过氧乙酸与伦拿灵用于可复用透析器消毒效果比较

A Comparative Study on Peracetic Acid and Peracidin to Sterilize the Reusable Hemodialysis Machine

目的通过过氧乙酸与伦拿灵对可复用透析器消毒效果监测的对比分析,选择对可复用透析器消毒可靠、经济和实用的消毒剂。方法采取40例肾病患者血液透析2h后的透析液及透析用反渗水进行细菌学监测筛选菌种;确定过氧乙酸和伦拿灵的有效浓度,对标准菌株进行杀、抑菌试验;观察2种消毒剂在不同pH值、不同温度、不同作用时间下对标准菌株和样本液及HBsAg的杀灭效果;在透析器复用机上进行过氧乙酸破膜试验。结果血液透析器污染菌以铜绿假单胞菌为主(占45.76%);过氧乙酸与伦拿灵原始浓度分别为19.2%和4.99%,杀、抑菌浓度均相同,分别为0.125%和0.0313%,且在pH1.07～4.21、温度9～32℃、浓度为0.5%,作用时间不少于10min条件下,对样本液和标准菌株及HBsAg具有较强杀灭作用;可复用透析器经压力测试未出现破膜现象。结论过氧乙酸和伦拿灵比较,两者杀、抑菌浓度相同。在过氧乙酸溶液中加入适量稳定剂,可延长放置时间。在对可复用透析器消毒效果相同情况下,过氧乙酸因其成本低、易清洗,更值得在基层医院使用。

Objective To compare the results of using peracidin and peracetic acid to sterilize the reusable hemodialysis machine. Methods Dialysate and reverse osmosis water were tested for bacteria strain screening of 40 patients with nephrosis 2 h after hemodialysis. Standard strains were tested for killing or bacteriostasis using peracidin and peracetic acid. The effects of peracidin and peracetic acid were compared under different pH, different temperature or different action time. Rupture of membrane test was performed on reusable hemodialysis machine. Results Non-acescence gram negative rod was the main contaminated bacterium and Pseudomonas aeruginosa was the major one of them. Initial concentration of peracidin and peracetic acid was 19.2 % and 4.99 % respectively, and the killing or bacteriostasis concentrations were the same as 0. 125% and 0. 0313% respectively. The killing effects on sample and standard strains were strong under pH 1.07-4.21, 9-32℃, 0.5% and more than 10 min. No rupture of membrane occurred by pressure test of reuasble hemodialysis machine. Conclusion Both peracidin and percetic acid had the same concentrations of killing or inhibiting bacteria. The killing effects on sample and standard strains and HBsAg had no difference between two antiseptics. But there was significant deference in the stability and economics between them. With the same sterilization effects on reusable hemodialysis machine, percetic acid is the better choice because of its low cost and washing easily.