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血液透析的水净化系统

Authors
Nicholas Hoenich, PhD
Richard A Ward, PhD
Section Editor
Steve J Schwab, MD
Deputy Editor
Alice M Sheridan, MD
Translators
刘迅, 主任医师

引言

血液透析中使用的不同水净化系统将总结在此。关于血液透析患者所接触的水源性污染物以及监测血液透析中所用水净化系统的方法的讨论，参见其他专题。 (参见“血液透析用水中的污染物”和“维护血液透析用水的质量 ”)

水净化系统的原理

所有透析中心都需要有合理设计且合理维护的水处理系统以保障患者安全[1]。由于某些毒性最强的污染物来自生活用水处理过程，所以认为如果没有水净化系统，就没有任何一种生活用水能够安全地用于血液透析。

血液透析患者特别容易受到用于制备浓缩液和透析液的水中污染物的影响，或受到用于透析器再处理的水中污染物的影响(参见“透析器复用”，关于‘再处理技术’一节)。这种易患性的原因，包括以下：

●水是透析液的主要组成部分，与不进行血液透析的个体相比，血液透析患者需要接触极大量的水。一名健康个体的水摄入量，估计为每日2L或每周14L。与之相比，在一次持续4小时、透析液流速为800mL/min的透析治疗中，一名血液透析患者要接触192L水，如果一周透析3次，则一周要接触576L水。

●血液透析患者对抵抗此类污染物的屏障不完善。在不进行透析的健康个体中，胃肠道会将血液与水中的污染物分开。相比之下，血液透析患者的血液与水的屏障为血液透析器中的膜，污染物通过透析膜的转移，仅受到污染物的分子或粒子大小的限制。

            

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Literature review current through: 2017-06 . | This topic last updated: 2016-07-14.
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