中国血液净化

中国血液净化 ›› 2014, Vol. 13 ›› Issue (04): 344-346.doi: 10.3969/j.issn.1671-4091.2014.04.014

• 中心管理与技术 • 上一篇    下一篇

北京市血液净化中心十年透析用水化学污染物变化分析

刘学军1,于力2   

  1. 1 中日友好医院血液净化中心 2. 北京矿冶研究总院
  • 收稿日期:2013-12-23 修回日期:2014-01-13 出版日期:2014-04-12 发布日期:2014-04-12

  • Received:2013-12-23 Revised:2014-01-13 Online:2014-04-12 Published:2014-04-12

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摘要： 目的透析用水的质量直接影响透析患者的治疗安全和透析并发症的发生。通过分析北京市属医院透析中心透析用水十年化学污染物检测结果，找出化学污染物不合格的原因，研究解决方法，可以帮助透析中心更好的选择合适的水处理系统，以及设备的正确维护方法。方法铝、、铜、钡、锌、砷、铅、银、锡、镉、铬采用电感耦合等离子体质谱法检测、硒和汞采用氢化物发生-原子吸收分光光度法，氯、氯胺采用分光光度测定法，氟、硝酸盐和硫酸盐应用离子色谱法检测。钙、镁、钠、钾采用电感耦合等离子体原子发射光谱法。结果从2003 年开始，19 家透析中心透析用水化学物质超标，第2 年4 家，随后超标中心逐步减少，直到最后2 年，北京全部透析中心透析用水化学物质全部达标。结论在血液透析质量控制和改进中心的统一管理和指导下，血液透析中心使用高品质的水处理系统，同时，透析设备的常规维护和水质监测是保证透析用水质量的关键。

关键词: 透析用水, 化学物质, 水处理系统

Abstract: Objective he quality of RO water directly affects the safety and complications in hemodialysis patients. To find out the cause of chemical contaminations leading to the water unsuitable for dialysate and its solving approaches, the guidelines for selection of water purification system, and the methods for maintenance of the system, we analyzed the chemical contaminants in the recent 10 years in RO water from Beijing Municipal Hospital Hemodialysis Center. Methods Al, Cu, Ba, Zn, As, Pb, Ag, Sn, Cd and Cr were tested with ICP_MS method, Se and Hg with HG-AAS method, R-Cl2 and X-NH2 with spectrophotometry method, F, NO3- and SO4-2 with IC method, and Ca, Mg, K and Na with ICP-AES method. Results Chemical contaminants exceeded the allowing amounts in RO water were detected in 19 hemodialysis centers in 2003, and decreased to 4 centers in 2004. In recent two years, all of the hemodialysis centers in Beijing area are using
the RO water matched the chemical contamination standards. Conclusion Under the management and guidance of Hemodialysis Quality Control and Improvement Center, high quality water purification system has been widely adopted by hemodialysis centers. Routine maintenance of hemodialysis equipment and monitoring of water quality are the key steps to assure the quality of RO water.