改进内镜清洗方法的临床应用研究

发布时间：2018-10-31 19:13

【摘要】：目的检测冲洗后内镜不同部位的有菌率,比较清洗方法改进前后的清洗效果。方法对《内镜清洗消毒技术操作规范》中酶处理和刷洗的方法进行改进,刷洗时调整大小螺旋的方向,并在清洗剂中初洗;刷洗手法从直刷改为螺旋式刷洗;延长冲洗时间,流程改进前后采集内镜不同部位的标本进行细菌学检验,改进后采集不同清洗阶段的标本进行ATP值测定,以检测清洗效果。结果内镜有菌率45°孔道最高为48.0%、90°孔道次之为44.0%、镜表最低为20.0%,不同部位有菌率比较,差异有统计学意义(P0.05);改进清洗方法前细菌阳性率为34.5%,改进后为0,差异有统计学意义(P0.05);离体后-预处理-初洗后(酶洗后)-冲洗后污染物下降明显,提高了内镜清洗的清洁度。结论流程改进后清洗内镜效果优于流程改进前。
[Abstract]:Objective to detect the bacteriological rate of different parts of the endoscope after washing and compare the cleaning effect before and after the improvement of the cleaning method. Methods to improve the method of enzyme treatment and washing in the Technical Standard of Endoscopic cleaning and Disinfection, to adjust the direction of the screw and the initial washing in the cleaning agent, to change the method of brushing from the straight brush to the spiral type. After extending the washing time, the samples of different parts of the endoscope were collected for bacteriological examination before and after the process was improved, and the ATP values of the samples at different cleaning stages were measured after the improvement, in order to detect the cleaning effect. Results the bacteriological rate of endoscope was 45 掳and the highest was 48.0 and 90 掳respectively, the second was 44.0, the lowest was 20.0, and the difference was statistically significant (P0.05). The positive rate of bacteria before improving cleaning method was 34.5%, and that after improvement was 0, the difference was statistically significant (P0.05). After in vitro-pretreatment-after primary washing (after enzyme washing)-after washing the contaminants decreased obviously, which improved the cleanliness of endoscopy cleaning. Conclusion the effect of cleaning endoscopy after process improvement is better than that before process improvement.
【作者单位】：北京积水潭医院内镜中心;
【基金】：国家卫计委公益性科研专项基金资助项目(201302007)
【分类号】：R187.4

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