[求助]AK200透析过程中频报FCN 4.05 015

AK200透析过程中频报FCN 4.05 015，上午间隔半小时左右报一次，下午十五分钟报一次，请教！

FCN 4.05 015 UNSTABLE SIGNALS DURING SELF CALIBRATION [T]

General description of conditions for occurring:

The self calibration failed because at least one of the measured flow signals varied too much. A new self calibration that was done 5 minutes later did also fail because at least one of the measured flow signals varied too much.

 

Technical description of conditions for occurring:

The following conditions occurred twice, and there was 5 minutes between the two attempts:

The calibration of the measuring system was successful.

The zero flow signals were measured for 15s.

Variance of the flow signals were calculated.

Flow channel 1 variance SRR(34) > 146.5 OR

Flow channel 2 variance SRR(35) > 146.5

( The measuring of zero flow signals was continued for 15s.Variance of flow signals were calculated from 30s data.Flow channel 1 variance SRR(34) > 293.0 OR Flow channel 2 variance SRR(35) > 293.0  )

OR ( New zero flow signals were measured for 15s.Variance of flow signals were calculated from 15s data. Flow channel 1 variance SRR(34) > 146.5 OR Flow channel 2 variance SRR(35) > 146.5 )

OR The following conditions occurred twice, and there was 5 minutes between the two attempts:

The calibration of the measuring system was successful.

The calibration of the offset flow was successful.

Wait for 15s.

The differential flow signals were measured for 15s.

Variance of the differential flow signal was calculated.

Differential flow variance SRR(36) > 585.9.

( The measuring of differential flow signals was continued for 15s. Variance of the differential flow signal was calculated from 30s data. Differential flow variance SRR(36) > 1171.9.

OR ( New measurement of differential flow.Variance of the differential flow signal was calculated from 15s data. Differential flow variance SRR(36) > 585.9. )

The same flow went through both the flow channels while the differential flow was measured.

The unit of the variances is 0.0064*(ml/min)*(ml/min)

Note! VFC channel 2 takes care of flow channel 1!

 

Some possible explanations why the error has occurred:

* Air is flowing through flow channel 1.

* The ultra sonic transducer in the bubble trap 1 is broken.

* TAVA: The taration valve is leaking.

* DIVA: The direct valve is leaking.

* BYVA: The bypass valve is leaking.

* FLOW CELL: The flow cell is dirty.

* FLOW CELL: The flow cell is broken.

* FLOW OUTPUT PUMP RESTRICTOR: The restrictor is dirty.

* FLOW OUTPUT PUMP: The pump is not working properly.

* The flow system before bubble trap 1 causes an unstable level in bubble trap 1.

* FLOW OUTPUT PUMP PRESSURE TRANSDUCER: Not working properly.

* FM CPU BOARD: The signal TMO0 is not buffered according to the change order 10827.

4.05 015是说机器在做超滤单元自检时测到的流量不稳定。可能的原因很多：

1、治疗中出现钙沉淀：首先做热脱钙，检查电导是否出现偏差，热脱钙后是否坚持的时间长一些，如果是配液要看下透析粉和配液情况。

2、超滤单元相关阀、管道、流阻：检查机器自检到阀漏测试时是否出现过报警或重复测试；检查相关阀、管路接头和流阻；

3、流量泵工作不正常，

4、超滤单元故障，

5、FM CPU板故障。

这个故障很麻烦，有可能弄下子能好一段时间，一般只能做下热脱钙、检查阀和管路，如果还是不好就只能找厂家帮助了。

自检正常无报警，做了冰醋酸与次氯酸钠，第二天上午好一点，下午就不行了，间隔十来分钟就报。找厂家，也说这个故障麻烦，没把握！机器前段时间崩管，值班医生接回管路时，将UF单元的碳管搞断一根。换了有两个多月了，不知是否有关系？

根据你的描述还是怀疑钙沉淀的可能性大些。如果换碳管时没有接牢靠漏气也有可能，老机器的硅胶接头动过也会密封不好，可以检查更换试试。

最好用柠檬酸做热脱钙更彻底些，再做电导的校正，没有电导计就比较麻烦了，如果有新装的95机器可以把它上面的新电导换到200电导A上，自检电导高位时看下3个电导的差距来判断是否偏差过大。

如果是配的透析液可以把A液中多加10ml冰醋酸，注意A液不能放置过久，不能放在温度高、阳光下，以免酸挥发造成使用中出项钙沉淀。

还可以在出现故障时看下漏血探测器的数值，如果数值比较高可以肯定是出现钙沉淀。

也不排除这批粉有问题，可以换批试试。

多谢多谢，明天再试试柠檬酸做热脱钙。A液中能加冰醋酸吗？会不会有什么副作用？漏血探测器的正常数值是多少？

A液中的酸性成分就是为了防止钙沉淀的，我以前推荐医院试过，没有问题，不要加太多了。如果有条件检测配好的透析液成分和PH值最好了。建议医院定期抽取配好的透析液做下离子成分检测。

我印象中漏血探测器自检时应该<30，否则会报错。运行中越小越好，好像是>60或100会出现报警旁路透析液。我遇到过严重的钙沉淀机器自检后漏血探测器在10多分钟就超过30，漏血探测器中能看到白色沉淀物。

除钙后故障仍存在。与一台正常工作的AK95对换了UF CELL，还是不行，看来得换FM CPU了！

更换FM CPU板，正常使用两天了！

用柠檬酸1.6KG加草酸400G，加入100度热水10L里，将UF单元拆下循环洗一个小时，能好就好，不好就报废！

碳管都弄断了，怎么会没影响？医生大多是禽兽来的，对机器都不屑一顾。只能说，你不走运！