血液透析机消毒效果的临床观察  

Clinical effect of disinfection of hemodialysis machine

作　　者：刘学军[1] 陆文进[1] 张凌[1] 

机构地区：[1]中日友好医院肾内科血液净化中心,北京100029

出　　处：《中华医院感染学杂志》2014年第1期245-246,249,共3页Chinese Journal of Nosocomiology

基　　金：北京市首都医学发展科研基金资助项目(2009-3023)

摘　　要：目的研究含氯消毒剂的化学消毒和柠檬酸热化学消毒对血液透析机的消毒效果。方法使用含氯消毒剂的化学消毒和柠檬酸热化学消毒对血液透析机进行消毒处理,消毒后取样进行细菌培养和内毒素检测,细菌培养采用国际标准的透析液细菌培养方法,即TGEA培养基,23℃,7d后读数,内毒素检测使用内毒素检测仪,动态浊度法,同时取反渗水和>1周未消毒过的血液透析机样本进行细菌培养和内毒素检测,综合评价血液透析机的消毒效果。结果经过含氯消毒剂的化学消毒或柠檬酸热化学消毒方法消毒过的血液透析机无细菌生长,内毒素均<0.1EU/ml,而未消毒的透析机内细菌检测结果是87CFU/ml,毒素检测结果为34.46EU/ml。结论含氯消毒液在确保原始浓度、消毒浓度和消毒时间的前提下可确保可靠的消毒效果;透析机在加热到85℃以上,同时吸入柠檬酸同样能达到非常好的消毒效果。OBJECTIVE To study the effects of chemical disinfection with chlorine-containing disinfectant and thermochemical disinfection with citric acid on the hemodialysis machine.METHODS The chemical disinfection of the hemodialysis machine was performed with the use of chlorine-containing disinfectant,while the thermochemical disinfection of the hemodialysis machine was conducted with the use of citric acid,then the disinfected hemodialysis machines were sampled for bacterial culture and detection of endotoxin,the bacterial culture was performed by using the bacterial culture of dialysis fluid of international standard,namely：TGEA medium,23 ℃,read at 7 days after the culture;the endotoxin testing was carried out by using endotoxin detection apparatus,turbidimetric method was used;meanwhile the reverse seepage water and the hemodialysis machines that have been not disinfected for more than one week were sampled for the bacterial culture and the detection of endotoxin,and the disinfection effects were comprehensively evaluated.RESULTS There was no growth of bacteria on the hemodialysis machines that have been disinfected with chlorine-containing disinfect or citric acid,the endotoxin levels were less than 0.1EU/ml,however,the bacterial colony counts on the hemodialysis machines without being disinfected were 87CFU/ml,and the endotoxin level was 34.46EU/ml.CONCLUSION The chlorine-containing disinfectant can achieve reliable disinfection effect wit the premise of ensuring the original concentration,disinfection concentration,and disinfection duration;while the citric acid can also achieve excellent disinfection effect when the hemodialysis machines are heated to more than 85℃.

关 键 词：血液透析机 消毒 含氯消毒剂 热化学消毒 

分 类 号：R187[医药卫生—流行病学]