透析機加裝內毒素過濾器的成效探討

Evaluating the Benefits of the Addition of an Endotoxin Filter in Hemodialysis Machines

為了解透析機加裝內毒素過濾器對病患治療之成效是否有幫助，在2004-2006 年間追蹤150位使用粉劑型透析液之病患，比較裝設內毒素過濾器之前、後，透析照護品質指標血清白蛋白、尿素氮清除指數（Kt/V）、血球容積、透析液中菌落數、內毒素之差異。內毒素過濾器裝置前與裝置後，透析液中細菌培養陽性率分別24% vs. 12% （P<0.05）；內毒素檢驗陽性率為9.67% vs. 0% （P<0.05）。病患血清白蛋白、Kt/V在使用內毒素過濾器後呈現明顯上升，血球容積也在使用後第二年呈現上升，自 31.27 ± 3.89上升至 32.93 ± 3.34 （P<0 . 0001） 。根據調查結果得知，透析機加裝內毒素過濾器可有效改善透析病人的營養狀況、減少紅血球生成激素的用量且大幅的提升透析品質。（ 感控雜誌 2008; 18: 283-9 ）。

To Evaluate the benefits of the addition of an endotoxin filter in hemodialysis machines, we analyzed bacterial colony counts and endotoxins of the dialysates and measured dialysis quality indices in 150 patients on hemodialysis from 2004 to 2006. Dialysates were sent for microbiologic cultures before and after installation. The positive rates of bacteria were 24% vs.l2%, respectively (p <0.05). Positive rates of endotoxin detection were 9.67% vs. 0% (p <0.05). Dialysis quality indices of the patients were also measured before and after the endotoxin filters were installed, and showed significant improvement in serum albumin, dialysis index (KT/V) and hematocrit values (p <0.0001). However, no significant reduction of erythropietin dosages was found. Adding an endotoxin filter to a hemodialysis machine can improve the patient's nutrient condition, reduce anemia and raise the dialysis quality, and furthermore, can have economic benefits. (Infect Control J 2008; 18:283-9).