术中加压冲洗在腹腔镜清洗中的应用研究  

Effect of High-pressure Flushing on Cleaning Surgical Laparoscopic Instruments During Operation

作　　者：杜合英[1] 张晋昕[2] 陈利芬[1] 罗春华 朱映霞[1] 张华英[1] 

机构地区：[1]中山大学附属第一医院手术室,广东广州510080 [2]中山大学公共卫生学院医学统计与流行病系,广东广州510080 [3]宁波市第一人民医院手术室,浙江宁波315010

出　　处：《中华医院感染学杂志》2010年第15期2252-2254,共3页Chinese Journal of Nosocomiology

摘　　要：目的比较4种不同腹腔镜手术器械清洗方法的清洗质量及所需时间。方法选择妇科腹腔镜手术使用的分离止血钳120件,分为4种方法组,每组30件,试验组A:术中加压冲洗+手工清洗;试验组B:术中加压冲洗+多酶+手工清洗;对照组C:手工清洗;对照组D:多酶+手工清洗,采用隐血试验监测清洗效果。结果不同组分离止血钳达到清洗效果,手工清洗所需时间分别为:试验组A(2.63±0.25)min,试验组B(2.33±0.30)min,对照组C(4.56±0.37)min,对照组D(3.43±0.29)min,术中加压冲洗组的清洗所需时间少于对照组,差异有统计学意义(F=730.79,P<0.01);经过一个清洗程序后,隐血试验检测阳性率分别为:试验组A=23.3%,试验组B=10.0%,对照组C=53.3%,对照组D=35.6%;Logistic回归分析结果:术中加压、术后加酶清洗均能显著降低隐血发生概率,两者清洗效果差异无统计学意义。结论对腹腔镜手术器械进行术中加压冲洗,可达到多酶清洗的效果,且缩短清洗时间,适用于对使用多酶清洗有一定条件限制的医院。OBJECTIVE To evaluate the effect and duration of four different cleaning methods for surgical laparoscopic instruments.METHODS One hundred and twenty gynecological laparoscopic forceps were divided into four cleaning groups,each group included 30 forceps（experimental group A： high-pressure flushing＋handied washing during operation;experimental group B： high-pressure flushing during operation ＋ handily washing＋ multi-enzyme abluent;control group C： handed washing;control group D： handied washing＋ multi-enzyme.The occult blood test was used to evaluate the effect of washing.RESULTS The ideal cleaning effect was as follows： experimental group A（2.63±0.25）min;and experimental group B（2.33±0.30） min.The duration time needed in control group C was（4.56±0.37） min;and in control group D（3.43±0.29）min,respectively.The duration needed in high-pressure flushing groups was less than control groups,There were significant differrence（F=730.79,P0.01）.The positive rate of occult blood test in the four groups were 23.3%,10.0%,53.3% and 35.6%,respectively.The Logistic analysis showed that there were no statistical differences between high-pressure flushing group and multi-enzyme abluent group.CONCLUSIONS The high-pressure flushing methods during operation can save time,while the same effectiveness may be obtained as multi-enzyme abluent on cleaning surgical laparoscopic instruments.The former may be a very good substitute in the hospital where there is a lack of multi-enzyme abluent.

关 键 词：腹腔镜器械 加压冲洗 多酶清洗 

分 类 号：R187[医药卫生—流行病学]