柠檬酸热化学消毒联合次氯酸化学消毒对血液透析机的消毒作用研究

摘要

Objective To investigate the effects of citric acid combined with hypochlorous acid in hemodialysis machine. Methods 10 sets of Fresenius 4008S hemodialysis machine from May 2015 to December 2015 were selected and randomly divided into the observa-tion group and control group, 5 in each group. The control group used citric acid chemical disinfection method, and the observation group used citric acid chemical disinfection combined with hypochlorous acid chemical disinfection. Both groups were taken 100 mL re-verse osmosis water respectively for bacterial culture and endotoxin detection, and the contrast analysis, comprehensive evaluation of the disinfection effect of hemodialysis machine were carried out. The event of failure during using hemodialysis machine in the two groups were recorded. Results Before the disinfection, the bacterial colonies of two groups were ﹥ 100 cfu / mL. After disinfection, the bacterial colonies of the observation group was(12. 36 ± 16. 87) cfu / mL, which was significantly lower than(33. 88 ± 19. 69) cfu / mL of the control group( P ﹤ 0. 05) . The qualified rate of bacterial colonies and qualified rate of endotoxin determination of the observation group were significantly higher than the control group( P ﹤ 0. 05) . Before disinfection, the bacterial endotoxin levels in the hemodialysis machine of the two groups were far beyond the eligibility criteria; after disinfection, the endotoxin levels in the two groups reached the eligible cri-teria, and the endotoxin content detected in the observation group was significantly lower than the control group, the qualified rate of endotoxin higher than the control group with significant differences( P ﹤ 0. 05) . During the use of hemodialysis machine, the average failure rate was 4. 00% in the observation group, which was significantly lower than 20. 00% of the control group ( P ﹤ 0. 05 ) . Conclusion Citric acid combined with hypochlorous acid has a better disinfection efficacy on hemodialysis machine, it can also reduce the machine failure caused by an incomplete sterilization, ensure the normal operation of the machine, and there is a safety guarantee for the treatment of patients.%目的：探讨柠檬酸热化学消毒联合次氯酸化学消毒法对血液透析机的消毒作用。方法选取医院2015年5月至12月使用的费森尤斯4008S 型血液透析机10台，随机分为观察组和对照组，每组5台。对照组采用柠檬酸热化学消毒法，观察组采用柠檬酸热化学消毒联合次氯酸化学消毒法对血液透析机进行消毒。分别取两组消毒前后的血液透析机反渗水100 mL，测定细菌菌落数及细菌内毒素，并进行对比分析，综合评价血液透析机的消毒效果。记录两组血液透析机在使用期间的故障情况，分析故障原因。结果消毒前，两组血液透析机细菌菌落数均超过100 cfu / mL，经过消毒，观察组菌落数为（12.36±16.87）cfu / mL，显著低于对照组的（33.88±19.69）cfu / mL，组间差异具有统计学意义（ P ﹤0.05），且观察组菌落测定合格率明显高于对照组（ P ﹤0.05）。消毒前，两组血液透析机细菌内毒素含量均远超合格标准，消毒后，两组内毒素含量均达到合格标准，且观察组检测得到内毒素含量显著低于对照组，内毒素测定合格率高于对照组，组间具有统计学差异（ P ﹤0.05）。在血液透析机使用期间，观察组平均故障率4.00%，明显低于对照组的20.00%，组间具有统计学差异（ P ﹤0.05）。结论柠檬酸热化学消毒联合次氯酸化学消毒对血液透析机具有更佳的消毒效果，同时还可减少因消毒不彻底造成的机器故障，保证机器正常运转，保障患者的治疗安全。