不同检测方法对手术器械清洗质量监测的比较研究  

A comparative study on different detection methods for monitoring of cleaning quality of surgical instruments

作　　者：韦凌娅[1] 顾菁华[2] 陆烨[3] 徐虹[1] 赵岚[2] 胡连根[1] 谢利军[2] 胡国庆[3] 倪晓平[1] 

机构地区：[1]杭州市疾病预防控制中心消毒与病媒生物防制所,浙江杭州310021 [2]杭州市红十字会医院消毒供应中心,浙江杭州310003 [3]浙江省疾病预防控制中心传染病防治所,浙江杭州310051

出　　处：《中华医院感染学杂志》2014年第10期2586-2588,共3页Chinese Journal of Nosocomiology

基　　金：浙江省重点科技创新团队基金项目(2011R50021-07);浙江省卫生医药研究基金资助项目(2012KYA048);杭州市医疗科研及重点专科专病基金项目(20110733Q25)

摘　　要：目的采用不同检测方法对经复用处置的手术器械清洗质量进行比较研究，为医疗机构开展手术器械清洗质量监测提供现场快速检测技术。方法2012年5月一2013年6月对某综合医院的消毒供应中心，采用残留蛋白检测和三磷酸腺苷（ATP）生物荧光法，对经过自动清洗机清洗后的手术器械进行随机抽检，比较两项检测技术的阳性率；采用SPSSl9．0软件对数据进行统计处理；计数资料用合格率进行统计描述，组间差异用妒检验进行统计分析。结果采用残留蛋白检测组，抽检各类手术器械共148件，阳性14件，阳性率为9．46％；ATP检测组共抽检144件器械，其中〈2000相对光单位值（RLU）／件的器械有108件，占总监测数的75．00％；2000～4000RLU／件，共有25件，占17．37％；≥5000RLU／件，有11件，占7．63％；≥8000RLu／件，仅为2件，占1．39％；ATP组如设定≥5000RLU／件为阳性判断标准，则阳性率为7．63％；两项技术检测的阳性率差异无统计学意义。结论残留蛋白和ATP检测技术均可用于手术器械清洗质量的现场监测，医疗机构应根据自身特点选择监测技术，提高手术器械清洗质量，保障高度危险物品的消毒与灭菌质量。OBJECTIVE To compare the cleaning quality of the recycled surgical instruments by using different de- tection methods so as to provide a rapid on-site detection technique for the monitoring of cleaning quality of the surgical instruments. METHODS From May 2012 to Jun 2013, the surgical instruments that were cleaned with au- tomatic cleaning machine in central sterile supply department of a certain general hospital were randomly sampled for test by using the residual protein test and ATP bioluminescence assay, then the positive rate was compared be- tween the two test techniques, the statistical analysis of the data was performed with the use of SPSS19.0 soft- ware, the count data were described by using the qualified rate, and the difference between the groups was statisti- cally analyzed by means of the chi-square test. RESULTS Totally 14 of 148 sampled surgical instruments were de- tected positive by using the residual protein test with the positive rate of 9. 46~ ; totally 144 instruments were sampled in the ATP group, among which there were 108 （75.00%） instruments with the relative light units （RLU） less than 2 000, 25 （17.37%） instruments with the RLU varying from 2 000 to 4 000, 11 （7.63%） in- struments with the RLU no less than 5 000, and 2 （1.39 %） instruments with the RLU no less than 8 000. As the no less than 5 000 RLU/piece was set as the standard for the positive in the ATP group, the positive rate was 7.63%; the difference in the positive rate of test between the two techniques was not significant. CONCLUSION Both the residual protein test and the ATP bioluminescence assay can be used for the on-site monitoring of cleaning quality of the surgical instruments; the medical institutions should choose the monitoring technique according to their own characteristics so as to improve the cleaning quality of the surgical instruments and ensure the quality of disinfection of the highly dangerous objects.

关 键 词：手术器械 清洗 残留蛋白 三磷酸腺苷 

分 类 号：R187[医药卫生—流行病学]