内镜消毒质量调查及其影响因素分析  

Investigation on the disinfection quality of endoscopes and influential factors

作　　者：徐岚[1] 徐薇[1] 韩颖[1] 刘玉红[1] 

机构地区：[1]镇江市疾病预防控制中心,江苏镇江212003

出　　处：《中国感染控制杂志》2008年第2期117-121,共5页Chinese Journal of Infection Control

基　　金：镇江市医学基金项目(ZY200639)

摘　　要：目的调查某市各级医院内镜消毒质量及其影响因素。方法采用问卷调查和现场抽样相结合的方法,对不同级别医院胃镜、肠镜、纤维支气管镜及其相关环境与用品按照《消毒技术规范》和《内镜清洗消毒技术操作规范》标准进行采样检测。结果内镜及其相关环境与用品全项指标合格率为57.36%,其中市级医院为83.70%,县级医院为61.00%,乡镇卫生院为37.59%;市级医院明显高于县级医院（χ2=6.96,P〈0.01）和乡镇卫生院（χ2=20.44,P〈0.01）,县级医院明显高于乡镇卫生院（χ2=4.12,P〈0.05）。各项抽样细菌总数合格率为68.66%-82.14%;高压水枪水、胃镜、肠镜细菌总数最高检出值分别为1.4×105CFU/mL、6.0×103CFU/件、6.3×103CFU/件。内镜内腔面抽样总合格率为61.90%;水洗槽及清洗槽内壁、冲洗槽内表面抽样总合格率为57.61%。结论内镜及其环境与用品污染较严重,特别是乡镇卫生院。内镜数量不足、清洗消毒不规范、设施不健全、缺乏规范管理,是造成内镜交叉污染的主要因素。Objective To investigate the disinfection quality of endoscopes and influential factors in several hospitals in a city. Methods A combining method of questionnaires and on the spot sampling was taken, according to ＂The Standards of Disinfection Techniques＂ and ＂ The Standards of Endoscope Disinfection Techniques＂, the following samples were sampled ： gastroscopes, enteroscopes, fiberbronchoscopes and other related material. Results The qualification rate of the endoscopes and other related material was 57. 36%. The qualification rate of the endoscopes and other related material in the city- level, county- level and town- level hospitals was 83.70 %, 61. 00% and 37. 59% respectively; the qualification rate in city- level hospitals was obviously higher than that in county - level hospitals（x^2 = 6.96, P〈0. 01 ） and town- level hospitals（x^2 = 20. 44, P〈0. 01 ）, the qualification rate in county- level hospitals was obviously higher than that in town- level hospitals（x^2 = 4. 12, P〈0. 05）. The qualification rate of total number of bacteria was 68. 66%-82. 14% The maximum value of bacteria isolated from water of high pressure gun, gastroscopes, enteroscopes was 1.4 × 10^5 CFU/mL, 6. 0 × 10^3 CFU/piece, 6. 3 × 10^3 CFU/ piece. The qualification rate of lumen surface of the endoscopes was 61.90%. The total qualification rate of water washing and enzyme cleaning troughs and the inner surface of rinsers was 57. 61 %. Conclusion The contamination of endoscopes and related material is severe, especially the health institutions in town. The main factors for the cross contamination of endoscopes are endoscopes shortage, nonstandardized washing and disinfection, insufficient facilities and non - standardized management.

关 键 词：内镜 消毒 感染控制 医院 监测 

分 类 号：R472.1[医药卫生—护理学]