Clinical Evaluation of Optimal Hemodialysis

• Main Authors: Ying Shun Chen, 陳盈勳
• Other Authors: Yan Lin Chang
• Format: Others
• Language: zh-TW
• Published: 1999
• Online Access: http://ndltd.ncl.edu.tw/handle/83319111615454242005

碩士 === 中原大學 === 醫學工程學系 === 87 === For the patients receiving long-term hemodialysis treatment, the disequilibrium syndromes during the dialysis process, which might eventually imperil their lives, has always been the most disturbing problem. The so-called disequilibrium syndrome refers to the epiphenomenoms during the dialysis treatment, including nausea, vomiting, headache, dizziness, convulsion, hypotension or hypertension. Theoretically, the reason for such complications can be attributed to the prompt decrease in density of extracellular fluid solute during dialysis that is far below the density of intercellular fluids. In recent years, Doc. Lee and Doc. Chang have employed a method of higher accuracy Two-Pool Model, and introduced a new concept of optimal dialysis. By controlling blood flow rate or dialysate flow rate step by step, patients receive the dialysis treatment while the density between extracellular and intercellular fluids is maintained at a lower level. This method has come by preliminary clinical evidence and our research center has been committed to the development of optimal dialysis systems. A complete set of software for blood dialysis treatment have been tested and proven effective both in theory and clinic simulations, and the primal prototype of dialysis machine central monitor/control system have also been perfected by our research center. This research follows the original design of blood dialysis center''s central monitor/ control system but improves its control interface so that the whole control system is more convenient to operate. Meanwhile, published literatures are consulted, the new concept of optimal dialysis is applied and the developed software of dialysis treatment is exploited to put this system into clinical use-control the dialysis machine. As for clinical experiments, we examine the dialysis machine''s mass transfer performance, then make evaluations of different dialysis strategies on three long-term hemodialysis patients. Dialysis strategies are divided as traditional and optimal dialysis treatment strategies and nursing staff can choose either strategy subject to the patient''s habitus or conditions. After two weeks of experiments, it is found that the optimal dialysis treatment strategy can clearly relieve the patients of the disequilibrium symptoms during their dialysis process, and therefore the optimal dialysis theory and this system are proven to be practical and feasible.