内窥镜消毒和灭菌方法的调查研究

发布时间：2018-08-21 08:18

【摘要】： 目的：旨在对内镜相关的消毒、灭菌的基本现状进行统计学分析,探讨内镜的各种安全、高效、实用的消毒法,找到内镜消毒灭菌的最佳途径,从而为内镜医师在手术中提供更加安全、方便、快捷的内窥镜手术设备和器械。方法：应用数学统计学方法和数学建模方法对调查数据进行处理 1、将广东省内医院2002年至2004年与2007年的内镜消毒灭菌数据进行对比,分析是否逐年上升；结合各地2001年至2007年软性内镜消毒灭菌的调查数据,用软件Matlab进行消毒合格率的曲线拟合,分析其现状,并对软性内镜2012年的合格率进行走势预测。 2、对广州市36家大型医院的手术室进行灭菌设备的调查,研究低温灭菌设备的市场占有率； 3、跟踪调查广州某三甲医院微创中心2005年至2008年的内镜消毒灭菌记录, 4、进行三项对比；分析内镜消毒灭菌设备的理想配置。 5、安装并运行Spss15和Matlab,进行统计数据分析。结果： 1、广东省软性镜的消毒合格率接近50%,全国各地的软性镜消毒合格率同样偏低。如果《内镜清洗消毒技术操作规范》没有大的调整,Matlab预测2012年的消毒灭菌合格率同样偏低； 2、通过高温高压和环氧乙烷灭菌的硬性镜,合格率为100%； 3、过氧化氢等离子和过氧乙酸灭菌效果一致,均为100%。在经济较发达地区,等离子和过氧乙酸等等低温灭菌设备已成为内镜消毒市场的主体； 4、各种现有低温灭菌方法中,过氧化氢等离子灭菌与过氧乙酸灭菌液是最为先进的灭菌方法；一般只需等离子和过氧乙酸设备各一套,即能满足一般医院的内镜手术要求。结论： 1、过氧化氢等离子灭菌与过氧乙酸灭菌液是最为先进的灭菌方法； 2、胃镜、肠镜等软性镜的消毒合格率偏低,内镜消毒水平并未逐年上升,硬性内镜的灭菌结果合格率高； 3、最佳的内镜灭菌方法,并非指某一种灭菌法,而是过氧化氢等离子、过氧乙酸甚至环氧乙烷等多种灭菌方法的组合,以期达到时效、安全、经济各方面的综合平衡。
[Abstract]:Objective: to analyze the basic status of endoscope-related disinfection and sterilization in order to find out the best way to sterilize endoscopy. Thus, endoscopes can provide more safe, convenient and fast endoscope operation equipment and instruments for endoscopes. Methods: the investigation data were processed by mathematical statistics method and mathematical modeling method. The data of endoscope disinfection and sterilization from 2002 to 2004 were compared with those of 2007 in Guangdong Province. According to the investigation data of soft endoscopy disinfection and sterilization in various places from 2001 to 2007, the qualified rate curve of disinfection was fitted with software Matlab, and the present situation was analyzed. The qualification rate of soft endoscopy in 2012 was forecasted. 2. The sterilization equipment in 36 large hospitals in Guangzhou was investigated and the market share of cryogenic sterilization equipment was studied. 3. To follow up and investigate the records of endoscopic disinfection and sterilization from 2005 to 2008 in a minimally invasive center of a third Class A Hospital in Guangzhou. 4, three items were compared. Analyze the ideal configuration of endoscope sterilizing equipment. 5. Install and run Spss15 and Matlab for statistical data analysis. Results: 1, the qualified rate of soft mirror disinfection in Guangdong Province was close to 50%, and the qualified rate of soft mirror disinfection was also low in various parts of the country. The qualified rate of disinfection in 2012 is also low if the standard of operation of endoscopic cleaning and disinfection technology is not adjusted greatly by Matlab. 2, the qualified rate of sterilizing rigid mirror through high temperature and high pressure and ethylene oxide sterilization is 100%; 3, hydrogen peroxide plasma and peracetic acid have the same sterilizing effect, both of which are 100. In economically developed areas, low-temperature sterilization equipment such as plasma and peracetic acid has become the main body of the endoscopic disinfection market. Hydrogen peroxide plasma sterilization and peracetic acid sterilization solution are the most advanced sterilization methods. Conclusion: 1, hydrogen peroxide plasma sterilization and peracetic acid sterilization solution are the most advanced sterilization methods, 2, gastroscope, enteroscopy and other soft mirror disinfection qualification rate is low, The sterilizing level of endoscopy has not increased year by year, and the qualified rate of sterilizing results of rigid endoscopy is high. 3. The best method of endoscopy sterilization is not a certain sterilization method, but hydrogen peroxide plasma. The combination of many sterilization methods, such as peracetic acid and even ethylene oxide, in order to achieve the comprehensive balance of aging, safety and economy.
【学位授予单位】：中南大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R187

【相似文献】