icu血液凈化指南

THEPARTSFORHIGHVOLUMEPARTSREQUIRESALOTOFTESTING4,STRUCTURESHOULDBESIMPLEANDSTRAIGHTFORWARD,BECAUSEYOUWANTTOSEEWHETHERTHEREISAIRBUBBLESINTHEWATERPRELIMINARYDESIGNTESTGASKEYSEXTOOLINGSTRUCTUREFOLLOWINGFIGUREBYSHOWSQIANCOVER2,ANDSEALEDPARTS13,ANDSEALEDCIRCLE1SEALEDCIRCLE25,ANDSEALEDPARTS2ASSHANGFIGUREBYSHOWSEARLYSETDOWNOFGASKEYSEXTOOLINGFORSHANGFIGUREBYSHOWS,SEALEDPARTS1AND2THROUGHTHREADCONNECTION,CANDEMOLITION,SEALEDPARTS1ANDQIANCOVERCONTACTPLACEHASSEALEDCIRCLE,PREVENTGASLEAK,A,DIRECTIONTHATFORGASENTEREDDIRECTIONTHESTRUCTUREHASMANYFLAWSTOBEIMPROVEDINCLUDETHEFOLLOWINGSEALPARTFORTUBULAR,CLAMP,SCREWEDTOGETHERDIRECTIONSFROMAGAS,BYWHATMEANSANDPIPECONNECTIONSIMPROVEDMETHODS,TUBESHAPEDPARTSDIFFICULTTOCLAMPANDTIGHTEN,YOUCANCHANGEITSSHAPE,HEXAGONALORRECTANGULAR,ANDTHEIMPORTATIONOFGASHOSESCANBEUSED,SOSEALINGPARTS2ADIRECTIONCANMAKEATHREADANDHOSECONNECTIONS,WILLENSURETHEGASINPUT,ANDDEPENDINGONTHEINSPECTIONREQUIREMENTS,SEALINGPARTS2ANDHOSECONNECTIONFORALONGTIME,SOTHATYOUCANUSEWITHBATCHINSPECTIONIMPROVEDSEALINGPARTS1AND2ASSHOWNINTHEFIGUREAREASFOLLOWS522AIRTIGHTTOOLINGDESIGNSTRUCTUREDESIGNANDCALCULATIONOFTHEMOSTSIZE,ARECALCULATEDACCORDINGTOSIZESEALINGDIAMETEROFPARTS126MMACCORDINGTOTHETOPDIAMETEROF20MMITTOTALWIDTH136MMCANMEETTHENATIONALSTANDARDINTHEHEXAGONOFHEXAGONSFIXTURECLAMPINGREQUIREMENTSSEALPARTS55MMWELDCANMEETTHELENGTHREQUIREMENTTHICKNESSOF7MMAND18MMWEREACQUIREDUNDERTHEPARTSAFTERWELDINGHEIGHT,CANMEETTHEREQUIREMENTSCOVEREDPARTSSEALPART1INTERNALDIMENSIONS94MMAND122MMACCORDINGTOTHEDIAMETEROFTHEWELDINGPARTS,ANDMEETSTHETESTREQUIREMENTSM125ISCOUNTRIESNEEDANINNERTHREADDIAMETERTOSUMUP,SEALINGPARTS1SIZEDESIGNFORWHICHSOURCESAREAVAILABLE,INLINEWITHTHEMECHANICALDESIGNREQUIREMENTS,BUTALSOFACILITATETHEMANUFACTURINGPROCESSOFTHEPARTS,INLINEWITHTHEECONOMIC,EASYPROCESSINGCHARACTERISTICS,MATERIALSELECTIONOFDURALUMINALLOYFINISHEDAFTERSURFACETREATMENT,DEBURRING,SURFACEROUGHNESSREQUIREDTO125ROUGHTURNINGTOMEETTHEPROCESSREQUIREMENTSSEALINGDIAMETEROFPARTS224MMCOMEUNDERWELDEDWELDDIAMETERTOTALWIDTH130MMCANMEETTHENATIONALSTANDARDINTHEHEXAGONOFHEXAGONSFIXTURECLAMPINGREQUIREMENTSSEALPARTS32MMWELDCANMEETTHELENGTHREQUIREMENTTHICKNESS8MMTOTIGHTENANDREMOVINGAREFIXTURESREQUIREDTHICKNESSTHICKNESSOF10MMISOBTAINEDINACCORDANCEWITHHOSE,ABLETOMEETGASREQUIREMENTSSEALPART1INTERNALDIMENSIONS106ACCORDINGTOTHEDIAMETEROFTHEWELDINGPARTS,ANDMEETSTHETESTREQUIREMENTSM125ISCOUNTRIESNEEDANINNERTHREADDIAMETERTOSUMUP,SEALEDPART2OFTHEDESIGNFORWHICHSOURCESAREAVAILABLE,INLINEWITHTHEMECHANICALDESIGNREQUIREMENTS,BUTALSOFACILITATETHEMANUFACTURINGPROCESSOFTHEPARTS,INLINEWITHTHEECONOMIC,EASYPROCESSINGCHARACTERISTICS,MATERIALSELECTIONOFDURALUMINALLOYSURFACEAFTERPROSEALINGSHOULDHAVEENOUGHPRELOAD,ISATWOSIDEDMANDATORYSEALINGUSUALLYINCONNECTIONWITHABALLINONEOFTHEUPPERANDORLOWERSTEMISEQUIPPEDWITHTHRUSTBEARINGFLOATINGBALLVALVEDESIGNSHOULDFOCUSONSEALINGMATERIALCANWITHSTANDTHESPHEREOFMEDIUMLOADBECAUSESPHERESWORKUNDERMEDIUMLOADTOEXPORTALLSEALS,THEREFORE,THISFLOATINGSPHEREISWIDELYUSEDINLOWPRESSUREBALLVALVESINADDITION,THEFLOATINGBALLVALVEBALLISFLOATING,UNDERMEDIAPRESSURE,SPHEREPRODUCESACERTAINAMOUNTOFDISPLACEMENTANDCOMPRESSIONONTHESEALINGRINGONTHEEXPORTSIDE,ENSURETHEOUTLETSEAL,ISASINGLEMANDATORYSEALINGSUMMARYSELECTAFIXEDBALLVALVESBALLVALVESFORTOOLINGPURCHASEACCESSTOBALLVALVE,TYPEQ617F16CDN20,EXPLAINSQBALLVALVE,6PNEUMATICDRIVEWRITE3TURBOTRANSMISSION,9ISTHEELECTRICDRIVE,1SCREWTHREADWROTE4FLANGECONNECTION,7FIXEDWRITE1ISFLOATING,SOFTSEALPTFEFWRITTENHISHARDKEYSSELECTIONOFAIRCOMPRESSORS，BECAUSETHEPARTSARENOTVERYBIG,BUBBLESWASOBSERVEDLESSOBVIOUSTOTHENAKEDEYE,SOFINDINGWAYSTOBUBBLEBECAMEOBVIOUS,ICAMEUPWITHABUBBLEMETHODISINTHEFIXTURESURFACEINTHISWAY,IFTHEREISABUBBLE,ITWILLBECOMEVERYAPPARENTCANBEWELLOBSERVED55GASTIGHTNESSTOOLSUSINGMETHOD1,PUTTHEPARTSINTOFIXTURES2,THEFIXTUREINTHESINK3,OPENTHEBALLVALVEFORGAS4,AFTERTHETESTINGISCOMPLETED,OPENINGANOTHERBALLVALVESFORGAS5,REMOVETHEWELDINGPARTS,REPEATTHESTEPSABOVE,FOREXAMINATION6CONCLUSIONTHISARTICLECOMPLETEDBEFOREAROCKETSCAPWELDINGPROCESSPREPARATIONANDINSPECTIONOFWELDEDAIRTIGHTFIXTURESINTWOPARTS,THEMAINTASKSAREASFOLLOWS1BYANALYZINGTHEPARTSOFTHEROLE,EXPLAINSTHEIMPORTANCEOFTHEFRONTCOVER,ITSTHERE,PROTECTTHEWARHEADFROMWINDANDWATEREROSION,TOILLUSTRATETHEFRONTCOVEROFRESEARCHISOFGREATSIGNIFICANCE2THROUGHTHEANALYSISOFPARTS,ACCORDINGTOTHEFINISHEDPARTDRAWINGSANDSPECIFICATIONS,ANALYSISOFFINISHEDPARTSMACHINING,MACHININGMETHODOFDETERMININGNECESSARY3THEREFERENCEPARTSHAPESELECTIONOFWELDINGJIGS,TOFACILITATETHECLAMPATTHESAMETIME,TOFACILITATETHEWELDING4SELECTTHEAPPROPRIATEWELDINGMETHODANDBYMATERIALANDSTRUCTURE5WELDING,THEWELDINGACCORDINGTOTHEWELDINGPROCESS6EXAMINATIONOFWELDINGQUALITY,ALUMINUMWELDINGMETHODSOFINSPECTION,INSPECTIONIFNOTQUALIFIED,YOUCANCARRYOUTAWELDING,COSTSAVINGS,BUTNOTFORASECONDWELD,IF,PARTDESTROYED7ACCORDINGTOTHESHAPE,THINKDESIGNATOOLTOTESTTHEAIRTIGHTNESS,NOTONLYTOMEETTHETESTINGREQUIREMENTS,BUTALSOFORICU中血液凈化的應(yīng)用指南血液凈化BLOODPURIFICATION技術(shù)指各種連續(xù)或間斷清除體內(nèi)過(guò)多水分、溶質(zhì)方法的總稱，該技術(shù)是在腎臟替代治療技術(shù)的基礎(chǔ)上逐步發(fā)展而來(lái)。血液凈化方法有腎臟替代治療、血液灌流、免疫吸附、內(nèi)毒素吸附和血漿置換等。每一種血液凈化方式都各有特點(diǎn)，且各適用于不同疾病或不同疾病狀態(tài)。本指南僅對(duì)ICU中應(yīng)用最多的腎臟替代治療RENALREPLACEMENTTHERAPY,RRT進(jìn)行討論并提出建議。血液凈化概念和常見(jiàn)種類上世紀(jì)70年代末，RRT主要用于治療重癥急性腎功能衰竭患者。隨著技術(shù)不斷發(fā)展，近30年，RRT已用于全身過(guò)度炎癥反應(yīng)如嚴(yán)重創(chuàng)傷、重癥急性胰腺炎等、膿毒血癥、中毒和多臟器功能衰竭等危重癥的救治。另外，對(duì)重癥患者并發(fā)的特殊情況，如嚴(yán)重電解質(zhì)紊亂、過(guò)高熱等，RRT也能顯示良好療效。RRT在重癥患者救治中起著極其重要的作用，是ICU醫(yī)師應(yīng)予掌握的基本技術(shù)。基于此，國(guó)內(nèi)ICU有關(guān)專家根據(jù)循證醫(yī)學(xué)證據(jù)制定本指南。制定本指南的意義循證醫(yī)學(xué)證據(jù)按照DELPHI分級(jí)標(biāo)準(zhǔn)見(jiàn)表1。循證醫(yī)學(xué)證據(jù)時(shí)間跨度為1999年1月至2009年3月；數(shù)據(jù)主要來(lái)自MEDLINE、EVIDENCEBASEDMEDICINEREVIEWSEBMR、LIPPINCOTTWILLIAMSWILKINSLWW和萬(wàn)方數(shù)據(jù)庫(kù)等4個(gè)數(shù)據(jù)庫(kù)。主題詞采用以下幾個(gè)HEMOFILTRATION；DIALYSIS；RENALREPLACEMENTTHEPARTSFORHIGHVOLUMEPARTSREQUIRESALOTOFTESTING4,STRUCTURESHOULDBESIMPLEANDSTRAIGHTFORWARD,BECAUSEYOUWANTTOSEEWHETHERTHEREISAIRBUBBLESINTHEWATERPRELIMINARYDESIGNTESTGASKEYSEXTOOLINGSTRUCTUREFOLLOWINGFIGUREBYSHOWSQIANCOVER2,ANDSEALEDPARTS13,ANDSEALEDCIRCLE1SEALEDCIRCLE25,ANDSEALEDPARTS2ASSHANGFIGUREBYSHOWSEARLYSETDOWNOFGASKEYSEXTOOLINGFORSHANGFIGUREBYSHOWS,SEALEDPARTS1AND2THROUGHTHREADCONNECTION,CANDEMOLITION,SEALEDPARTS1ANDQIANCOVERCONTACTPLACEHASSEALEDCIRCLE,PREVENTGASLEAK,A,DIRECTIONTHATFORGASENTEREDDIRECTIONTHESTRUCTUREHASMANYFLAWSTOBEIMPROVEDINCLUDETHEFOLLOWINGSEALPARTFORTUBULAR,CLAMP,SCREWEDTOGETHERDIRECTIONSFROMAGAS,BYWHATMEANSANDPIPECONNECTIONSIMPROVEDMETHODS,TUBESHAPEDPARTSDIFFICULTTOCLAMPANDTIGHTEN,YOUCANCHANGEITSSHAPE,HEXAGONALORRECTANGULAR,ANDTHEIMPORTATIONOFGASHOSESCANBEUSED,SOSEALINGPARTS2ADIRECTIONCANMAKEATHREADANDHOSECONNECTIONS,WILLENSURETHEGASINPUT,ANDDEPENDINGONTHEINSPECTIONREQUIREMENTS,SEALINGPARTS2ANDHOSECONNECTIONFORALONGTIME,SOTHATYOUCANUSEWITHBATCHINSPECTIONIMPROVEDSEALINGPARTS1AND2ASSHOWNINTHEFIGUREAREASFOLLOWS522AIRTIGHTTOOLINGDESIGNSTRUCTUREDESIGNANDCALCULATIONOFTHEMOSTSIZE,ARECALCULATEDACCORDINGTOSIZESEALINGDIAMETEROFPARTS126MMACCORDINGTOTHETOPDIAMETEROF20MMITTOTALWIDTH136MMCANMEETTHENATIONALSTANDARDINTHEHEXAGONOFHEXAGONSFIXTURECLAMPINGREQUIREMENTSSEALPARTS55MMWELDCANMEETTHELENGTHREQUIREMENTTHICKNESSOF7MMAND18MMWEREACQUIREDUNDERTHEPARTSAFTERWELDINGHEIGHT,CANMEETTHEREQUIREMENTSCOVEREDPARTSSEALPART1INTERNALDIMENSIONS94MMAND122MMACCORDINGTOTHEDIAMETEROFTHEWELDINGPARTS,ANDMEETSTHETESTREQUIREMENTSM125ISCOUNTRIESNEEDANINNERTHREADDIAMETERTOSUMUP,SEALINGPARTS1SIZEDESIGNFORWHICHSOURCESAREAVAILABLE,INLINEWITHTHEMECHANICALDESIGNREQUIREMENTS,BUTALSOFACILITATETHEMANUFACTURINGPROCESSOFTHEPARTS,INLINEWITHTHEECONOMIC,EASYPROCESSINGCHARACTERISTICS,MATERIALSELECTIONOFDURALUMINALLOYFINISHEDAFTERSURFACETREATMENT,DEBURRING,SURFACEROUGHNESSREQUIREDTO125ROUGHTURNINGTOMEETTHEPROCESSREQUIREMENTSSEALINGDIAMETEROFPARTS224MMCOMEUNDERWELDEDWELDDIAMETERTOTALWIDTH130MMCANMEETTHENATIONALSTANDARDINTHEHEXAGONOFHEXAGONSFIXTURECLAMPINGREQUIREMENTSSEALPARTS32MMWELDCANMEETTHELENGTHREQUIREMENTTHICKNESS8MMTOTIGHTENANDREMOVINGAREFIXTURESREQUIREDTHICKNESSTHICKNESSOF10MMISOBTAINEDINACCORDANCEWITHHOSE,ABLETOMEETGASREQUIREMENTSSEALPART1INTERNALDIMENSIONS106ACCORDINGTOTHEDIAMETEROFTHEWELDINGPARTS,ANDMEETSTHETESTREQUIREMENTSM125ISCOUNTRIESNEEDANINNERTHREADDIAMETERTOSUMUP,SEALEDPART2OFTHEDESIGNFORWHICHSOURCESAREAVAILABLE,INLINEWITHTHEMECHANICALDESIGNREQUIREMENTS,BUTALSOFACILITATETHEMANUFACTURINGPROCESSOFTHEPARTS,INLINEWITHTHEECONOMIC,EASYPROCESSINGCHARACTERISTICS,MATERIALSELECTIONOFDURALUMINALLOYSURFACEAFTERPROSEALINGSHOULDHAVEENOUGHPRELOAD,ISATWOSIDEDMANDATORYSEALINGUSUALLYINCONNECTIONWITHABALLINONEOFTHEUPPERANDORLOWERSTEMISEQUIPPEDWITHTHRUSTBEARINGFLOATINGBALLVALVEDESIGNSHOULDFOCUSONSEALINGMATERIALCANWITHSTANDTHESPHEREOFMEDIUMLOADBECAUSESPHERESWORKUNDERMEDIUMLOADTOEXPORTALLSEALS,THEREFORE,THISFLOATINGSPHEREISWIDELYUSEDINLOWPRESSUREBALLVALVESINADDITION,THEFLOATINGBALLVALVEBALLISFLOATING,UNDERMEDIAPRESSURE,SPHEREPRODUCESACERTAINAMOUNTOFDISPLACEMENTANDCOMPRESSIONONTHESEALINGRINGONTHEEXPORTSIDE,ENSURETHEOUTLETSEAL,ISASINGLEMANDATORYSEALINGSUMMARYSELECTAFIXEDBALLVALVESBALLVALVESFORTOOLINGPURCHASEACCESSTOBALLVALVE,TYPEQ617F16CDN20,EXPLAINSQBALLVALVE,6PNEUMATICDRIVEWRITE3TURBOTRANSMISSION,9ISTHEELECTRICDRIVE,1SCREWTHREADWROTE4FLANGECONNECTION,7FIXEDWRITE1ISFLOATING,SOFTSEALPTFEFWRITTENHISHARDKEYSSELECTIONOFAIRCOMPRESSORS，BECAUSETHEPARTSARENOTVERYBIG,BUBBLESWASOBSERVEDLESSOBVIOUSTOTHENAKEDEYE,SOFINDINGWAYSTOBUBBLEBECAMEOBVIOUS,ICAMEUPWITHABUBBLEMETHODISINTHEFIXTURESURFACEINTHISWAY,IFTHEREISABUBBLE,ITWILLBECOMEVERYAPPARENTCANBEWELLOBSERVED55GASTIGHTNESSTOOLSUSINGMETHOD1,PUTTHEPARTSINTOFIXTURES2,THEFIXTUREINTHESINK3,OPENTHEBALLVALVEFORGAS4,AFTERTHETESTINGISCOMPLETED,OPENINGANOTHERBALLVALVESFORGAS5,REMOVETHEWELDINGPARTS,REPEATTHESTEPSABOVE,FOREXAMINATION6CONCLUSIONTHISARTICLECOMPLETEDBEFOREAROCKETSCAPWELDINGPROCESSPREPARATIONANDINSPECTIONOFWELDEDAIRTIGHTFIXTURESINTWOPARTS,THEMAINTASKSAREASFOLLOWS1BYANALYZINGTHEPARTSOFTHEROLE,EXPLAINSTHEIMPORTANCEOFTHEFRONTCOVER,ITSTHERE,PROTECTTHEWARHEADFROMWINDANDWATEREROSION,TOILLUSTRATETHEFRONTCOVEROFRESEARCHISOFGREATSIGNIFICANCE2THROUGHTHEANALYSISOFPARTS,ACCORDINGTOTHEFINISHEDPARTDRAWINGSANDSPECIFICATIONS,ANALYSISOFFINISHEDPARTSMACHINING,MACHININGMETHODOFDETERMININGNECESSARY3THEREFERENCEPARTSHAPESELECTIONOFWELDINGJIGS,TOFACILITATETHECLAMPATTHESAMETIME,TOFACILITATETHEWELDING4SELECTTHEAPPROPRIATEWELDINGMETHODANDBYMATERIALANDSTRUCTURE5WELDING,THEWELDINGACCORDINGTOTHEWELDINGPROCESS6EXAMINATIONOFWELDINGQUALITY,ALUMINUMWELDINGMETHODSOFINSPECTION,INSPECTIONIFNOTQUALIFIED,YOUCANCARRYOUTAWELDING,COSTSAVINGS,BUTNOTFORASECONDWELD,IF,PARTDESTROYED7ACCORDINGTOTHESHAPE,THINKDESIGNATOOLTOTESTTHEAIRTIGHTNESS,NOTONLYTOMEETTHETESTINGREQUIREMENTS,BUTALSOFOR2THERAPY；CONTINUOUSRENALREPLACEMENTTHERAPY；CRITICALILLNESS；ACUTERENALFAILUREDELPHI循證醫(yī)學(xué)分級(jí)標(biāo)準(zhǔn)指導(dǎo)建議分級(jí)A至少有2項(xiàng)級(jí)研究結(jié)果支持B僅有1項(xiàng)級(jí)結(jié)果支持C僅有級(jí)研究結(jié)果支持D至少有1項(xiàng)級(jí)研究結(jié)果支持E僅有級(jí)或級(jí)研究結(jié)果支持研究文獻(xiàn)分級(jí)大樣本、隨機(jī)研究，結(jié)論確定，假陽(yáng)性或假陰性錯(cuò)誤的風(fēng)險(xiǎn)較低小樣本、隨機(jī)研究，結(jié)論不確定，假陽(yáng)性和/或假陰性錯(cuò)誤的風(fēng)險(xiǎn)較高非隨機(jī)，同期對(duì)照研究非隨機(jī)，歷史對(duì)照研究和專家意見(jiàn)系列病例報(bào)道，非對(duì)照研究和專家意見(jiàn)制定指南的方法第一部分血液凈化的相關(guān)概念一相關(guān)概念THEPARTSFORHIGHVOLUMEPARTSREQUIRESALOTOFTESTING4,STRUCTURESHOULDBESIMPLEANDSTRAIGHTFORWARD,BECAUSEYOUWANTTOSEEWHETHERTHEREISAIRBUBBLESINTHEWATERPRELIMINARYDESIGNTESTGASKEYSEXTOOLINGSTRUCTUREFOLLOWINGFIGUREBYSHOWSQIANCOVER2,ANDSEALEDPARTS13,ANDSEALEDCIRCLE1SEALEDCIRCLE25,ANDSEALEDPARTS2ASSHANGFIGUREBYSHOWSEARLYSETDOWNOFGASKEYSEXTOOLINGFORSHANGFIGUREBYSHOWS,SEALEDPARTS1AND2THROUGHTHREADCONNECTION,CANDEMOLITION,SEALEDPARTS1ANDQIANCOVERCONTACTPLACEHASSEALEDCIRCLE,PREVENTGASLEAK,A,DIRECTIONTHATFORGASENTEREDDIRECTIONTHESTRUCTUREHASMANYFLAWSTOBEIMPROVEDINCLUDETHEFOLLOWINGSEALPARTFORTUBULAR,CLAMP,SCREWEDTOGETHERDIRECTIONSFROMAGAS,BYWHATMEANSANDPIPECONNECTIONSIMPROVEDMETHODS,TUBESHAPEDPARTSDIFFICULTTOCLAMPANDTIGHTEN,YOUCANCHANGEITSSHAPE,HEXAGONALORRECTANGULAR,ANDTHEIMPORTATIONOFGASHOSESCANBEUSED,SOSEALINGPARTS2ADIRECTIONCANMAKEATHREADANDHOSECONNECTIONS,WILLENSURETHEGASINPUT,ANDDEPENDINGONTHEINSPECTIONREQUIREMENTS,SEALINGPARTS2ANDHOSECONNECTIONFORALONGTIME,SOTHATYOUCANUSEWITHBATCHINSPECTIONIMPROVEDSEALINGPARTS1AND2ASSHOWNINTHEFIGUREAREASFOLLOWS522AIRTIGHTTOOLINGDESIGNSTRUCTUREDESIGNANDCALCULATIONOFTHEMOSTSIZE,ARECALCULATEDACCORDINGTOSIZESEALINGDIAMETEROFPARTS126MMACCORDINGTOTHETOPDIAMETEROF20MMITTOTALWIDTH136MMCANMEETTHENATIONALSTANDARDINTHEHEXAGONOFHEXAGONSFIXTURECLAMPINGREQUIREMENTSSEALPARTS55MMWELDCANMEETTHELENGTHREQUIREMENTTHICKNESSOF7MMAND18MMWEREACQUIREDUNDERTHEPARTSAFTERWELDINGHEIGHT,CANMEETTHEREQUIREMENTSCOVEREDPARTSSEALPART1INTERNALDIMENSIONS94MMAND122MMACCORDINGTOTHEDIAMETEROFTHEWELDINGPARTS,ANDMEETSTHETESTREQUIREMENTSM125ISCOUNTRIESNEEDANINNERTHREADDIAMETERTOSUMUP,SEALINGPARTS1SIZEDESIGNFORWHICHSOURCESAREAVAILABLE,INLINEWITHTHEMECHANICALDESIGNREQUIREMENTS,BUTALSOFACILITATETHEMANUFACTURINGPROCESSOFTHEPARTS,INLINEWITHTHEECONOMIC,EASYPROCESSINGCHARACTERISTICS,MATERIALSELECTIONOFDURALUMINALLOYFINISHEDAFTERSURFACETREATMENT,DEBURRING,SURFACEROUGHNESSREQUIREDTO125ROUGHTURNINGTOMEETTHEPROCESSREQUIREMENTSSEALINGDIAMETEROFPARTS224MMCOMEUNDERWELDEDWELDDIAMETERTOTALWIDTH130MMCANMEETTHENATIONALSTANDARDINTHEHEXAGONOFHEXAGONSFIXTURECLAMPINGREQUIREMENTSSEALPARTS32MMWELDCANMEETTHELENGTHREQUIREMENTTHICKNESS8MMTOTIGHTENANDREMOVINGAREFIXTURESREQUIREDTHICKNESSTHICKNESSOF10MMISOBTAINEDINACCORDANCEWITHHOSE,ABLETOMEETGASREQUIREMENTSSEALPART1INTERNALDIMENSIONS106ACCORDINGTOTHEDIAMETEROFTHEWELDINGPARTS,ANDMEETSTHETESTREQUIREMENTSM125ISCOUNTRIESNEEDANINNERTHREADDIAMETERTOSUMUP,SEALEDPART2OFTHEDESIGNFORWHICHSOURCESAREAVAILABLE,INLINEWITHTHEMECHANICALDESIGNREQUIREMENTS,BUTALSOFACILITATETHEMANUFACTURINGPROCESSOFTHEPARTS,INLINEWITHTHEECONOMIC,EASYPROCESSINGCHARACTERISTICS,MATERIALSELECTIONOFDURALUMINALLOYSURFACEAFTERPROSEALINGSHOULDHAVEENOUGHPRELOAD,ISATWOSIDEDMANDATORYSEALINGUSUALLYINCONNECTIONWITHABALLINONEOFTHEUPPERANDORLOWERSTEMISEQUIPPEDWITHTHRUSTBEARINGFLOATINGBALLVALVEDESIGNSHOULDFOCUSONSEALINGMATERIALCANWITHSTANDTHESPHEREOFMEDIUMLOADBECAUSESPHERESWORKUNDERMEDIUMLOADTOEXPORTALLSEALS,THEREFORE,THISFLOATINGSPHEREISWIDELYUSEDINLOWPRESSUREBALLVALVESINADDITION,THEFLOATINGBALLVALVEBALLISFLOATING,UNDERMEDIAPRESSURE,SPHEREPRODUCESACERTAINAMOUNTOFDISPLACEMENTANDCOMPRESSIONONTHESEALINGRINGONTHEEXPORTSIDE,ENSURETHEOUTLETSEAL,ISASINGLEMANDATORYSEALINGSUMMARYSELECTAFIXEDBALLVALVESBALLVALVESFORTOOLINGPURCHASEACCESSTOBALLVALVE,TYPEQ617F16CDN20,EXPLAINSQBALLVALVE,6PNEUMATICDRIVEWRITE3TURBOTRANSMISSION,9ISTHEELECTRICDRIVE,1SCREWTHREADWROTE4FLANGECONNECTION,7FIXEDWRITE1ISFLOATING,SOFTSEALPTFEFWRITTENHISHARDKEYSSELECTIONOFAIRCOMPRESSORS，BECAUSETHEPARTSARENOTVERYBIG,BUBBLESWASOBSERVEDLESSOBVIOUSTOTHENAKEDEYE,SOFINDINGWAYSTOBUBBLEBECAMEOBVIOUS,ICAMEUPWITHABUBBLEMETHODISINTHEFIXTURESURFACEINTHISWAY,IFTHEREISABUBBLE,ITWILLBECOMEVERYAPPARENTCANBEWELLOBSERVED55GASTIGHTNESSTOOLSUSINGMETHOD1,PUTTHEPARTSINTOFIXTURES2,THEFIXTUREINTHESINK3,OPENTHEBALLVALVEFORGAS4,AFTERTHETESTINGISCOMPLETED,OPENINGANOTHERBALLVALVESFORGAS5,REMOVETHEWELDINGPARTS,REPEATTHESTEPSABOVE,FOREXAMINATION6CONCLUSIONTHISARTICLECOMPLETEDBEFOREAROCKETSCAPWELDINGPROCESSPREPARATIONANDINSPECTIONOFWELDEDAIRTIGHTFIXTURESINTWOPARTS,THEMAINTASKSAREASFOLLOWS1BYANALYZINGTHEPARTSOFTHEROLE,EXPLAINSTHEIMPORTANCEOFTHEFRONTCOVER,ITSTHERE,PROTECTTHEWARHEADFROMWINDANDWATEREROSION,TOILLUSTRATETHEFRONTCOVEROFRESEARCHISOFGREATSIGNIFICANCE2THROUGHTHEANALYSISOFPARTS,ACCORDINGTOTHEFINISHEDPARTDRAWINGSANDSPECIFICATIONS,ANALYSISOFFINISHEDPARTSMACHINING,MACHININGMETHODOFDETERMININGNECESSARY3THEREFERENCEPARTSHAPESELECTIONOFWELDINGJIGS,TOFACILITATETHECLAMPATTHESAMETIME,TOFACILITATETHEWELDING4SELECTTHEAPPROPRIATEWELDINGMETHODANDBYMATERIALANDSTRUCTURE5WELDING,THEWELDINGACCORDINGTOTHEWELDINGPROCESS6EXAMINATIONOFWELDINGQUALITY,ALUMINUMWELDINGMETHODSOFINSPECTION,INSPECTIONIFNOTQUALIFIED,YOUCANCARRYOUTAWELDING,COSTSAVINGS,BUTNOTFORASECONDWELD,IF,PARTDESTROYED7ACCORDINGTOTHESHAPE,THINKDESIGNATOOLTOTESTTHEAIRTIGHTNESS,NOTONLYTOMEETTHETESTINGREQUIREMENTS,BUTALSOFOR3血液凈化包括RRT、血液灌流（HEMOPERFUSION，HP）及血漿置換（PLASMAEXCHANGE，PE）等，其中RRT是本指南重點(diǎn)。HP是將患者血液引入灌流器，受灌流器中吸附劑或其他生物材料的作用，引入灌流器的血液凈化后返回體內(nèi)的一種治療方式，目前多用于藥物過(guò)量或中毒的治療。PE是指將患者血液引出，用血漿分離器將血細(xì)胞與血漿分離，去除血漿以清除患者血漿中抗體、免疫復(fù)合物及毒素等物質(zhì)，用于治療自體免疫性疾病、肝功能衰竭、血液病及甲狀腺危象等疾病。下面重點(diǎn)闡述RRT的有關(guān)概念。進(jìn)一步解釋血液凈化的具體概念，引入重點(diǎn)討論RRTRRT是利用血液凈化技術(shù)清除溶質(zhì)，以替代受損腎功能以及對(duì)臟器功能起保護(hù)支持作用的治療方法1，基本模式有三類，即血液透析（HEMODIALYSIS，HD）、血液濾過(guò)（HEMOFILTRATION，HF）和血液透析濾過(guò)（HEMODIAFILTRATION，HDF）。HD主要通過(guò)彌散機(jī)制清除物質(zhì)，小分子物質(zhì)清除效率較高；HF主要通過(guò)對(duì)流機(jī)制清除溶質(zhì)和水分，對(duì)炎癥介質(zhì)等中分子物質(zhì)的清除效率優(yōu)于透析；HDF可通過(guò)彌散和對(duì)流兩種機(jī)制清除溶質(zhì)。濾過(guò)膜的吸附作用是RRT的第三種溶質(zhì)清除機(jī)制，部分炎癥介質(zhì)、內(nèi)素素、藥物和毒物可能通過(guò)該作用清除2,3。臨床上一般將單次治療持續(xù)時(shí)間一、血管通路的建立重癥患者CRRT的療程較晚期腎病患者的血液透析療程短得多，因此靜脈通路一般選擇中心靜脈置管而不是動(dòng)靜脈瘺。為滿足RRT血流量的要求，置管部位可選擇股靜脈、鎖骨下靜脈或頸內(nèi)靜脈，動(dòng)脈置管因并發(fā)癥較多已較少采用。鎖骨下靜脈導(dǎo)管的優(yōu)點(diǎn)是發(fā)生導(dǎo)管相關(guān)感染（CATHETERRELATEDBLOODSTREAMINFECTION,CRBI）的幾率較低，缺點(diǎn)是易受鎖骨壓迫而致管腔狹窄，因此血栓形成風(fēng)險(xiǎn)較其他部位的導(dǎo)管高；壓迫止血法效果差、出血并發(fā)癥較多，因此CRRT應(yīng)盡可能避免鎖骨下靜脈置管。頸內(nèi)靜脈導(dǎo)管沒(méi)有上述缺點(diǎn)，且對(duì)患者活動(dòng)限制少，因而一直是血透患者中心靜脈置管的首選，但缺點(diǎn)是CRBI發(fā)生率相對(duì)較高8,9V級(jí)。股靜脈置管的優(yōu)點(diǎn)是壓迫止血效果好，血腫THEPARTSFORHIGHVOLUMEPARTSREQUIRESALOTOFTESTING4,STRUCTURESHOULDBESIMPLEANDSTRAIGHTFORWARD,BECAUSEYOUWANTTOSEEWHETHERTHEREISAIRBUBBLESINTHEWATERPRELIMINARYDESIGNTESTGASKEYSEXTOOLINGSTRUCTUREFOLLOWINGFIGUREBYSHOWSQIANCOVER2,ANDSEALEDPARTS13,ANDSEALEDCIRCLE1SEALEDCIRCLE25,ANDSEALEDPARTS2ASSHANGFIGUREBYSHOWSEARLYSETDOWNOFGASKEYSEXTOOLINGFORSHANGFIGUREBYSHOWS,SEALEDPARTS1AND2THROUGHTHREADCONNECTION,CANDEMOLITION,SEALEDPARTS1ANDQIANCOVERCONTACTPLACEHASSEALEDCIRCLE,PREVENTGASLEAK,A,DIRECTIONTHATFORGASENTEREDDIRECTIONTHESTRUCTUREHASMANYFLAWSTOBEIMPROVEDINCLUDETHEFOLLOWINGSEALPARTFORTUBULAR,CLAMP,SCREWEDTOGETHERDIRECTIONSFROMAGAS,BYWHATMEANSANDPIPECONNECTIONSIMPROVEDMETHODS,TUBESHAPEDPARTSDIFFICULTTOCLAMPANDTIGHTEN,YOUCANCHANGEITSSHAPE,HEXAGONALORRECTANGULAR,ANDTHEIMPORTATIONOFGASHOSESCANBEUSED,SOSEALINGPARTS2ADIRECTIONCANMAKEATHREADANDHOSECONNECTIONS,WILLENSURETHEGASINPUT,ANDDEPENDINGONTHEINSPECTIONREQUIREMENTS,SEALINGPARTS2ANDHOSECONNECTIONFORALONGTIME,SOTHATYOUCANUSEWITHBATCHINSPECTIONIMPROVEDSEALINGPARTS1AND2ASSHOWNINTHEFIGUREAREASFOLLOWS522AIRTIGHTTOOLINGDESIGNSTRUCTUREDESIGNANDCALCULATIONOFTHEMOSTSIZE,ARECALCULATEDACCORDINGTOSIZESEALINGDIAMETEROFPARTS126MMACCORDINGTOTHETOPDIAMETEROF20MMITTOTALWIDTH136MMCANMEETTHENATIONALSTANDARDINTHEHEXAGONOFHEXAGONSFIXTURECLAMPINGREQUIREMENTSSEALPARTS55MMWELDCANMEETTHELENGTHREQUIREMENTTHICKNESSOF7MMAND18MMWEREACQUIREDUNDERTHEPARTSAFTERWELDINGHEIGHT,CANMEETTHEREQUIREMENTSCOVEREDPARTSSEALPART1INTERNALDIMENSIONS94MMAND122MMACCORDINGTOTHEDIAMETEROFTHEWELDINGPARTS,ANDMEETSTHETESTREQUIREMENTSM125ISCOUNTRIESNEEDANINNERTHREADDIAMETERTOSUMUP,SEALINGPARTS1SIZEDESIGNFORWHICHSOURCESAREAVAILABLE,INLINEWITHTHEMECHANICALDESIGNREQUIREMENT