透析用水内毒素指标与供水管路使用寿命的探讨

The Exploration on the Endotoxin Index of Dialysis Water and the Service Life of Water Supply Pipelines

目的通过分析透析用水内毒素检测指标探讨供水管路的维护方法及更换周期。方法调查某透析中心使用10年以上的供水管路内毒素检测指标,根据供水管路使用现状、水处理系统日常维护流程,分析透析用水内毒素超标原因,并探讨透析用水内毒素相关防控策略。结果2022年4月15日发现反渗水出口内毒素含量为0.096 EU/ml、反渗水回口内毒素含量为0.156 EU/ml,予以消毒、冲洗等干预措施后未达标,更换反渗膜后反渗水出口内毒素含量为0.022 EU/ml、反渗水回口内毒素含量为0.036 EU/ml;2022年9月内毒素指标又出现异常,对供水管路进行消毒后发现反渗膜出口内毒素含量为1.025 EU/ml,反渗膜回口内毒素含量为2.012 EU/ml,整体更换供水管路后内毒素指标恢复正常值。结论加强透析用水供水管路的日常监管及维护,可降低透析用水内毒素超标风险,确保患者透析安全。

Objective To explore maintenance methods and replacement cycles for water supply pipelines,by analyzing the endotoxin detection indicators of dialysis water.Methods With the investigation of endotoxin testing indicators in the water supply pipeline of a dialysis center used for more than 10 years,according to the current usage status of water supply pipelines and the daily maintenance process of water treatment systems,the reasons for excessive endotoxin levels in dialysis water were analyzed,and relevant prevention and control strategies for endotoxin levels in dialysis water were explored.Results On April 15,2022,it was found that the endotoxin level at the outlet of reverse osmosis water was 0.096 EU/ml,and the endotoxin content at the return of reverse osmosis water was 0.156 EU/ml.After disinfection,flushing and other intervention measures,the standard was not met.After replacing the reverse osmosis membrane,the endotoxin content at the outlet of the reverse osmosis water was 0.022 EU/ml,and the endotoxin content at the return of the reverse osmosis water was 0.036 EU/ml.In September 2022,the endotoxin index showed abnormalities again.After disinfection of the water supply pipeline,it was found that the endotoxin content at the outlet of the reverse osmosis membrane was 1.025 EU/ml,and the endotoxin content at the return of the reverse osmosis membrane was 2.012 EU/ml.After the whole water supply pipeline was replaced,endotoxin index returned to normal value.Conclusion Strengthening the daily supervision and maintenance awareness of the dialysis water supply pipeline can reduce the risk of excessive endotoxin in dialysis water and ensure the safety of patient dialysis.