不同采样点间血液透析用水内毒素含量比较

The comparision of endotoxin content in hemodialysis water at different sampling points

目的:通过比较同一时段血液透析供水循环管路上不同采样点之间的透析用水内毒素含量之间差异,探讨临床透析用水内毒素检测最合适的标本采样点。方法:2017年6~11月采集武汉市第五医院血液透析用水样本共计552份分别做内毒素定量检测,查看每份样本内毒素含量。结果:血液透析用水内毒素含量在水处理设备供水循环管路的反渗膜出口点最低,主供水管道经过一节连接软管与血透机的连接点处内毒素含量及阳性检出率均最高,且随着透析设备使用年限的不断延长,此点的内毒素含量及阳性检出率也随之增加。结论:对血液透析用水检测的采样点除常规出口点和回路点外,末端供水采样应尽量靠近机器,主供水管道经过连接软管后与透析机相连接的点就是每台透析机供水的最末端,该点最能反映每台透析机的供水质量,此处采样的内毒素含量及阳性检出率最高,因此是最合适的透析用水标本采样点。

Objective: To compare the difference of endotoxin content in hemodialysis water at different sampling points on the circulation tube of hemodialysis water supply during the same period,and explore the most suitable sample sampling points for testing clinical dialysis water endotoxin. Methods: A total of 552 samples of hemodialysis water were collected from June to November 2017 in Wuhan Fifth Hospital. Quantitative endotoxin test was performed for each sample. Results: Hemodialysis water content of bacterial endotoxin was the lowest at the exit point of the reverse osmosis membrane of the water treatment equipment water supply circulation line. The main water supply pipe through the section connecting hose connection with hemodialysis machine endotoxin content and positive detection rate were the highest,and as the life of dialysis equipment continued to increast,this point of endotoxin content and positive detection rate also increased. Conclusion: In addition to the conventional exit point and loop point for detecting hemodialysis water sampling points,the end of the water sample should be close to the machine,and the main water supply pipeline after connecting hoses connected to a dialysis machine point is the end of each dialysis machine water supply,which can reflect each dialysis machine water supply quality. It’s the most sampling of endotoxin content and the highest positive detection rate. Therefore,the main water supply pipeline after connecting hoses connected to a dialysis machine point is the most appropriate dialysis water sampling points.