长沙市血液透析单位透析用水及透析液质量的研究  

Quality of hemodialysis water and dialysate in Hemodialysis Centers in Changsha

作　　者：陈英[1,2,3] 陈星[1,2,3] 彭佑铭[1,2,3] 刘虹[1,2,3] 杨丽君[1,2,3] 滕朝宇[1,2,3] 刘伏友[1,2,3] 

机构地区：[1]中南大学湘雅二医院肾内科 [2]湖南省肾脏病与血液净化学重点实验室 [3]中南大学肾脏病研究所

出　　处：《中国血液净化》2007年第9期473-477,共5页Chinese Journal of Blood Purification

摘　　要：目的了解长沙市血液透析单位透析用水及透析液质量的状况。方法采用统一的透析调查表对长沙市20家透析单位进行调查。选择血液透析水处理系统易于取样又能代表水处理污染情况的4点:原水、反渗水1(配制B液取样点)、反渗水2(进入透析机前取样点)、透析器入口透析液取样点,采水样进行内毒素定性和定量、游离氯定性和硬度定性3方面检测。结果①长沙市20家透析单位透析用水及透析液内毒素有14家合格、6家不合格;游离氯完全合格;硬度有13家合格、7家不合格;②长沙市20家透析单位水处理系统中双级反渗3家,单级反渗17家;18家有储水罐,2家无储水罐;A液7家自配、13家购买干粉;B液6家自配、14家购买干粉;③原水内毒素为(166.005±11.716)EU/ml,反渗水1内毒素为(0.193±0.101)EU/ml,反渗水2内毒素为(0.219±0.118)EU/ml,透析器入口透析液内毒素为(0.428±0.226)EU/ml;④双级反渗与单级反渗水处理系统透析用水及透析液内毒素比较差异有显著性(P<0.01);⑤水处理系统使用时间2004年后投入使用与2004年前投入使用、3年内与超过3年更换反渗透膜、3月与超过3月消毒反渗透膜透析用水及透析液内毒素比较差异有显著性(P<0.01);3月与超过3月消毒管路透析用水及透析液内毒素比较差异有显著性(P<0.05);⑥管路设计方面,无死腔热消毒次环路与有死腔、无热消毒次环路双级反渗透析用水内毒素比较差异有显著性(P<0.05)。无储水罐与有储水罐透析用水及透析液内毒素比较差异有显著性(P<0.01);⑦A、B液购买干粉与A、B液自配透析液内毒素比较差异有显著性(P<0.01)。结论①透析用水的卫生质量与水处理系统使用年代和及时更换及消毒,以及与管路设计有无死腔、有无储水罐和A、B液配制等有关;②透析用水及透析液双级反渗优于单级反渗水处理系统。Object To investigate the status of quality of hemodialysis water and dialysate in Hemodialysis Centers of Changsha. Method A formal questionnaire was prepared and accounted in 20 hospitals＇ Hemodialysis Centers in Changsha. We had selected four points of hemodialysis water of water treatment system, which not only acquired easily but also represent polluted situation： tap water, reverse osmosis water 1 （prepare B fluid sampling point）, reverse osmosis water 2 （go into dialysis machine sampling point）, dialyser entrance dialysate sampling point, to detect endotoxin, free chlorine, hardness. Result （1） There are 6 disqualifications and 14 qualifications in endotoxin of hemodialysis water and dialysate, all qualifications in free chlorine of hemodialysis water and dialysate, 7 disqualifications and 13 qualifications in hardness of dialysate for 20 hospitals Hemodialysis Centers in Changsha. （2） In 20 Hemodialysis Centers there were 3 Hemodialysis Centers having double osmosis system and 17 Hemodialysis Centers have one osmosis systems of water treatment system. There were 18 Hemodialysis Centers have water storage tank, 2 Hemodialysis Centers haven＇t. In aspect of preparation, there were 7 Hemodialysis Centers prepare A concentration fluid prepare by themselves and 13 Hemodialysis Centers purchase dry powder, there were 6 Hemodialysis Centers prepare B concentration fluid prepare by themselves and 14 Hemodialysis Centers purchase dry powder. （3） The levels of endotoxin in tap water was （166.005±11.716） EU/ml, the levels of endotoxin in reverse osmosis water 1 was （0.193±0.101）EU/ml, the levels of endotoxin in reverse osmosis water 2 was （0.219±0.118）EU/ml, the levels of endotoxin in dialyser entrance dialysate was （0.428±0.226）EU/ml. （4） There was significantly difference between double osmosis systems and one osmosis systems on endotoxin of hemodialysis water and dialysate of water treatment system （P 〈 0.01）. （5） There was significantly difference betwee

关 键 词：透析用水 透析液 内毒素 

分 类 号：R459.5[医药卫生—治疗学]