腹膜透析基础 PPT课件.ppt

腹膜透析-ESRD治疗
中南大学湘雅医院
宁建平
How PD works  腹透原理
What is the peritoneal membrane ?
腹膜是被覆于腹腔的光滑浆膜
脏层腹膜
壁层腹膜
腹膜凹陷
腹腔和腹膜腔
The mesothelium
The interstitium
Macrophages/Monocytes
Peritoneal capillaries
Plays important role water and solute exchange
间皮
间质
巨噬细胞/单核细胞
腹膜毛细血管
在水和溶质的转换中起重要作用
Components of the peritoneum
Role of the peritoneum 腹膜的功能
Protect ans
Prevent friction of ans
Host defense mechanisms:
Mesothelial cells, monocytesmacrophages, opsonins
支持、保护腹腔脏器
分泌滑液防止脏器移动时的摩擦
宿主的防御机制:
间皮细胞、单核巨噬细胞、调理素
Components of the peritoneum as a dialysis membrane 腹膜(做为透析膜)的组成
The mesothelium
The stagnant fluid film
The interstitium
Peritoneal capillaries
Stagnant capillary fluid
The capillary endothelium itself
The endothelial basement membrane
间皮
滞留液体层(阻力)
间质
腹膜毛细血管
毛细血管滞留液体
毛细血管内皮
内皮基底膜
The transport of solutes and water across a “membrane” that separates two fluid partments.
The blood in the peritoneal capillaries
Dialysis solution in the peritoneal cavity
腹膜将下列两种液体分隔,水分和溶质进行跨膜转运
腹膜毛细血管中的血液
腹腔中的透析液
A Basic Concept of Peritoneal Dialysis 腹透基本概念
PERITONEAL TISSUE
BLOOD
腹膜组织
血液
Membrane腹膜
PERITONEAL CAVITY
DIALYSATE
腹腔
透析液
Membrane model
腹膜模型
Removal of uremic toxins 尿毒症毒素清除
Small solutes
Diffusion:
Convective transport
Middle or large solutes
Peritoneal leak
小分子溶质
弥散:
对流转运:
中等或大分子溶质
腹膜渗漏
Diffusion 弥散
Definition:
Solute movement due to concentration gradient of two solutes ponents across a semi-permeable membrane
Main driving force for small solute removal
Factors involved in diffusion
Size of solute
Peritoneal surface area
Hydrostatic pressure
Electrical charge of solutes
定义:
溶质依靠溶液之间浓度梯度透过半透膜(腹膜)进行的转运
弥散是小分子溶质清除的主要机制
影响弥散的因素
溶质分子的大小
腹膜表面积
静水压
溶质的电负荷
Convective transport  对流转运
Solute transport along with fluid movement
High during active ultrafiltration
Terms used in convective transport
Sieving coefficient:
Ratio of solute being passed the barrier
Reflection coefficient
Ratio of solute being rejected by the barrier
Sieving coeffic