实施规范化管理后血液透析患者肝炎感染情况调查  

Survey of hepatitis infection after the implementation of standardized management in hemodialysis palients

作　　者：王丽[1] 栾韶东[1] 陈凌宇[1] 彭庆[1] 谢于惠[1] 徐艺[1] 廖莹[1] 

机构地区：[1]广东省深圳市第二人民医院,518035

出　　处：《国际移植与血液净化杂志》2012年第6期26-29,共4页International Journal of Transplantation and Hemopurification

基　　金：广西自然科学基金项目（2010GXNZFA013272）

摘　　要：目的研究血液透析单位实施规范化管理后肝炎感染的发生情况。方法研究对象为2006年10月至2008年10月实施规范化管理前、后在我院血液净化中心维持性血液透析患者。规范化管理方法：规范血液透析室布局；尽可能减少输血次数；一次性使用透析器、血路管、穿刺针、注射器、压力传感器；重视工作人员手卫生，每操作1例患者更换1副手套；避免患者之间共用物品；两班之间透析机的化学消毒；患者定期做乙型肝炎、丙型肝炎血清学检测；肝炎病毒阳性患者应与易感患者分开或有严格的隔离措施；对乙肝二对半阴性者给予乙肝疫苗注射；对乙型肝炎病毒定量、丙型肝炎病毒定量阳性者给予α干扰素治疗。结果实施规范化管理措施后2年的随访结果表明，新增丙型肝炎感染者2例，乙型肝炎感染者1例。其中第1年新增加的乙型肝炎感染者1例，新增加的丙型肝炎感染者1例；第2年新增加的丙型肝炎感染者1例。结论通过规范化管理，可以减少血液透析患者肝炎病毒感染机会。Objective Research hepatitis infection after the implementation of standardized manage- ment in hemodialysis unit. Methods The object of study is the maintenance hemodialysis（MHD） patients before and after the implementation of standardized management in October 2006 to October 2008, in our hos- pital blood purification center. Standardized management methods： standardized hemedialysis room layout; to minimize the times of transfusions; single-use dialyzers, vascular access, needle, syringe, pressure trans- ducer; pay attention to staff hand hygiene by a pair of gloves to a single patient; to avoid sharing items be- tween patients; chemical disinfection between two classes of dialysis machines; detect serological hepatitis B virus and hepatitis C virus regularly;hepatitis virus positive patients should be separated with susceptible pa- tients or have strict quarantine measures; patients with HBV maker negative were given hepatitis B vaccina- tion; patients with HBV-DNA/HCV-RNA positive were given a-interferon treatment. Result Follow-up out- comes of 2 years after the implementation of standardized management measures show that： two new cases of HCV infection and single HBV infection case. Among them, one new eases of HBV infection and HCV infec- tion, respectively in the first year; one new HCV infection ease in second year. Conclusion Through stan- dardized management, the chances of hepatitis virus infection can be reduced in hemodialysis patients.

关 键 词：维持性血液透析 丙型肝炎 乙型肝炎 

分 类 号：R459.5[医药卫生—治疗学]