上海市9所医院骨科外来器械清洗效果监测  

Surveillance of cleaning effects of rented surgical instruments from orthopedics department of 9 hospitals in Shanghai

作　　者：高晓东[1] 胡必杰[1] 沈燕[1] 崔扬文[1] 孙伟[1] 徐晶 

机构地区：[1]复旦大学附属中山医院感染管理科,上海200023 [2]上海聚力康消毒灭菌技术有限公司,上海200000

出　　处：《中华医院感染学杂志》2014年第21期5426-5428,共3页Chinese Journal of Nosocomiology

基　　金：国家科技重大专项基金资助项目(2013ZX10004217005)

摘　　要：目的了解上海市骨科外来器械灭菌前清洗效果。方法 2011年12月随机选取上海市骨科手术较多的9所医院外来骨科器械和医院自行清洗器械,采用残留血、残留蛋白、ATP和细菌培养计数等4种方法进行监测。结果共监测1 405件手术器械,其中1 115件外来器械,290件医院自行清洗器械;残留血阳性率外来器械35.7%、医院自行清洗器械4.3%(OR=12.39);残留蛋白阳性率外来器械59.1%、医院自行清洗器械32.5%(OR=3.00);ATP对数值外来器械(3.19±0.89)、医院自行清洗器械(1.71±0.47)(P<0.001);细菌菌落数均值外来器械为165.69CFU/cm2、医院自行清洗器械为12.36CFU/cm2,秩和检验P<0.001。结论外来器械灭菌前清洗不到位,残留血、残留蛋白、ATP和细菌菌落数合格率均低于医院自行清洗器械。OBJECTIVE To understand the cleaning effects of the rented surgical instruments from orthopedics de-partments in Shanghai .METHODS In Dec 2011 ,the rented surgical instruments that were used frequently for sur-geries in the orthopedics departments of 9 hospitals in Shanghai were randomly collected ,meanwhile ,the surgical instruments cleaned by the hospitals themselves were also included ,then the monitoring was performed by using 4 methods ,including the residual blood ,residual protein ,ATP ,and bacterial culture counts .RESULTS A total of 1405 pieces of surgical instruments have been monitored ,including 1115 pieces of rented surgical instruments and 290 hospital-hold instruments .The positive rate of blood residue test of the rented instruments was 35 .7% ,the hospital-hold instruments 4 .3% （OR=12 .39）;the positive rate of protein residue of the rented instruments was 59 .1% ,the hospital-hold instruments 32 .5% （OR=3 .00） .The ATP logarithm value of the rented instruments was （3 .19 ± 0 .89） ,the hospital-hold instruments （1 .71 ± 0 .47）（P〈0 .001） .The median bacterial colony counts of the rented instruments was 165 .69 CFU/cm2 ,the hospital-hold instruments 12 .36 CFU/cm2 ,and the rank sum test showed that the P value was less than 0 .001 .CONCLUSION The cleaning of the rented instrument is far to be qualified before the sterilization ,and the qualified rates of the blood residue test ,protein residue test ,ATP test ,and bacterial colony counts of the rented instruments are lower than those of the hospital-hold instruments .

关 键 词：外来器械 清洗 残留血 残留蛋白 三磷酸腺苷 细菌培养 

分 类 号：R187.3[医药卫生—流行病学]