of last time dialysis is then recalled, start to carry out haemodialysis and real-time monitoring is carried out to the hematocrit of patient；When the hematocrit value that real-time detection arrives reaches set hematocrit thresholding, lower ultrafiltration volume, until hematocrit is lower than thresholding.The present invention can control the ultrafiltration in blood dialysis by way of intellectual monitoring, to realize intelligentized control method dry weight.
Description
Technical field
The present invention relates to haemodialysis fields, more particularly to ultrafiltration monitoring method in a kind of blood dialysis.
Background technique
Haemodialysis (HD) is one of acute or chronic renal failure kidneys of patients Replacement Therapy.It is by by internal blood
Liquid is drained in vitro, through one by the dialyzer that is formed without several hollow fibres, blood electrolysis similar with concentration containing body
Matter solution (dialyzate) carries out mass exchange inside and outside hollow fibre one by one, through disperse, ultrafiltration, absorption and convective principles,
It removes intracorporal metabolic waste, maintain electrolyte and acid-base balance；Moisture excessive in vivo is removed simultaneously, and will be by purification
The whole process of blood recovery is known as haemodialysis.
That is, the task of dialysis treatment first is that moisture content extra in removing machine body is reached with keeping capacitance balance
Ideal weight, that is, " dry weight " often said.
In the prior art, doctor generally estimates dry weight according to the clinical manifestation of dialysis patient, general saturating by judgement
Whether analysis patient has the progress such as lung's moist rales, oedema, changes of weight, expiratory dyspnea.The symptom and sign of fluid overload has water
It is swollen (eyelid, lower limb, it is serious when be found in whole body), hydrothorax, distension of jugular vein, hepatomegaly etc.；And low capacity state is then shown as
Thirsty, mucocutaneous, dry elasticity attenuation, eye socket recess etc..If patient does not have above-mentioned performance, it is believed that flat in body fluid
Weighing apparatus state.The method is affected by evaluator's subjective factor, and does not have specific sign.It should be noted that only working as
Water l oad significantly increases rear patient and just shows as oedema, especially patients undergoing peritoneal dialysis.
Other than the basic methods of above-mentioned clinical manifestation, ambition ratio (whether less than 0.5), the echocardiogram (heart are often combined
Dirty size variation) it assesses whether to have reached dry weight.
Based on above-mentioned stem body reevaluating, common simple and easy method be the weight after last normal dialysis is considered as roughly it is dry
Dehydrating amount when dialysing next time is considered as weight dialyse next time before and subtracts dry weight, or carries out letter on this basis by weight
Single correction.
It is above-mentioned be relatively conventional clinical assessment method, such method sensibility is poor, and do not consider patient disease, diet,
Nutrition condition etc. influences, and patient compliance's degree is difficult to ensure, and then increases difficulty and uncertainty for the determination of dry weight.
Hypotension is one of main complication in blood dialysis, thus the reason of low blood pressure first is that thoroughly
The decline of effective circulating blood volume caused by being dehydrated during analysis.
Summary of the invention
The present invention in order to overcome at least one of the drawbacks of the prior art described above (deficiency), provides a kind of blood dialysis
Middle ultrafiltration monitoring method can control the ultrafiltration in blood dialysis by way of intellectual monitoring, to realize intelligent control
Dry weight processed.
In order to solve the above technical problems, technical scheme is as follows:
Ultrafiltration monitoring method in a kind of blood dialysis, comprising:
Into database, the current weight data of typing patient and detection calculate hematocrit before dialysis；
The history dialysis data of patient are extracted from database；
Weight after the current weight of patient and last dialysis is made the difference, and by the body of patient's last time Before and after dialysis
Difference is reformed, if the difference of two differences is located in difference domain value range, recalls the set hematocrit domain of last time dialysis
Value starts to carry out haemodialysis and carries out real-time monitoring to the hematocrit of patient；
When the hematocrit value that real-time detection arrives reaches set hematocrit thresholding, lower ultrafiltration volume, directly
It is lower than thresholding to hematocrit.
In above scheme, the history dialysis data of patient are recorded in database, including patient per's Before and after dialysis
The hematocrit thresholding of set mistake when weight data, hematocrit value and ultrafiltration.
In above scheme, last time dialysis refers to carrying out based on set hematocrit thresholding when dialysis detects simultaneously
Do not occur the last dialysis of malaise symptoms.
In above scheme, the method is also monitored the blood pressure of patient, when the blood pressure for real-time monitoring patient deviates
Ultrafiltration volume or pause ultrafiltration are reduced when normal range (NR).
In above scheme, the method also includes danger button operating procedures, when patient malaise symptoms occurs by lower button
When, button signal is received, lowers ultrafiltration volume or suspends ultrafiltration and issue alarm signal.
In above scheme, the method also includes: the ultrafiltration volume governing stage of setting and time correlation, lowering ultrafiltration volume is root
It is carried out according to ultrafiltration volume governing stage, after ultrafiltration volume is adjusted there is the real value of hematocrit in certain time relevant to governing stage
The ultrafiltration volume is kept when reduction, after ultrafiltration volume is adjusted there is the real value of hematocrit in certain time relevant to governing stage
Do not change or continue then to continue to adjust to next stage ultrafiltration volume when rising.
In above scheme, the adjusting number of ultrafiltration volume is no more than three times, more than then sending a warning message and suspend super three times
Filter.
Compared with the existing technology, the invention has the advantages that with effective effect:
It is now recognized that it is horizontal closer to the blood volume of dialysis patient to continue blood volume determination, and blood volume changes and red blood cell
Hematocrit is inversely proportional.Measuring velocity of blood flow by ultrasound can detecte the variation of hematocrit, pass through the monitoring of hematocrit
The variation that blood volume in patients in dialysis procedure can intuitively be understood helps avoid the generation of hypotension and is conducive to
Evaluate the dry weight of patient.In the present invention, initial hematocrit thresholding is determined using the dialysis data of history, according to
The thresholding is monitored the ultrafiltration in blood dialysis, can provide accurate auxiliary characteristics for medical staff, monitors
In the process when real-time hematocrit occurs higher than set hematocrit thresholding, continued by lowering ultrafiltration volume
Observe dialysis procedure.Patient itself is chosen when due to hematocrit thresholding the last time the dialysis of malaise symptoms does not occur
Hematocrit thresholding set by journey, it is ensured that the accuracy of selected thresholding.
Detailed description of the invention
Fig. 1 is the flow chart of ultrafiltration monitoring method in a kind of blood dialysis of the present invention.
Specific embodiment
The attached figures are only used for illustrative purposes and cannot be understood as limitating the patent；
In order to better illustrate this embodiment, the certain components of attached drawing have omission, zoom in or out, and do not represent actual product
Size；
To those skilled in the art, it is to be understood that certain known features and its explanation, which may be omitted, in attached drawing
's.
In the description of the present invention, it is to be understood that, in addition, term " first ", " second " are used for description purposes only, and
It cannot be understood as indicating or implying relative importance or imply the quantity of indicated technical characteristic." first " that limits as a result,
One or more of the features can be expressed or be implicitly included to the feature of " second ".In the description of the present invention, unless separately
It is described, the meaning of " plurality " is two or more.
In the description of the present invention, it should be noted that unless otherwise clearly defined and limited, term " installation " " connects
Connect " it shall be understood in a broad sense, for example, it may be being fixedly connected, it may be a detachable connection, or be integrally connected；It can be machine
Tool connection, is also possible to be electrically connected；It can be directly connected, be also possible to be indirectly connected with by intermediary, it may be said that two
Connection inside element.For the ordinary skill in the art, above-mentioned term can be understood in the present invention with concrete condition
Concrete meaning.
The following further describes the technical solution of the present invention with reference to the accompanying drawings and examples.
Embodiment 1
As shown in Figure 1, the specific steps of ultrafiltration monitoring method include: in a kind of blood dialysis of the present embodiment
S101. into database, the current weight data of typing patient and detection calculate red blood cell pressure before dialysis
Product；
S102. the history dialysis data of patient are extracted from database；The history of patient is recorded in database
Dialyse data, weight data, hematocrit value including patient per's Before and after dialysis and ultrafiltration when set mistake it is red thin
Born of the same parents' hematocrit thresholding further includes the disease etc. of the discomfort generated in dialysis procedure；
S103. the weight after the current weight of patient and last dialysis is made the difference, and before patient's last time is dialysed
Weight afterwards makes the difference, if the difference of two differences is located in difference domain value range, recalls the set red blood cell of last time dialysis
Hematocrit thresholding starts to carry out haemodialysis and carries out real-time monitoring to the hematocrit of patient；Wherein, in order to select subject to more
True hematocrit codomain value, last dialysis of the present invention refer to based on set hematocrit thresholding into
Do not occur the last dialysis of malaise symptoms when row dialysis monitoring.The dialysis procedure for malaise symptoms occur is possible as
Hematocrit field value set is inappropriate to cause monitoring process to fail caused by finding in time, therefore, newest primary setting
Selection does not occur the hematocrit thresholding of the last dialysis of the disease of discomfort when hematocrit thresholding, so that monitoring process
It is more safe and safe.In addition, in blood dialysis dehydrating amount and patient's last time dialyse after to next time dialyse before
Weight gain has great relationship, and dialysis patient requires the increase of strict control weight between dialysis twice；For this purpose, setting
Also need to consider that weight gain situation of the patient between dialysis twice, the present invention are red thin in setting when determining hematocrit thresholding
The weight gain situation of patient is compared in advance when born of the same parents' hematocrit thresholding, the weight gain of dialysis patient it is upper once dialyse it is dry
In weight range, then hematocrit thresholding when can be dialysed using the last time is monitored, it is ensured that hematocrit domain
It is worth the accuracy of setting, it is ensured that the safety of monitoring process.
S104. when the hematocrit value that real-time detection arrives reaches set hematocrit thresholding, lower ultrafiltration
Amount, until hematocrit is lower than thresholding.Theoretically, in dialysis procedure blood volume decline less patient's weight be higher than it is true dry
Weight, blood volume variation are inversely proportional with hematocrit.The prison of dialysis procedure ultrafiltration is carried out by setting hematocrit thresholding
When survey, when the hematocrit value that real-time monitors increases, indicate that blood volume is declining, the true weight of patient is not yet at this time
The level for reaching dry weight, can be continuously monitored dialysis procedure, when the real value of hematocrit rises to hematocrit domain
When value, show that blood volume drops to suitable level, the true weight of patient at this time can pass through at this time closer to dry weight
Ultrafiltration volume is reduced to continue the process of observation ultrafiltration.In actual mechanical process, need to be arranged and the adjusting of the ultrafiltration volume of time correlation
Grade, lowering ultrafiltration volume is carried out according to ultrafiltration volume governing stage, red in certain time relevant to governing stage after ultrafiltration volume is adjusted
The real value of cell pack keeps the ultrafiltration volume when having reduction, red in certain time relevant to governing stage after ultrafiltration volume is adjusted
The real value of cell pack either with or without change or continue rise when then continue to next stage ultrafiltration volume adjust.That is, ultrafiltration
The regulated quantity and time correlation of amount, for example, reducing the ultrafiltration volume centainly measured, after lowering ultrafiltration volume, phase in every n seconds of time
It monitored that hematocrit value has decline after n seconds time, then current ultrafiltration volume can be kept to continue to dialyse, when subtracting
After low ultrafiltration volume, monitors that hematocrit value does not decline or still persistently rises after being separated by n seconds time, then continue downward
The ultrafiltration volume of one magnitude lowers, and so adjusts, and wherein the adjusting number of ultrafiltration volume is no more than three times, more than then giving a warning three times
Information simultaneously suspends ultrafiltration.
In addition, method of the invention is also monitored the blood pressure of patient in order to improve the safety of monitoring and intelligence,
Ultrafiltration volume or pause ultrafiltration are reduced when the blood pressure for real-time monitoring patient deviates normal range (NR).When specific operation, Ke Yigen
Presetting according to the dialysis data of patient history reduces ultrafiltration volume or pause ultrafiltration.
At the same time, method of the invention can also include danger button operating procedure, when patient occur malaise symptoms by
When lower button, when receiving button signal, lowers ultrafiltration volume or suspend ultrafiltration and issue alarm signal.This mode considers patient and exists
Malaise symptoms in dialysis procedure can be with when the patient feels are to not in due course, such as when there is spasm, slight headache, nausea symptom
By reducing ultrafiltration volume or pause ultrafiltration by lower button.Likewise, when specific operation, it can be according to the dialysis of patient history
Data come be when presetting by lower button execute reduce ultrafiltration volume or pause ultrafiltration.
The same or similar label correspond to the same or similar components；
Described in attached drawing positional relationship for only for illustration, should not be understood as the limitation to this patent；
Obviously, the above embodiment of the present invention be only to clearly illustrate example of the present invention, and not be pair
The restriction of embodiments of the present invention.For those of ordinary skill in the art, may be used also on the basis of the above description
To make other variations or changes in different ways.There is no necessity and possibility to exhaust all the enbodiments.It is all this
Made any modifications, equivalent replacements, and improvements etc., should be included in the claims in the present invention within the spirit and principle of invention
Protection scope within.
Claims (6)
1. ultrafiltration monitoring method in a kind of blood dialysis characterized by comprising
Into database, the current weight data of typing patient and detection calculate hematocrit before dialysis；
The history dialysis data of patient are extracted from database；
Weight after the current weight of patient and last dialysis is made the difference, and the weight of patient's last time Before and after dialysis is done
Difference recalls the set hematocrit thresholding of last time dialysis, opens if the difference of two differences is located in difference domain value range
Begin to carry out haemodialysis and real-time monitoring is carried out to the hematocrit of patient；
When the hematocrit value that real-time detection arrives reaches set hematocrit thresholding, lower ultrafiltration volume, Zhi Daohong
Cell pack is lower than thresholding.
2. ultrafiltration monitoring method in blood dialysis according to claim 1, which is characterized in that remember in database
Record the history dialysis data of patient, weight data, hematocrit value and ultrafiltration when institute including patient per's Before and after dialysis
The hematocrit thresholding being arranged.
3. ultrafiltration monitoring method in blood dialysis according to claim 1, which is characterized in that the method is also to trouble
The blood pressure of person is monitored, and ultrafiltration volume or pause ultrafiltration are reduced when the blood pressure for real-time monitoring patient deviates normal range (NR).
4. ultrafiltration monitoring method in blood dialysis according to claim 1, which is characterized in that the method also includes
Danger button operating procedure receives button signal when patient malaise symptoms occurs by lower button, lowers ultrafiltration volume or pause is super
It filters and issues alarm signal.
5. ultrafiltration monitoring method in blood dialysis according to claim 2 or 4, which is characterized in that the method is also
It include: the ultrafiltration volume governing stage of setting and time correlation, lowering ultrafiltration volume is carried out according to ultrafiltration volume governing stage, when ultrafiltration volume tune
The ultrafiltration volume is kept when the real value of hematocrit has reduction in certain time relevant to governing stage after section, when ultrafiltration volume tune
After section in certain time relevant to governing stage hematocrit real value either with or without change or continue rise when then continue to
Next stage ultrafiltration volume is adjusted.
6. ultrafiltration monitoring method in blood dialysis according to claim 5, which is characterized in that the adjusting time of ultrafiltration volume
Number is no more than three times, more than then sending a warning message three times and suspend ultrafiltration.
Hematocrit is to calculate hematocrit according to velocity of blood flow by ultrasonic measurement velocity of blood flow.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201910319619.1A CN110064086A (en) | 2019-04-19 | 2019-04-19 | Ultrafiltration monitoring method in a kind of blood dialysis |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201910319619.1A CN110064086A (en) | 2019-04-19 | 2019-04-19 | Ultrafiltration monitoring method in a kind of blood dialysis |
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| Publication Number | Publication Date |
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| CN110064086A true CN110064086A (en) | 2019-07-30 |
Family
ID=67368193
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN201910319619.1A Pending CN110064086A (en) | 2019-04-19 | 2019-04-19 | Ultrafiltration monitoring method in a kind of blood dialysis |
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Cited By (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN112826463A (en) * | 2020-12-31 | 2021-05-25 | 苏州爱琴生物医疗电子有限公司 | Device for determining blood pressure regulation and control range and related equipment |
| CN112843363A (en) * | 2020-12-31 | 2021-05-28 | 复旦大学附属华山医院 | Procedure management system for dialysis patients |
| CN113730689A (en) * | 2021-09-08 | 2021-12-03 | 吉林大学 | Weighing-based hemodialysis ultrafiltration volume and ultrafiltration rate real-time monitoring system and method |
-
2019
- 2019-04-19 CN CN201910319619.1A patent/CN110064086A/en active Pending
Cited By (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN112826463A (en) * | 2020-12-31 | 2021-05-25 | 苏州爱琴生物医疗电子有限公司 | Device for determining blood pressure regulation and control range and related equipment |
| CN112843363A (en) * | 2020-12-31 | 2021-05-28 | 复旦大学附属华山医院 | Procedure management system for dialysis patients |
| CN112826463B (en) * | 2020-12-31 | 2023-11-10 | 苏州爱琴生物医疗电子有限公司 | Blood pressure regulation range determining device and related equipment |
| CN113730689A (en) * | 2021-09-08 | 2021-12-03 | 吉林大学 | Weighing-based hemodialysis ultrafiltration volume and ultrafiltration rate real-time monitoring system and method |
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Application publication date: 20190730 |