CN110314260A - 持续白蛋白透析吸附净化系统及其在儿童人工肝的应用 - Google Patents
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- 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
- A61M1/16—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis with membranes
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- A61M1/14—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis
- A61M1/16—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis with membranes
- A61M1/1654—Dialysates therefor
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- 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
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Abstract
本发明公开了一种持续白蛋白透析吸附净化系统及其在儿童人工肝的应用，系统包括血液回路和白蛋白再生循环回路，所述血液回路包括高通量透析器连接人体循环，所述白蛋白再生循环回路通过透析管路依次连接高通量透析器、广谱吸附柱、胆红素吸附柱，回路内充满白蛋白透析液。本发明血液透析回路容积小，可避免因体外血液回路容量过大导致的循环不稳定问题；白蛋白再生循环，能高效清除肝衰竭儿童的蛋白结合毒素，并可序贯血液透析和/或滤过系统，清除水溶性的中小分子毒素。本发明系统耗材自主选择面广，白蛋白透析液可循环再生利用，有效降低儿童人工肝治疗费用，操作流程简单，可有效减轻医护人员的工作压力。
Description
技术领域
本发明涉及非生物型儿童人工肝系统。
背景技术
人工肝支持系统(Artificial Liver Support System,ALSS)，简称人工肝，是暂时性替代肝脏部分功能的体外支持系统，通过体外的机械、理化和生物装置，清除各种有害物质，补充必须物质，改善内环境，为肝功能恢复创造条件，或作为肝移植前的桥接。人工肝分为非生物型人工肝、生物型人工肝和混合型人工肝。非生物型人工肝技术本质上属于血液净化技术的范畴，基于弥散、对流及吸附的血液净化基本原理，已发展出一系列的人工肝技术，包括血浆置换、血浆(血液)灌流/胆红素吸附、血液滤过、血液透析等。
新型的人工肝杂交技术一直在不断探索和发展，并有一些比较成熟的商业化治疗模式应用于成人人工肝支持治疗，如分子吸附再循环系统(Molecular AdsorbentsRecirculating System，MARS)，血浆成份分离吸附(Fractionated Plasma Separationand Adsorption，FPSA)，又称Prometheus系统。MARS和Prometheus系统的工作机制都是基于吸附原理，同时杂交了透析或/和滤过技术。但是Prometheus系统由于体外循环的容量大(700-750ml)，并不适用于儿童，MARS也没有开发适用于小体重儿童的系统；同时上述两种人工肝系统操作复杂，设备及耗材昂贵。
发明内容
为了解决现有技术中存在的问题，本发明提供一种持续白蛋白透析吸附净化系统及其在儿童人工肝的应用，以解决现有人工肝杂交技术由于体外循环容量大而不适用于小体重儿童的问题。
本发明的技术方案为：
一种持续白蛋白透析吸附净化系统(Continuous Albumin Dialysis andAbsorption Purification System,CADAPS)，包括血液回路和白蛋白再生循环回路，所述血液回路包括高通量透析器连接人体循环，所述白蛋白再生循环回路通过透析管路依次连接高通量透析器、广谱吸附柱、胆红素吸附柱，回路内充满白蛋白透析液。
所述白蛋白再生循环回路连接管路为标准接口，可实现无缝序贯常规血液透析。
持续白蛋白透析吸附净化系统在儿童人工肝的应用。
本发明的有益效果：
1.本发明CADAPS的血液回路只设计了血液透析，回路容积小，可避免体外血液回路容量过大导致的循环不稳定，对于小体重儿童尤为关键。
2.本发明CADAPS采用白蛋白透析液吸附方式替代直接的血液或血浆吸附，可避免儿童患者因治疗血流速度受限而继发的吸附柱凝血；CADAPS的白蛋白透析液速度可调节范围大，吸附柱不易堵塞，保证完成治疗。CADAPS高效整合了血液净化的弥散和吸附原理，对白蛋白结合毒素设计了白蛋白再生循环，能解决目前临床上对肝衰竭儿童胆红素、胆汁酸等毒素清除困难的问题；同时该系统可以无缝序贯血液透析和/或血液滤过，能对肝衰竭儿童常常继发的急性肾功能衰竭、脑水肿、胃肠功能不全等严重并发症及水电解质酸碱平衡进行有效调节，有望显著提高儿童肝衰竭的救治水平。
3.本发明CADAPS白蛋白再生循环回路采用了白蛋白吸附再生的技术，也是一种持续性血液净化技术，可持续长时间治疗直到吸附柱饱和，治疗过程对循环影响小，且治疗充分；同时由于CADAPS可以无缝序贯血液透析和/或血液滤过，避免了反复引血、回血带来的循环不稳定问题。
4.本发明CADAPS对设备和耗材的兼容性好，该系统可用于目前绝大多数品牌的血滤机，且耗材自主选择面广，可无缝序贯持续性肾脏替代治疗，序贯治疗不需更换透析器，将极大降低儿童人工肝治疗费用。该系统操作流程简单，可有效减轻医护人员的工作压力。
附图说明：
图1是本发明系统结构示意图；
其中：1-高通量透析器；2-广谱吸附柱；3-胆红素吸附柱；4-泵。
具体实施方式：
下面结合附图和具体实施方式详细介绍本发明技术方案。
本发明中所用透析器、吸附柱等均为常规市售材料。
本发明为针对儿童的新型人工肝支持系统，持续白蛋白透析吸附净化系统(Continuous Albumin Dialysis and Absorption Purification System,CADAPS)，包括血液回路和白蛋白再生循环回路，白蛋白再生循环回路基于白蛋白透析原理，在白蛋白透析液通路上串联两个吸附柱(一个广谱吸附柱2，一个胆红素吸附柱3)，形成闭环的的白蛋白再生循环回路，能高效清除肝衰竭儿童的蛋白结合毒素。连接管路为标准接口，可实现无缝序贯血液透析和/或滤过系统，清除水溶性的中小分子毒素；而且，序贯治疗不需要更换透析器，只需更换透析液即可。血液回路上只设置了高通量透析器1，血室容积小，适用于小体重儿童。
以体重4kg婴儿为例，应用本发明系统血液回路中体外循环血液量为60-70ml，远远低于Prometheus系统体外循环血液量700ml，这对于小体重的婴幼儿尤为关键；白蛋白再生循环回路所需白蛋白透析液约700ml，一般可持续治疗8h以上，而普通非循环再生系统则需要白蛋白透析液2400ml/h，对于价格昂贵的白蛋白透析液，本发明大大降低了治疗成本。
以上对本发明做了示例性的描述，应该说明的是，在不脱离本发明的核心的情况下，任何简单的变形、修改或者其他本领域技术人员能够不花费创造性劳动的等同替换均落入本发明的保护范围。
Claims (3)
1.一种持续白蛋白透析吸附净化系统，其特征在于，包括血液回路和白蛋白再生循环回路，所述血液回路包括高通透析器连接人体循环，所述白蛋白再生循环回路通过透析管路依次连接高通量透析器、广谱吸附柱、胆红素吸附柱，回路内充满白蛋白透析液。
2.根据权利要求1所述持续白蛋白透析吸附净化系统，其特征在于，所述白蛋白再生循环回路连接管路为标准接口，可实现无缝序贯常规血液透析。
3.持续白蛋白透析吸附净化系统在儿童人工肝的应用。
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| Publication number | Priority date | Publication date | Assignee | Title |
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| CN201033178Y (zh) * | 2007-04-05 | 2008-03-12 | 苏州大学附属第一医院 | 一种新型体外人工肝支持治疗系统 |
| CN211884744U (zh) * | 2019-04-02 | 2020-11-10 | 天津市第一中心医院 | 持续白蛋白透析吸附净化系统 |
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| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN201033178Y (zh) * | 2007-04-05 | 2008-03-12 | 苏州大学附属第一医院 | 一种新型体外人工肝支持治疗系统 |
| CN211884744U (zh) * | 2019-04-02 | 2020-11-10 | 天津市第一中心医院 | 持续白蛋白透析吸附净化系统 |
Non-Patent Citations (1)
| Title |
|---|
| 孙世澜等: "《血液净化新理论新技术》", 河南科学技术出版社, pages: 180 * |
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