血液透析液细菌超标调查与分析

Investigation and analysis of unqualified level of bacteria in blood dialysis solution

目的查找血液透析器出入口液、B液细菌含量超标原因,制定整改措施,使其符合国家评价标准。方法对不合格者采取综合控制措施后再次监测。结果血液透析器出入口液、B液细菌菌落数分别由整改前(2152.95±826.45)(、1234.59±523.45)(、267.33±103.18)CFU/ml降至整改后(10.53±5.09)、(5.56±15.76)、0 CFU/ml;经χ2检验,透析器出入口液整改前后比较,差异有统计学意义(χ2=10.41、7.63,P<0.01),A、B浓缩液、AB干粉、反渗水无菌生长。结论血液透析液细菌污染主要来源于B浓缩液;B浓缩液配制过程必须严格执行无菌技术,做到现配现用。

OBJECTIVE To find out the causes of unqualified level of bacteria in blood dialysis solution, so as to promote measures to rectify and reform it. METHODS A survey was made on the level and species of bacteria in exit-entrance fluid, concentrated fluid A and B, reverse osmosis water etc. of hemodialyzer before and after rectify measures. RESULTS The arithmetic mean of bacteria in exit fluid, entrance fluid and concentrated fluid B decreased from （2152.95±826.45）, （234.59±523.45）, （267.33±103. 18） CFU/ml before rectify to （10.53±5.09）, （5.56±15.76）, （0） CFU/ml after rectify respectively. The wald and p-value of exit-entrance fluid was （X^2 = 10.41, P〈0.01） and （X^2=7.63, P〈0.01） respectively. Bacteria had not been checked out in concentrated fluid A, dry powders A and B, and reverse osmosis water. CONCLUSIONS The main bacteria pollution in blood dialysis solution come from concentrated fluid B. Concentrated fluid 13 should be prepared in aseptic technique, and be used immediately.