不同血液透析预冲方法中洁净度的观察与比较  

Observation and comparison of cleanliness of different pre-rinse methods in hemodialysis

作　　者：任琴琴[1] 赵小淋 马志芳[1] 赵晓晓 于茜[1] Ren Qinqin;Zhao Xiaolin;Ma Zhifang;Zhao Xiaoxiao;Yu Qian(Department of Nephropathy,First Medical Center of PLA General Hospital,Beijing,100853,China)

机构地区：[1]解放军总医院第一医学中心肾脏病科,北京100853

出　　处：《西南国防医药》2020年第4期328-330,共3页Medical Journal of National Defending Forces in Southwest China

摘　　要：目的探讨全自动预冲与手动生理盐水密闭式预冲法在血液透析管路预冲中洁净度的效果观察。方法使用3种进口品牌的透析器在两种不同型号血液透析机上进行管路安装及预冲,观察组采用全自动超纯透析液预冲法,对照组采用手动生理盐水密闭式预冲法,两组分别预冲至500 ml、800 ml、1000 ml、1500 ml、2000 ml、2500 ml、3000 ml、3500 ml、4000 ml时用无热源试管采集预冲废液,采用酶标仪来检测预冲废液中的吸光度值和甘油残余量比较两种方法预冲中的洁净度。结果两组预冲废液吸光度值与甘油残余量在预冲至500 ml时下降不明显,预冲至800 ml时,手动预冲法甘油残余量为326 mg/dl,全自动预冲甘油残留量为32 mg/dl,两组洁净度比值有明显差异(P <0.05)。结论全自动预冲法相比手动生理盐水密闭式预冲法有更大的优越性,中央透析液供应系统(central dialysis delivery system,CDDS)中全自动预冲方式不仅洁净度高,而且可减轻医务人员负担,缩短准备预冲的操作时间,提高护士的工作效率。Objective To explore the effects of automatic pre-rinse method and the method of manual closed pre-rinse with saline to yield cleanliness in pre-rinsing the hemodialysis tubing. Methods Three imported dialyzers with different models were used for tubing installation and pre-rinse on two models of hemodialysis systems. The method of automatic pre-rinse with ultrapure dialysate was used in the observation group and the method of manual closed pre-rinse with saline was used in the control group. When the volume of pre-rinse solution in each group reached 500 ml, 800 ml, 1000 ml, 1500 ml, 2000 ml, 2500 ml, 3000 ml, 3500 ml and 4000 ml, a pyrogen-free tube was used to collect the waste pre-rinse solution. The absorbance value and glycerol residue in the waste pre-rinse solution was detected by a microplate reader to compare the resultant cleanliness of the two pre-rinse methods. Results In terms of the absorbance value and glycerol residue in the waste pre-rinse solution, neither group showed a significant decline when the volume of pre-rinse solution reached 500 ml. When the volume reached 800 ml, the control group had 326 mg/dl and the observation group had 32 mg/dl glycerol residue. There was a significant difference in the ratio of cleanliness between the two groups( P < 0.05).Conclusion The automatic pre-rinse method in the central dialysis delivery system(CDDS) is superior to the method of manual closed pre-rinse with saline, since it not only has high cleanliness, low absorbance and low glycerol residue, but also can ease the burden of medical staff, shorten the preparation time of pre-rinse, and improve the working efficiency of nurses.

关 键 词：血液透析 全自动密闭式预冲法 密闭式管路预冲法 吸光度 洁净度 

分 类 号：R459.5[医药卫生—治疗学]