麻醉机内部呼吸回路消毒有效时间研究及污染危险因素分析  

Effective time of disinfection of anesthesia machines′internal breathing circuits and risk factors for contamination

作　　者：杨凡[1,2] 李武平[2] 王宇[1] 杜白茹[1] 袁展望[2] 杨璐[3] 

机构地区：[1]第四军医大学西京医院外科手术室,陕西西安710032 [2]第四军医大学西京医院医院感染管理科,陕西西安710032 [3]第四军医大学西京医院麻醉科,陕西西安710032

出　　处：《中华医院感染学杂志》2014年第20期5115-5117,共3页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金资助项目(30872155);国家科技重大专项基金资助项目(2013ZX 10004805-003);全军医学科技"十二五"科研基金资助项目(AWS11L009;11BJZ01)

摘　　要：目的探讨麻醉机内部呼吸回路消毒的有效时间,并分析麻醉机内部呼吸回路污染危险因素,为医院采取针对性的预防措施提供依据。方法选取2013年4-11月医院Ohmeda麻醉机90台,分为对照组30台和处理组60台,消毒麻醉机后,处理组临床正常使用7d,每天对内部7个部位进行采样并细菌培养;对照组不使用连续15d每天采样,使用生存分析探讨麻醉机消毒有效时间,收集904例手术患者信息,分析麻醉机污染的危险因素。结果呼气口端单向阀污染严重,占29.39%;共检测出病原菌287株,革兰阴性菌152株占52.96%;革兰阴性菌93株占32.41%;真菌42株占14.63%;麻醉机内部呼吸回路消毒后,共有33台污染,应用生存分析,处理组内部回路污染为7d,对照组内部回路污染天数为15d;年龄、腹腔镜手术、手术时间、俯卧位、侧卧位是污染麻醉机内部呼吸回路的危险因素,差异有统计学意义(P<0.05)。结论麻醉机内部回路细菌污染严重,应高度重视麻醉机消毒工作,加大管理力度,制定相关制度,特别对手术时间长、腔镜手术、手术体位更换频繁、老年、危重患者等手术,及时对内部回路进行清洁或消毒,减少麻醉机污染概率。OBJECTIVE To explore the effective time of disinfection of anesthesia machines′ internal breathing circuits and analyze the risk factors for contamination of the anesthesia machines＇internal breathing circuits so as to take targeted prevention measures .METHODS From Apr 2013 to Nov 2013 ,totally 90 sets of Ohmeda anesthesia machines were included in the study and divided into the control group with 30 sets and the treatment group with 60 sets ;the anesthesia machines in the treatment group were normally used for 7 days after the anesthesia machines were disinfected ,and 7 internal parts were sampled everyday for the bacterial culture;the anesthesia machine in the control group were not used and sampled for 15 consecutive days ;the survival analysis was per-formed to observe the effective time of disinfection of the anesthesia machines ,the information was collected from 904 patients who underwent surgeries ,and the risk factors for contamination of the anesthesia machines were analyzed .RESULTS The anesthesia machines with severe contamination of exhalation port-side check valve accounted for 29 .39% .Totally 287 strains of pathogens have been isolated ,including 152 （52 .96% ） strains of gram-negative bacteria ,93 （32 .41% ） strains of gram-negative bacteria ,and 42 （ 14 .63% ） strains of fungi .After the anesthesia machines′ internal breathing circuits were disinfected , totally 33 sets were contaminated . The survival analysis indicated that the time of contamination of the internal circuits was 7 days in the treatment group , 15 days in the control group .The age ,laparoscopy ,operation duration ,prone position ,and lateral position were the risk factors for the contamination of the anesthesia machines＇internal breathing circuits .CONCLUSIONS The anesthesia machines′internal breathing circuits are seriously contaminated;it is necessary to pay great attention to the disinfection of the anesthesia machines ,strengthen the management ,develop relevant systems ,and carry out the cleaning or

关 键 词：麻醉机 呼吸回路 污染 消毒时间 危险因素 

分 类 号：R181.32[医药卫生—流行病学]