中国血液净化

中国血液净化 ›› 2018, Vol. 17 ›› Issue (11): 777-779.doi: 10.3969/j.issn.1671-4091.2018.11.014

• 中心管理与技术 • 上一篇    下一篇

多地区多中心透析用水质量控制情况调查分析

田其生1,魏新平2,柳竹青3,张东亮3   

  1. 1. 周口市中心医院肾内科
    2. 商丘市第一人民医院肾内科
    3. 北京大学国际医院血液净化中心
  • 收稿日期:2018-06-26 修回日期:2018-08-06 出版日期:2018-11-12 发布日期:2018-11-13
  • 通讯作者: 张东亮 zhangdongliang@pkuih.edu.cn E-mail:zhangdongliang@pkuih.edu.cn

Study on quality control of dialysis water among different hemodialysis centers from different areas

  • Received:2018-06-26 Revised:2018-08-06 Online:2018-11-12 Published:2018-11-13

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摘要： 【摘要】目的调查不同地区、不同透析中心透析用水和透析液质量控制情况，分析质控不达标的因素。方法选取3 个地区河南周口地区(ZK)、商丘地区(SQ)、北京市昌平地区(CP)43 家血液透析中心，对其2017 年度透析用水和透析液质量控制记录进行收集，对常见影响质量控制的信息进行问卷调查，对质量控制不合格与合格单位各参数进行对比，对各地区之间的差异进行对比。结果根据2017 年新的行业标准，3 个中心存在管理不合格，均来自SQ 地区，其他40 个中心有8 个存在检测结果不合格，与另32 个中心对比，透析液的细菌培养[(77.500±44.571)CFU/ml 对(17.523±20.000)CFU/ml,t=5.663,P＜0.001]和内毒素[(0.276±0.156)EU/ml 对(0.094 ± 0.063) EU/ml, t = 4.893, P＜0.001]最大检出值显著增高，各地区对比显示内毒素是否外送的差异有统计意义(ZK 地区12/4, SQ 地区2/11, CP 地区3/8, χ2= 10.933，P=0.004)。ZK 和SQ 地区100%的中心对新的行业标准不知晓或未执行。结论不同地区血液透析中心水质量控制存在显著差异，新标准的宣传和执行需要加强。

关键词: 血液透析, 质量控制, 透析液, 透析用水, 内毒素

Abstract: 【Abstract】Objective To compare the quality of dialysis water and dialysate among different hemodialysis(HD) centers from different areas. Methods The records regarding to quality control of dialysis water and dialysate in 2017 were collected from 43 HD centers located in the 3 areas (ZK, SQ, and CP). A questionnaire survey was conducted in order to analyze the factors for failure to pass quality examinations. Results Three centers from SQ area failed to pass quality examinations in 2017 because of management problems. Eight of the other 40 centers failed to pass the examinations; the dialysate from these centers had bacterial culture (77.50±44.57 CFU/ml vs. 17.52±20.00 CFU/ml, t=5.663, P=0.000) and endotoxin levels (0.276±0.156 EU/ml vs. 0.094±0.063 EU/ml, t=4.893, P=0.000) higher than the standards, as compared with those of the 32 centers passed the quality examinations. There was significant difference in the endotoxin test method among the 3 cities. The ratio of samples examined in other places and those examined by themselves were 12/4 in ZK area, 2/11 in SQ area and 3/8 in CP area (χ2=10.933, P=0.004). All of the centers in ZK and SQ areas did not follow the new standards for quality control of dialysis water. Conclusion There were significant differences in quality control of dialysis water and dialysate among different HD centers. The use of new standards for water and dialysate qualify control should be emphasized.

Key words: Hemodialysis, Quality control, Dialysis water, Dialysate, Endotoxin