Selelekela
Tsamaisong ea lefu la renal la ho qetela (ESRD) le kotsi e mpe ea liphio (AKI), thedialyzer—eo hangata e bitsoang “liphio tsa maiketsetso”—ke eona khubusesebelisoa sa bongakae ntshang chefo le lero le feteletseng mading. E ama ka ho toba katleho ea phekolo, liphello tsa mokuli, le boleng ba bophelo. Bakeng sa bafani ba tlhokomelo ea bophelo, ho khetha dialyzer e nepahetseng ke ho leka-lekana lipakeng tsa lipheo tsa bongaka, polokeho ea mokuli le litšenyehelo. Bakeng sa bakuli le malapa, ho utloisisa phapang pakeng tsa mefuta ea dialyzer ho ba thusa ho nka karolo ho etseng liqeto tse arolelanoang.
Sengoliloeng sena se arola likarolo tse kholo tsa li-dialyzer, likarolo tsa bona tsa tekheniki, le maano a sebetsang a khetho a thehiloeng ho tataiso ea sejoale-joale joalo ka KDIGO.
Sehlopha sa mantlha sa Dialyzer
Li-dialyzer tsa sejoale-joale tsa hemodialysis li ka aroloa ka likarolo tse 'ne tse kholo: lisebelisoa tsa membrane, moralo oa sebopeho, litšoaneleho tsa ts'ebetso, le lintlha tse tobileng mokuli.
1. Ka Membrane Material: Tlhaho vs. Synthetic
Membranes e thehiloeng ho Cellulose (Tlhaho).
Ka tloaelo e entsoe ka lintho tse tsoang ho cellulose joalo ka cuprophane kapa cellulose acetate, li-membrane tsena li theko e tlase ebile li fumaneha hohle. Leha ho le joalo, li na le biocompatibility e fokolang, li ka tsosa ts'ebetso ea tlatsetso, 'me li ka baka feberu kapa hypotension nakong ea dialysis.
Membranes ea Synthetic (Ts'ebetso e Phahameng).
E entsoe ka li-polymer tsa boemo bo holimo joalo ka polysulfone (PSu), polyacrylonitrile (PAN), kapa polymethyl methacrylate (PMMA). Li-membrane tsena li fana ka boholo bo laoloang ba pore, tumello e phahameng ea molek'hule e bohareng, le biocompatibility e phahameng, ho fokotsa ho ruruha le ho ntlafatsa mamello ea mokuli.
2. Ka Moralo oa Sebopeho: Hollow Fiber vs. Flat Plate
Li-dialyzer tsa Fiber tse se nang letho(≥90% ea ts'ebeliso ea bongaka)
E na le likete tsa likhoele tse ntle tsa capillary tse nang le bokaholimo bo boholo (1.3–2.5 m²) le molumo o tlase oa priming (<100 mL). Ba fana ka tumello e phahameng ea katleho ha ba ntse ba boloka mekhoa e tsitsitseng ea phallo ea mali.
Li-dialyzer tsa Plate tse bataletseng
Ha li sebelisoe hangata kajeno, li na le libaka tse nyane tsa membrane (0.8-1.2 m²) le li-priming volumes tse phahameng. Li boloketsoe mekhoa e khethehileng e kang phapanyetsano ea plasma e kopantsoeng le dialysis.
3. Ka Litšobotsi tsa Ts'ebetso: Flux e tlase vs. High Flux vs. HDF-Optimized
Li-dialyzer tse tlase tsa Flux (LFHD)
Ultrafiltration coefficient (Kuf) <15 mL/(h·mmHg). Haholo-holo tlosa li-solutes tse nyane (urea, creatinine) ka phallo. E na le litšenyehelo, empa e na le tumello e fokolang ea molek'hule e bohareng (β2-microglobulin <30%).
High Flux Dialyzers (HFHD)
Ho feta ≥15 mL/(h·mmHg). Lumella convective clearance ea limolek'hule tse khōloanyane, ho fokotsa mathata a kang dialysis-related amyloidosis le ho ntlafatsa liphello tsa pelo.
Hemodiafiltration (HDF) - Li-dialyzer tse khethehileng
E etselitsoe bakeng sa ho tlosa chefo e kholo ea bohareng ba molek'hule le protheine, hangata e kopanya li-membrane tsa maiketsetso tse khonang ho kenella ka bongata le likarolo tsa adsorption (mohlala, li-coatings tsa khabone).
4. Ka Tlaleho ea Mokuli: Batho ba baholo, Bana, Tlhokomelo ea Bohlokoa
Mehlala e Tloaelehileng ea Batho ba Baholo: 1.3–2.0 m² bakeng sa bakuli ba bangata ba baholo.
Mehlala ea Bana: Li-membrane tsa 0.5-1.0 m² tse nang le molumo o tlaase oa priming (<50 mL) ho qoba ho se tsitse ha hemodynamic.
Mehlala e Bohlokoa ea Tlhokomelo: Li-anticoagulant le li-priming volume tse tlaase haholo (<80 mL) bakeng sa phekolo e tsoelang pele ea renal replacement (CRRT) ho bakuli ba ICU.
Kena ka ho teba ka Mefuta e Meholo ea Dialyzer
Membranes ea Cellulose ea Tlhaho
Likarolo: E theko e tlaase, e thehiloe hantle, empa e sa lumellane le biocompatible; kotsi e kholo ea liketso tsa ho ruruha.
Tšebeliso ea Clinical: E loketse ts'ehetso ea nako e khuts'oane kapa libakeng tseo ho amehang haholo ho tsona.
Li-Membrane tsa Synthetic tse Phahameng ka ho Fetisisa
Polysulfone (PSu): Sesebelisoa se tloaelehileng sa dialyzer se phahameng, se sebelisoang haholo ho hemodialysis e phahameng ea flux le HDF.
Polyacrylonitrile (PAN): E tsejoa ka ho ba le adsorption e matla ea chefo e nang le protheine; e sebelisoa ho bakuli ba nang le hyperuricemia.
Polymethyl Methacrylate (PMMA): Ho tlosoa ha solute ka mokhoa o leka-lekaneng ho pholletsa le boholo ba limolek'hule, hangata ho sebelisoa lefung la liphio la lefu la tsoekere kapa mathata a masapo-mineral.
Ho bapisa Khetho ea Dialyzer le Maemo a Clinical
Boemo ba 1: Tlhokomelo ea Hemodialysis ho ESRD
E khothalelitsoe: Dialyzer e phahameng ea flux synthetic (mohlala, PSu).
Lebaka: Lithuto tsa nako e telele le litataiso tsa KDIGO li ts'ehetsa li-membrane tsa phallo e phahameng bakeng sa liphetho tse ntle tsa pelo le methapo ea kutlo.
Tšoantšiso ea 2: Tšehetso ea Kotsi e Ntle ea Liphio (AKI).
E khothaletsoa: Selulose e tlase e tlase kapa dialyzer ea maiketsetso ea tekanyetso.
Lebaka: Phekolo ea nako e khutšoanyane e lebisa tlhokomelo ho tumello e nyenyane ea solute le tekanyo ea mokelikeli; ho sebetsa hantle ha litšenyehelo ke ntho ea bohlokoa.
Mokhelo: Ho sepsis kapa AKI ea ho ruruha, nahana ka li-dialyzer tse phahameng tsa flux bakeng sa ho tlosa cytokine.
Boemo ba 3: Haemodialysis (HHD)
E khothaletsoa: Sehlahisoa sa fiber se senyenyane se sebakeng se senyenyane se nang le li-priming tse itirisang.
Mabaka: Seta e nolofalitsoeng, litlhoko tse tlase tsa mali, le polokeho e betere bakeng sa libaka tsa ho itlhokomela.
Boemo ba 4: Bana ba Hemodialysis
E khothalelitsoe: Li-dialyzer tsa maiketsetso tsa boleng bo tlase tse ikhethileng (mohlala, PMMA).
Lebaka: Ho fokotsa khatello ea maikutlo le ho boloka botsitso ba hemodynamic nakong ea kholo.
Boemo ba 5: Bakuli ba ICU ba kulang haholo (CRRT)
E khothalelitsoe: Li-anticoagulant-coagulant-coagulant, li-dialyzer tsa maiketsetso tsa molumo o tlase tse etselitsoeng kalafo e tsoelang pele.
Lebaka: E fokotsa kotsi ea ho tsoa mali ha e ntse e boloka tumello e sebetsang ho bakuli ba sa tsitsang.
Mekhoa ea Bokamoso ho Dialyzer Technology
Ntlafatso ea Biocompatibility: Li-membrane tse se nang Endotoxin le li-endothelial tse bululetsoeng ka bio ho fokotsa ho ruruha le likotsi tsa ho koala.
Smart Dialyzers: Tekolo e hahelletsoeng ka har'a marang-rang le taolo ea anticoagulation e thehiloeng ho algorithm bakeng sa ntlafatso ea kalafo ea nako ea nnete.
Liphio tsa Maiketsetso tse Aparehang: Li-membrane tsa fiber tse sekoti tse khonang ho nkeha, dialysis ea lihora tse 24 bakeng sa ho tsamaea ha mokuli.
Lisebelisoa tsa Eco-Friendly: Nts'etsopele ea li-membrane tse senyehang (mohlala, polylactic acid) ho fokotsa litšila tsa bongaka.
Qetello
Ho khetha hemodialysis dialyzer ha se qeto ea tekheniki feela - ke ho kopanya boemo ba mokuli, lipheo tsa kalafo, le lintlha tsa moruo. Bakuli ba ESRD ba rua molemo haholo ho li-dialyzer tse phahameng ho fokotsa mathata a nako e telele. Bakuli ba AKI ba ka etelletsa pele litšenyehelo le bonolo. Bana le bakuli ba hlokang tlhokomelo e khethehileng ba hloka lisebelisoa tse hlophisitsoeng ka hloko. Ha ntlafatso e ntse e tsoela pele, li-dialyzer tsa hosane li tla ba bohlale ho feta, li bolokehile, 'me li le haufi le ts'ebetso ea liphio ea tlhaho-ho ntlafatsa bophelo le boleng ba bophelo.
Nako ea poso: Sep-08-2025