血液透析室之逆滲透管路消毒監測

Monitoring Disinfection of Reverse Osmosis Water Distribution Systems in Hemodialysis Units

透析用逆滲透（Reverse Osmosis, RO）純水必須是無菌、無熱原且無化學物質的污染，而其製造系統每月應至少進行一次純水輸送管路消毒，包括儲水桶、供水管路、RO出水口至透析機，消毒方式可使用漂白水、過醋酸、臭氧或熱水消毒法等。在透析治療的過程中，造成細菌和內毒素污染的來源，可能來自於原水（自來水）、逆滲透水、超過濾器、輸送分佈系統、濃縮液、透析機消毒不完全等。需定期進行各種裝置的消毒、維護及保養，以維持透析的品質與安全。本文將會分享本院漂白水（次氯酸鈉）消毒的經驗。

The reverse osmosis water system in hemodialysis should be free from bacteria, pyrogens, and chemical pollution. This system should undergo disinfection of circuits, including, the water storage tank, pipes, water outlet, and hemodialysis machine, at least once per month. Methods of disinfection include using bleach, peracetic acid, ozone, and hot water. During hemodialysis, the source of bacterial and endotoxin contamination may be raw water, reverse osmosis water, dialysis concentrates, inadequate disinfection of hemodialysis machines, ultrafilters, and distribution systems. It is essential to conduct the disinfection and maintenance of equipment in order to maintain the quality and safety of hemodialysis. This article will share the experience of disinfection with bleach (sodium hypochlorite) in our hospital.