关键词: 透析用水, 透析液, 内毒素

Abstract: Object To investigate the status of quality of hemodialysis water and dialysate in Hemodialysis Centers of Changsha. Method A formal questionnaire was prepared and accounted in 20 hospitals Hemodialysis Centers in Changsha. We had selected four points of hemodialysis water of water treatment system, which not only acquired easily but also represent polluted situation: tap water, reverse osmosis water 1 (prepare B fluid sampling point), reverse osmosis water 2 (go into dialysis machine sampling point), dialyser entrance dialysate sampling point, to detect endotoxin, free chlorine, hardness. Result ①There are 6 disqualifications and 14 qualifications in endotoxin of hemodialysis water and dialysate, all qualifications in free chlorine of hemodialysis water and dialysate, 7 disqualifications and 13 qualifications in hardness of dialysate for 20 hospitals Hemodialysis Centers in Changsha. ② In 20 Hemodialysis Centers there were 3 Hemodialysis Centers having double osmosis system and 17 Hemodialysis Centers have one osmosis systems of water treatment system. There were 18 Hemodialysis Centers have water storage tank, 2 Hemodialysis Centers haven抰. In aspect of preparation, there were 7 Hemodialysis Centers prepare A concentration fluid prepare by themselves and 13 Hemodialysis Centers purchase dry powder, there were 6 Hemodialysis Centers prepare B concentration fluid prepare by themselves and 14 Hemodialysis Centers purchase dry powder. ③ The levels of endotoxin in tap water was (166.005 11.716) EU/ml，the levels of endotoxin in reverse osmosis water 1 was (0.193 0.101)EU/ml, the levels of endotoxin in reverse osmosis water 2 was (0.219 0.118)EU/ml, the levels of endotoxin in dialyser entrance dialysate was (0.428 0.226) EU/ml. ④ There was significantly difference between double osmosis systems and one osmosis systems on endotoxin of hemodialysis water and dialysate of water treatment system (P＜0.01). ⑤ There was significantly difference between after 2003 and before 2003 put into production on endotoxin of hemodialysis water and dialysate of water treatment system (P＜0.01). There was significantly difference between no more than 3 years and surpass 3 years change reverse osmosis membrane on endotoxin of hemodialysis water and dialysate (P＜0.01). There was significantly difference between 3 months and surpass 3 months disinfected reverse osmosis membrane on endotoxin of hemodialysis　water and dialysate (P＜0.01). There was significantly difference between no more than 3 months and surpass 3 months disinfected pipeline on endotoxin of hemodialysis water and dialysate (P＜0.05). ⑥ There was significantly difference between nondead-space heat-sterilization of secondary circuit loop and no on endotoxin of Hemodialysis water in double osmosis systems (P＜0.05), there was also significantly difference between water storage tank and no on endotoxin of Hemodialysis water and dialysate (P＜0.01). ⑦ There was significantly difference between A and B concentration fluid prepare on endotoxin of dialysate (P＜0.01). Conclusion ①The sanitary quality of the dialysate in hospitals was associated with the using time of water system, the timely exchange and disinfection of the water treatment system, and whether there were deep space and water storage tank in the channel design, and A or B concentration fluid preparation. ② Double osmosis systems was superior to one osmosis systems in Hemodialysis system of water treatment system.

Key words: Dialysate, Endotoxin