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[目的]了解郴州市医院血液透析用水的卫生质量及动态分析。[方法]选择郴州市开展血液透析项目的8家医院,连续4年采集血液透析用水,检测钙、氟化物、锌、钠等15个理化指标和细菌总数。按照美国人工脏器协会(ASAIO)和美国医疗促进协会(AAMI)制定的透析用水标准进行评价分析。[结果]郴州市8家医院血液透析用水经4年连续监测完全合格的仅1家,占12.50%。透析用水检测项目中钙、细菌总数、氟离子、锌离子、钠离子合格率分别为84.38%、92.71%、100%、100%、100%。2005年8家医院透析用水合格率为70.83%,随后3年合格率有所上升,各年度合格率差异无统计学意义(χ2=2.52,P﹥0.05)。市级医院透析用水合格率(89.06%)显著高于县级医院(59.37%)(χ2=11.40,P﹤0.05)。[结论]郴州市医院透析用水合格率低的指标为钙、细菌总数。血液透析用水卫生质量有所提高。市级医院透析用水合格率高于县级医院。血液透析用水卫生质量与医院对水处理系统的管理、正确维护和定期消毒等有关。
[Objective] To understand the hygienic quality and dynamic analysis of hemodialysis water in Chenzhou hospital. [Methods] Eight hospitals in Chenzhou for hemodialysis were selected and hemodialysis water was collected for 4 consecutive years. Fifteen physical and chemical indexes, such as calcium, fluoride, zinc and sodium, and the total number of bacteria were detected. Evaluation was performed according to the dialysis water standards established by the American Association of Human Viscera (ASAIO) and the American Association for the Advancement of Anesthesiology (AAMI). [Results] There was only 1 qualified hemodialysis water in 8 hospitals in Chenzhou City after 12 years of continuous monitoring, accounting for 12.50%. Dialysis water test items of calcium, bacteria, fluoride, zinc, sodium ion pass rates were 84.38%, 92.71%, 100%, 100%, 100%. The passing rate of dialysis water in eight hospitals in 2005 was 70.83%, and then the passing rate in three years went up. There was no significant difference in passing rate in each year (χ2 = 2.52, P> 0.05). The passing rate of dialysis water in municipal hospitals (89.06%) was significantly higher than that in county hospitals (59.37%) (χ2 = 11.40, P <0.05). [Conclusion] The indicators of low passing rate of dialysis water in Chenzhou hospital are calcium and total bacteria. Hemodialysis water hygienic quality has improved. Municipal hospital dialysis water pass rate higher than the county hospital. Hemodialysis water hygienic quality and hospital water treatment system management, proper maintenance and regular disinfection.