血液透析患者出现热原反应原因调查  

INVESTIGATION OF CAUSE OF PYROGEN REACTION IN PATIENTS RECEIVING HEMODIALYSIS

作　　者：龚明勋 王荣芝[2] 王宣 宋梅[2] 付军[3] 

机构地区：[1]吉林省四平市神经精神病医院,四平136000 [2]吉林省人民医院 [3]吉林省卫生防疫站

出　　处：《中国消毒学杂志》2000年第3期180-182,共3页Chinese Journal of Disinfection

摘　　要：为探寻血液透析患者出现热原反应的原因，进行了微生物污染与消毒剂浓度调查。结果，消毒透析器所用过氧乙酸浓度低至０．０５％～０．１６％，贮罐中自来水、反渗水及透析器入口处透析液的细菌总数分别高达 １１ ２００ｃｆｕ／ｍｌ、 １５８０ｃｆｕ／ｍｌ与 １２５０ｃｆｕ／ｍｌ，透析液、反渗水细菌内毒素阳性率均为 １００％（ ２０／ ２０）。经确保过氧乙酸浓度≥０．３％，缩短消毒周期，改善液体过滤除菌设备，液体微生物检测均达标，未再出现热原反应。In order to find out the cause of pyrogen reaction in patients receiving hemodialysis, microorganism contamination and disinfectant concentration were investigated. The results indicated that the concentration of peracetic acid used for disinfection of dialyzer was as low as 0.05% - 0. 16%, the total bacterial counts of tap water and reverse dialysis water in reservoir and the dialysate at the inlet of the dialyzer were as high as 11 200 cfu / ml, 1580 cfu / ml and 1250 cfu / ml respectively, and the positive rate of bacterial endotoxin both in dialysate and reverse dialysis water was 100% (20/ 20). After raising the concentration of paracetic acid to ≥ 0.3%, shortening the disinfection cycle and improving the equipment for fluid filtration and bacteria removal, microorganism examination of the fluid found to meet the sanitary standard and no pyrogen reaction occurred again.

关 键 词：血液透析 透析液污染 细菌污染 热原反应消毒 

分 类 号：R459.5[医药卫生—治疗学] R187[医药卫生—临床医学]