血液透析室消毒灭菌监测与医院感染控制  

Monitoring of disinfection and sterilization in hemodialysis room and control of nosocomial infections

作　　者：谭创[1] 姚小红[1] 黄秀良[1] 吴传芳[1] 

机构地区：[1]长沙市中心医院护理部,湖南长沙410004

出　　处：《中华医院感染学杂志》2014年第21期5423-5425,共3页Chinese Journal of Nosocomiology

基　　金：湖南省医药卫生科研计划基金项目(C2013-043)

摘　　要：目的加强血液透析室消毒灭菌监测,预防和控制血液透析患者医院感染的发生。方法按原卫生部《消毒技术规范》生物监测方法和结果判断标准执行;病例监测采取前瞻性调查的方法,诊断标准按《医院感染诊断标准》执行。结果生物监测2010年采样304份,合格281份,合格率92.43%,其中合格率最低的是透析液80.49%;2011年采样294份,合格291份,合格率98.98%;其中环境空气、工作人员手、无菌物品、消毒物品、使用中消毒液、透析用水合格率均100.00%,物体表面合格率95.83%,透析液合格率97.44%;监测维持血液透析患者2010年168例,感染19例感染率11.36%,2011年175例,感染8例感染率4.57%;感染部位主要是静脉置管部位、呼吸道和泌尿道,2011年与2010年比较差异有统计学意义(P<0.05)。结论改变血液透析室布局流程、更新设备设施、严格消毒灭菌、使用一次性医疗用品、严格洗手消毒、加强医疗废物管理,是控制医院感染的重要措施。OBJECTIVE To strengthen the monitoring of disinfection and sterilization in the hemodialysis room so as to control the nosocomial infections in the patients undergoing hemodialysis .METHODS The disinfection and steri-lization were performed according to the biological monitoring methods in Technical guidelines for disinfection of o-riginal Ministry of health ,and the criteria for interpretation of results were followed ;the case monitoring was car-ried out by means of prospective survey ,and the criteria for diagnosis executed according to the Standards for di-agnosis of nosocomial infections .RESULTS Of 304 samples taken for biological monitoring ,281 samples were qual-ified with the qualified rate of 92 .43% ,and the qualified rate of dialysate was the lowest （80 .49% ） .Of 294 sam-ples monitored in 2011 ,291 were qualified with the qualified rate of 98 .98% ,and the qualified rates of the air in the room ,staff＇s hands ,aseptic objects ,sterilized objects ,disinfections in use ,and dialysis water were 100 .00% , the qualified rate of the surfaces of objects was 95 .83% ,and the qualified rate of dialysate was 97 .44% .Among the 168 maintenance hemodialysis patients monitored in 2010 ,19 cases were infected with the infection rate of 11 .36% ,and 8 of 175 patients were infected in 2011 with the infection rate of 4 .57% .The main infection sites in-cluded the venous catheter indwelling site ,respiratory tract ,and urinary tract ,there was statistically significant difference between 2011 and 2010 （P〈0 .05） .CONCLUSION It is crucial for the control of nosocomial infections to change the layout of hemodialysis room ,update the facilities ,strictly carry out the disinfection and sterilization , rigidly comply with the hand washing and disinfection ,and enhance the management of medical waste .

关 键 词：血液透析室 消毒灭菌 监测 感染控制 

分 类 号：R187[医药卫生—流行病学]