血液透析机消毒作用的探讨

Dicussion on disinfection of hemodialysis machine

在一些透析部门中,对血液透析机的消毒不仅在每天治疗结束后进行,而且还在每次透析治疗后也对透析机执行消毒。在第一项15个透析单位(5个单位每次透析治疗结束后执行消毒和10个单位仅在每天治疗结束后消毒)参加的多方面研究当中发现,上述两种对血液透析机消毒的方式,对于发生丙型肝炎病毒(HCV)的阴转阳率并没有影响,而透析单位加强一般性预防措施,对降低HCV的阴转阳率有重要作用。在第二项研究中,对四台金宝的血液透析机平均分两一组,执行上述两种对血透机的消毒方式(即:两台在每次透析治疗结束后消毒,两台在每天治疗结束后消毒),分别检测这两组血液透析机的透析液中的细菌与内毒素的含量,结果发现它们指标参数并无明显差异。结论:血液透析机在每次透析治疗结束后消毒,对预防HCV的感染并非起到重要作用,并且对透析液中细菌和内毒素的含量无显著影响。

In some dialyse departments, the disinfection of hemodialysis machine is executed not only at the end of everyday treatment, but also after each session. In the first study including 15 departments （five with and ten without disinfection after each session）, we found that these two disinfections make no difference to the incidence of sero-conversion for HCV. However, the reinforcement of general precautions which could reduce the incidence to zero is significant. In the second study, we divided four Gambro hemodialysis machines into two groups to begin the abovementioned disinfections, that is, disinfected after each dialysis （n=2） and those disinfected at the end of the day only （n = 2）. No difference was found in dialysate bacteria and endotoxin characteristics between dialysis machines. In conclusion, the systematic disinfection of all dialysis machines after each session does not appear to help prevent HCV infection nor to have a detectable impact on optimal dialysate bacterial and endotoxin characteristics.