使用酸性氧化电位水消毒血液透析浓缩液容器的安全性和有效性研究

目的 通过研究酸性氧化电位水对血液透析浓缩液容器消毒的有效性和安全性,探讨血液透析浓缩液盛放器安全便捷的消毒方案.方法 在北京市某三甲医院血液透析中心随机选取当天透析结束后的B液塑料桶80个,用自来水接种细菌后,容器盛满酸性氧化电位水并以2L/min的速度流动消毒,分别用4种消毒技术路线对B液桶消毒,同时直接培养自来水及当天透析结束后剩余的B液作为对照.结果 ①4种消毒技术路线对血液透析浓缩液容器消毒均有效（P＜0.05）;但路线A残余总氯量最大,与其它路线比较有统计学差异（3.31±1.69） mg比（0.03±0.02） mg比（0.03±0.08） mg比（0.07±0.13） mg,P＜0.05].不冲洗无论桶盖盖与否（路线A、B）残余内毒素总量较冲洗（路线C、D）多（P＜0.05）.②路线C、D残余总氯量（0.03±0.08）mg,（0.07±0.13）mg]和残余内毒素总量（29.54±28.60EU和21.87±17.37EU）较路线A、B明显降低,具有良好的有效性及安全性,但路线C和D间无明显统计学差异（P＞0.05）.结论 酸性氧化电位水用于血液透析浓缩液容器的消毒具有良好的有效性和安全性,酸性氧化电位水消毒5分钟后冲洗、盖好桶盖的消毒方法是较优选择.

Efficiency and safety of disinfection for hemodialysis concentrated fluid containers by acidic electrolyzed oxidizing water

Objective The aim of this study was to evaluate the efficiency and safety of acidic electro- lyzed oxidizing water （AEOW） for disinfecting the concentrated dialysate containers. Methods A total of 80 containers for bicarbonate concentrated dialysate were collected from one hemodialysis center. The containers were contaminated by the bacteria in tap water, and the efficiency and safety of the four disinfection protocols were then compared. Results The four protocols were all effective for disinfecting the concentrated dialysate containers （P 〈 0.05）. After the disinfection of protocol A, however, residual chlorine in dialysate was higher than the upper safety limit, and was also higher than that after the disinfection of protocols B, C and D （3.31± 1.69mg, 0.03±0.02 mg, 0.03±0.08 mg, and 0.07±0.13 mg using protocol A, B, C and D, respectively; P 〈 0.05）. Residual endotoxin was higher using protocols A and B than using protocols C and D （P 〈0.05）, but was indifferent between protocols C and D. After the disinfection of protocols C and D, residual chlorine was 0.03±0.08 mg and 0.07±0.13 mg, respectively, and residual endotoxin was 29.54±28.60 EU and 21.87±17.37 EU, respectively, significantly lower than those by protocols A and B, and indifferent between protocols C and D （P 〉0.05）. Conclusions AEOW was effective and safe for disinfecting the concentrated dialysate contain- ers. The optimal disinfection procedure included treatment with AEOW for 5 minutes followed by rinse and lid covering.