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临床实践指南:血液透析单元中血源性病毒的管理。

Clinical practice guideline management of blood borne viruses within the haemodialysis unit.

机构信息

Leeds Teaching Hospitals NHS Trust, Leeds, UK.

Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.

出版信息

BMC Nephrol. 2019 Oct 28;20(1):388. doi: 10.1186/s12882-019-1529-1.

Abstract

Some people who are receiving dialysis treatment have virus infection such as hepatitis B, hepatitis C and/or HIV that is present in their blood. These infections can be transmitted to other patients if blood is contaminated by the blood of another with a viral infection. Haemodialysis is performed by passing blood from a patient through a dialysis machine, and multiple patients receive dialysis within a dialysis unit. Therefore, there is a risk that these viruses may be transmitted around the dialysis session. This documents sets out recommendations for minimising this risk.There are sections describing how machines and equipment should be cleaned between patients. There are also recommendations for dialysing patients with hepatitis B away from patients who do not have hepatitis B. Patients should be immunised against hepatitis B, ideally before starting dialysis if this is possible. There are guidelines on how and when to do this, for checking whether immunisation is effective, and for administering booster doses of vaccine. Finally there is a section on the measures that should be taken if a patient receiving dialysis is identified as having a new infection of hepatitis B, hepatitis C or HIV.

摘要

一些正在接受透析治疗的人患有乙型肝炎、丙型肝炎和/或艾滋病毒等病毒感染,这些病毒存在于他们的血液中。如果血液被另一个带有病毒感染的人的血液污染,这些感染可能会传播给其他患者。血液透析是通过将患者的血液从患者体内引出,经过透析机处理,然后再输回患者体内。因此,在透析过程中存在这些病毒传播的风险。本文件提出了降低这种风险的建议。其中包括如何在患者之间清洁机器和设备的说明。还建议将乙型肝炎患者与没有乙型肝炎的患者分开透析。如果可能的话,患者应在开始透析前接种乙型肝炎疫苗,这是理想的。本文件就如何以及何时进行免疫接种、检查免疫接种是否有效以及给予疫苗加强剂量提供了指南。最后,文件还就如何应对接受透析治疗的患者新感染乙型肝炎、丙型肝炎或艾滋病毒的情况提供了建议。

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