被忽視的事—血液透析用逆滲透膜的清洗和消毒（下）

A Neglected Thing-Cleaning and Disinfection of Reverse Osmosis Membrane Used in Hemodialysis

10.6340/KD.202312_35(4).0008

蔡佳璋(Chia-Chang Tsai)；樊照鑫(Zhao-Xin Fan)；林世龍(Shih-Lung Lin)；李怡錫(Yi-Hsi Lee)；張津維(Chin-Wei Chang)；廖健富(Jian-Fu Liao)；徐永堂(Yung-Tang Hsu)

血液透析 ； 逆滲透膜 ； 清洗 ； 積垢 ； 水垢 ； hemodialysis ； reverse osmosis (RO) ； cleaning ； fouling ； scaling

腎臟與透析

35卷4期（2023 / 12 / 01）

195 - 200

繁體中文;英文

透析用水的品質對患者的透析安全與長期預後有重大的影響，逆滲透膜是生產透析用水的設備中最重要的核心部件。隨著長期連續性地使用及前級處理維護不當，膜表面污垢沉積與生物膜孳生是影響產水量和透析用水微生物水準的關鍵因素之一。本文從逆滲透膜工作原理、膜表面污垢形成原因及處理對策，並結合實例分享水處理逆滲透膜產水量降低的處置經驗。闡述血液透析中心經常被忽視的事－逆滲透膜的清洗與消毒工作的重要性與必要性。

The quality of water used in hemodialysis seriously affects the safety and long-term prognosis of end-stage renal disease patients. Reverse osmosis (RO) membrane is the most important core component of water treatment apparatus for producing pure water. With lasting and continuous use of RO membrane and improper maintenance of pre-treatment of water treatment system, foulants' accumulation and biofilm growth onto the membrane surfaces and/or inside the membrane pores is one of the key factors affecting water production and microbial levels. This paper discusses the rationale of the RO membrane, the causes of fouling on the membrane surface and the resolving solutions. This paper also combines examples to share our experience in dealing with the reduction of water production of the RO membrane. We explain the importance and necessity of cleaning and disinfection of RO membrane, which is often overlooked in hemodialysis centers.