2003-2007年衡阳市医院血液透析用水卫生质量状况及分析

Analysis of Sanitary Quality of Blood Dialysis Water in Hospital in Hengyang City during 2003～2007

目的了解衡阳市医院血液透析用水的卫生质量及动态分析。方法选择衡阳市开展血液透析项目的13家医院,连续5年采集血液透析用水,检测钙、氯化物、氟化物、锌、钠等22个理化指标及致热原和细菌总数。按照美国人工脏器协会(ASAIO)和美国医疗促进协会(AAMI)制定的透析用水标准进行评价分析。结果衡阳市13家医院血液透析用水经5年连续监测完全各格的仅6家,占46.15%。透析用水检测项目中细菌总数、致热原、钙、氯离子、氟离子、锌离子、钠离子合格率分别为94.87%、96.58%、98.29%、94.01%、99.14%、100%、100%。2003年13家医院透析用水合格率为65.38%,逐年上升,2006年为92.30%,各年度合格率差异有显著性(χ2=10.64,P<0.05)。三级甲等医院透析用水合格率(93.33%)显著高于二级甲等医院(76.38%)(χ2=5.61,P<0.05)。结论衡阳市医院透析用水合格率低的指标为细菌总数、致热原及氯化物。透析用水卫生质量在逐年提高。三级甲等医院透析用水合格率高于二级甲等医院。血液透析用水卫生质量与医院对水处理系统的管理、正确维护和定期消毒等有关。

Objective To study the sanitary quality of blood dialysis water used in hospitals of Hengyang City. Methods Pyrogen, total bacteria count, and altogether 22 physical and chemical indexes including calcium, chloride, fluoride, zinc, sodium and others in the blood dialysate water samples from blood dialysis rooms of 13 hospitals in Hengyang City were evaluated. The data were evaluated and analyzed on the standards for the blood dialysate recommendation of ASAIO and AAMI. Results Only the blood dialysate samples from 6 hospitals were completely met with the sanitary quality, which was accounted 46.15% only. The qualified rates were 94.87%, 96.58%, 98.29%, 94.01%, 99.14%, 100%, and 100% for total count of bacteria, pyrogen, calcium, chloride, fluoride, zinc, and sodium among the blood dialysate samples respectively. The qualified rate of blood dialysis water from 3A grade hospitals was 93.33%, which was significantly higher than that from the 2A grade hospitals （76.38 % ）, （χ^2 = 5.6, P 〈 0.05 ）. Conclusions The low qualified rates of dialysate water in hospitals of Hengyang City are pyrogen, total bacterial count and chloride. The sanitary quality of dialysis water in hospitals is associated with the timely improvement and disinfection of the filtering sand, ion- exchange resin, tubes and water storage tanks.