PERITONEAL MASS TRANSFER ENHANCEMENT WITH APPLICATION OF ULTRASOUND

部分间歇性腹膜透析，即夜间腹膜透析(NPD)和日间非卧床腹膜透析(DAPD)，采用超声提高腹膜传质速度。超声作用可显著提高尿素氮和肌酐的腹膜传质速率，但对尿素和肌酐的增强程度无显著差异。以腹膜透析度为评价指标，超声强度为0、28、45和100 kHz时，尿素氮的增强率分别为106、159、113和83%，肌酐的增强率分别为130、149、112和94%。根据这些结果，腹膜传质增强的速度似乎依赖于超声波的频率。对照腹膜传质实验在使用超声前后进行(试验性实验)。结果显示，第二次对照实验中发现的比率与试验实验中发现的几乎相同。这些结果表明，只要在短时间内评估，超声对腹膜的传质作用是不可逆转的。我们还用取自兔的壁腹膜进行了体外渗透实验。28和45 kHz的超声对肌酐的增强率分别为162%和149%。体外增强腹膜传质的速率也依赖于超声波的频率，这与体内实验结果吻合较好。由此可以得出结论，应用超声增强腹膜传质的作用至少部分是由于腹膜通透性不可逆地增加所致。

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.