血液透析机超滤控制装置临床使用故障特点调研分析

目的:调研血液透析机内部超滤控制装置故障发生情况及特点,分析原因规范其维护保养。方法:对上海市82家血液净化中心(室)的3 664台透析设备超滤故障进行调研,分析故障发生特点,找出超滤故障和超滤偏差发生原因。从执行透析设备自检程序、制定透析设备维护管理制度、掌握超滤控制装置结构部件误差和其他人为因素4个方面制定血液透析机超滤故障解决方案。结果:在82家血液净化中心(室)的3664台透析机中,超滤故障1 692台(次),其中使用年限>5年的"平衡腔+超滤泵"类故障率最高,占比31.21%。血液透析机临床使用管理制度缺失、透析机日常消毒疏忽和专职透析临床工程师配置不足是超滤故障和超滤偏差发生的主要原因。结论:血液净化中心(室)应定期进行透析设备超滤控制装置的维护检查,规范血液透析机使用管理,严格细致的维护保养,配备专职透析临床工程师,保障血液透析机超滤控制装置日常运作的精准性和稳定性,确保透析患者获得最佳透析效果。

Investigation and analysis on the characteristics of the failure in clinical use of ultrafiltration control device of hemodialysis machine

Objective:To investigate the occurrence and characteristics of the failure of the ultrafiltration control device in the interior of hemodialysis machine,and analyze the relevant reasons and standardize its maintenance.Methods:The ultrafiltration failures of 3,664 dialysis equipment in 82 blood purification centers(rooms)in Shanghai were investigated,and the characteristics of the failures of them were further analyzed.And the causes of failures and deviations of ultrafiltration were found out.The solutions of ultrafiltration failures of hemodialysis machine were formulated from four aspects:the implementation of self-inspection procedures of dialysis equipment,the formulation of the system of maintenance and management of dialysis equipment,the grasp and control of the errors of structural component of the ultrafiltration control device and other human factors.Results:In the 3,664 dialysis machines in 82 blood purification centers(rooms)in Shanghai,1,692 sets(times)occurred ultrafiltration failures.Among of them,the failure rate of"balance cavity+ultrafiltration pump"which service life was larger than 5 years was the highest,accounting for 31.21%.The main reasons of failures and deviations of ultrafiltration included the lack of management system in clinical use,the negligence in daily disinfection of dialysis machine and the insufficient allocation of clinical engineers with fulltime for dialysis.Conclusion:The blood purification center(room)should conduct regular maintenance and inspection for the ultrafiltration control device of dialysis equipment,and standardize the use and management of hemodialysis machine,and strictly and meticulously implement maintenance,and allocate clinical engineer with full-time for dialysis,and guarantee the accuracy and stability of the daily operation of the ultrafiltration control device of the hemodialysis machine,and ensure the best dialysis effects for patients who undergo dialysis.