PERITONEAL MASS TRANSFER ENHANCEMENT WITH APPLICATION OF ULTRASOUND

超声用于提高腹膜团转移率，以获得部分间歇性腹膜透析的成功，即夜间腹膜透析（NPD）和日间动态腹膜透析（DAPD）。应用超声可显著提高腹膜尿素氮和肌酐转移率；然而，尿素和肌酐在增强程度上没有显著差异。应用0、28、45和100 kHz超声对腹膜透析进行强化评价，强化率分别为106,159,113，尿素氮强化率为83%，130,149,112，肌酐强化率为94%。从这些结果来看，腹膜肿块转移增强率似乎与超声频率有关。控制腹膜传质实验没有使用超声波进行实验前后超声实验(试验)。结果表明，在第二个控制实验中发现的速率几乎与在试验中发现的速率相同。这些结果表明，只要超声在短时间内进行评估，腹膜肿块转移可能会不可逆转地增强。采用家兔腹膜壁进行体外渗透实验。28 kHz和45 kHz超声对肌酐的增强率分别为162和149%。体外腹膜质转移增强率也依赖于超声频率，这与体内实验结果吻合良好。从这些观察结果，我们可以得出结论，应用超声所观察到的腹膜质转移的增强至少部分是由腹膜通透性的不可逆增加引起的。

Ultrasound was used to enhance the rate of peritoneal mass transfer for the success of partially intermittent peritoneal dialysis, i, e., Nightly Peritoneal Dialysis (NPD) and Day-time Ambulatory Peritoneal Dialysis (DAPD). Rates of peritoneal mass transfer for urea-nitrogen and creatinine were enhanced in significant level with applying ultrasound ; however, no significant difference was found in degree of enhancement between urea and creatinine. The enhancement was evaluated by the peritoneal dialysance and rates of enhancement were 106,159,113, and 83% for urea-nitrogen and 130,149,112, and 94% for creatinine by application of ultrasound of 0,28,45, and 100 kHz, respectively. From these results, the rate of peritoneal mass transfer enhancement seemed to be dependent on frequency of the ultrasound.Control peritoneal mass transfer experiments without use of ultrasound were performed before and after the experiment with ultrasound (trial experiment). Results showed that the rate found in the second control experiment was almost identical to that found in the trial experiment. These findings should suggest that the peritoneal mass transfer migiht have been irreversibly enhanced with ultrasound as long as it is evaluated in a short period of time.In vitro permeation experiments were also performed with the parietal peritoneum taken from a rabbit. The rates of enhancement were 162 and 149% for creatinine by application of ultrasound of 28 and 45 kHz, respectively. Then rates of peritoneal mass transfer enhancement in vitro were also dependent on frequency of the ultrasound, which corresponded well with experimental results obtained in vivo.From these observations, it would be concluded that the observed enhancement in peritoneal mass transfer by application of ultrasound should at least partially be caused by irreversible increase of permeability of the peritoneal membrane.