高压蒸汽灭菌法处理医院检验科废弃标本的研究

发布时间：2018-01-19 20:30

本文关键词： 医院检验科废弃标本高压蒸汽灭菌法荧光定量PCR检测法　出处：《南昌大学》2016年硕士论文　论文类型：学位论文

【摘要】：随着现代医学技术的不断进步,在经济持续发展的背景下,人们越来越重视个人健康,每年至少一次体检成为了人们的生活常态。同时,由于生活条件和环境变化的影响,导致患乙型肝炎、丙型肝炎、糖尿病以及生殖系统疾病等慢性病的人越来越多,对于这类疾病,医学检验伴随着长期的治疗过程。因此,无论是综合性医院还是专科医院,检验科的检验标本数量都越来越多,而且病原体的类型也越来越复杂。在我国的城市规划建设中,具有医学检验功能的医院一般都集中在城市中心区或者人口聚集区,而专门的医疗废物处置中心位置都较偏远,且处理量有限,因此,这些携带大量有害病原体的检验科废弃标本在储存与运输过程造成的环境安全问题已经逐渐凸显。本文专门针对综合性医院检验科废弃标本的预处理方法作了详细研究,对不同类型的病原体采用含氯消毒液浸泡和高压蒸汽灭菌法两种方式的预处理,然后进行荧光定量PCR(即Polymerase Chain Reaction,聚合酶链式反应)检测,发现对革兰氏阳性菌、革兰氏阴性菌、支原体、DNA(即Deoxyribonucleic acid,脱氧核糖核酸)病毒和RNA(即Ribonucleic acid,核糖核酸)病毒五种不同类型微生物致病菌来说,两种预处理方法均有有效的灭活作用,但高压蒸汽灭菌法在操作、消耗时间、成本、安全性方面都比化学消毒预处理法更有优势。由于含氯消毒液对于操作人员的身心健康及环境都有一定的危害,且操作时间长,导致很多医院都不对检验科废弃标本作专门的预处理。本文探讨分析用简便易行的高压蒸汽灭菌法作为检验科废弃标本预处理的方式可行性。针对不同医院检验科废弃标本量,测算高压蒸汽灭菌法操作成本,同时还应该开展更深入的研究,达到推广高压蒸汽灭菌法作为医院检验科废弃标本预处理的目的。通过本次实验研究得出以下结果:1、高压蒸汽灭菌法对革兰氏阳性菌、革兰氏阴性菌、支原体、DNA病毒和RNA病毒的灭活效果均能达到100%。2、高压蒸汽灭菌法对革兰氏阳性菌、革兰氏阴性菌、支原体、DNA病毒和RNA病毒的灭活率达到100%时所需的时间为1~1.5小时,比用湿式化学消毒预处理法进行灭菌所用时间缩短了50%以上。3、高压蒸汽灭菌法对检验科废弃标本预处理的成本极低,为3元/千份标本,比湿式化学消毒预处理法经济性高。
[Abstract]:With the continuous progress of modern medical technology, people pay more and more attention to personal health under the background of sustained economic development, at least once a year physical examination has become the normal life of people. Chronic diseases such as hepatitis B, hepatitis C, diabetes, and reproductive system diseases are more and more common as a result of changes in living conditions and the environment. Medical examination is accompanied by a long-term treatment process. Therefore, whether in general hospitals or specialized hospitals, the number of laboratory specimens is increasing. And the types of pathogens are becoming more and more complex. In the urban planning and construction of our country, the hospitals with the function of medical testing are generally concentrated in the urban center or population gathering areas. Specialized medical waste disposal centres are located in remote locations and have limited disposal capacity, so. The environmental safety problems caused by the storage and transportation of these discarded specimens from laboratory departments carrying a large number of harmful pathogens have been gradually highlighted. This paper specifically deals with the pretreatment methods of discarded specimens from laboratory departments of general hospitals. Research. Different pathogens were pretreated with chlorinated disinfectant solution and high pressure steam sterilization. Then fluorescence quantitative PCR (Polymerase Chain reaction, polymerase chain reaction) was used to detect Gram-positive bacteria and Gram-negative bacteria. Mycoplasma DNA (i.e. Deoxyribonucleic acid, deoxyribonucleic acid) virus and RNAs (Ribonucleic acid). Ribonucleic acid) virus five different types of microbial pathogens, the two pretreatment methods have effective inactivation, but high-pressure steam sterilization in operation, consumption of time, cost. Because chlorine disinfectant solution is harmful to operators' physical and mental health and environment, and the operation time is long. As a result, many hospitals do not make special pretreatment of waste specimens from laboratory departments. This paper discusses the feasibility of using simple and convenient high-pressure steam sterilization method as the preprocessing method of waste specimens in laboratory departments. Waste specimens of the family. The operating cost of high pressure steam sterilization method should be calculated, and more in-depth research should be carried out at the same time. The purpose of popularizing the high pressure steam sterilization method as the pretreatment of waste specimen in the laboratory department of hospital is to get the following results: 1. High pressure steam sterilization method for Gram-positive bacteria and Gram-negative bacteria. The inactivation effect of mycoplasma virus and RNA virus can reach 100. 2. The method of high pressure steam sterilization was used to treat Gram-positive bacteria, Gram-negative bacteria and Mycoplasma. The inactivation rate of DNA virus and RNA virus was 1 / 1. 5 hours, which was 50% or more shorter than that of wet chemical disinfection pretreatment. The cost of pretreatment of waste samples by high pressure steam sterilization is very low, which is 3 yuan / 1000, which is more economical than that of wet chemical disinfection pretreatment.
【学位授予单位】：南昌大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R187

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