铜材质手术器械清洗灭菌质量的控制  

Observation and control of cleaning and disinfection quality of surgical instruments

作　　者：俞丽云[1] 周霞[1] 应瑶芸[1] 朱赛君[1] 

机构地区：[1]宁波市医疗中心李惠利医院消毒供应中心,浙江宁波315040

出　　处：《中华医院感染学杂志》2013年第22期5499-5501,共3页Chinese Journal of Nosocomiology

基　　金：浙江省医药卫生科技基金项目(2012KYB180)

摘　　要：目的观察手术器械在消毒供应中心(CSSD)清洗消毒灭菌过程中表面形成黑色污渍的原因,并找出降低黑污形成的相关控制方法,从而确保铜材质手术器械的使用时清洁质量合格。方法对360件铜材质器械按性能及工艺构造分为A、B、C 3组,分别采用不同的清洗消毒、灭菌方法,在每次完成操作程序后检查器械表面及管腔内面的清洁程度。结果铜材质器械在CSSD的常规再处理流程中器械表面常会有一定程度的黑污形成,有黑污器械率达53.33%;新器械直接进入清洗消毒灭菌流程后表面也会生成黑色污渍,柔性器械黑污率高于实体器械,二者产生器械的黑污率均>80.0%;处理过程中温度、湿度及操作方法的不同所引起器械表面黑污程度也有区别,高温高湿易引起铜材质表面氧化;在同样清洗消毒灭菌过程,铜材质器械中柔性器械的黑污程度比实体器械严重,差异有统计学意义(P<0.01);器械制造工艺影响其表面清洁度,管腔器械内面表面氧化程度比管腔外表面严重,差异有统计学意义(P<0.01)。结论铜材质手术器械的材质特点决定其易与空气中氧气发生反应生成氧化铜,在清洗消毒灭菌过程中,控制处理过程的温度、湿度可以降低该类器械的氧化反应,延长器械的使用寿命。OBJECTIVE To observe the causes of the formation of black stains on surfaces of surgical instruments during the cleaning and disinfection in the central sterile supply department（CSSD） and put forward the related control measures so as to ensure the qualified cleaning of the copper material surgical instruments. METHODS Totally 360 copper material surgical instruments were divided into the group A, B, and C according to the performance and fabrication, then the cleaning and disinfection were performed, and the cleanliness of the instruments surfaces and intraluminal sides was examined after the procedures. RESULTS A certain degree of black stains were formed on the surfaces of the copper material surgical instruments during the retreatment process with the formation rate of 53.33%, and the black stains could form on the surfaces of new instruments as they were directly involved in the cleaning and disinfection process, the formation rate of the flexible instruments was higher than that of the entity equipments, both of which were higher than 80.0%; the degrees of blood stains formation differed in the temperature, humidity, and operation method, which were prone to lead the oxidation of copper material surfaces; the degree of the blood stains formation of flexible instruments was more severe than that of the rigid instruments during the same process of cleaning and disinfection of copper material surgical instruments, the difference was statistically significant（P〈0. 01）. The fabrication could affect the surface cleanliness, and the degree of oxidation of the inner surfaces of lumen instruments was more severe than that of the outer surface, the difference was statistically significant （P〈0. 01）. CONCLUSION The nature of the copper instruments determines that they are prone to be oxidized with air to form copper oxide, an appropriate temperature and humidity can reduce the oxidation reaction during the process of cleaning and disinfection, which extends the service life of the instruments.

关 键 词：铜材质手术器械 消毒灭菌 清洁程度 

分 类 号：R187[医药卫生—流行病学]