两种消化内镜高水平消毒对乙肝病毒灭活的效果评价  

Evaluation of the Effect on HBV Inactivation by Two High-level Digestive Endoscope Sterilization Methods

作　　者：周丽华[1] 邓琼[1] 阳运超[1] 张仁翼[1] 肖华慧[1] 

机构地区：[1]四川省人民医院消化内镜中心,四川成都610072

出　　处：《四川医学》2016年第3期264-267,共4页Sichuan Medical Journal

基　　金：四川省卫计委科研课题(编号:30305030689)

摘　　要：目的通过两种消化内镜高水平消毒方法对HBV灭活的对照研究,探讨被HBV污染的消化内镜最佳的高水平消毒方案,为探讨被HBV污染的消化内镜有效的消毒时间提供临床证据。方法将HBV污染的消化胃镜209条,按入组先后,采用随机单双号分配方法分为一般高水平消毒组(n=104)和特殊高水平消毒组(n=105)。一般高水平消毒组按我国《内镜清洗消毒技术规范》普通污染内镜法处理,即床侧清洗→初洗→HBV专用全自动内镜清洗消毒机处理(消毒时间:10min)→干燥,耗时19min;特殊高水平消毒组按我国《内镜清洗消毒技术规范》特殊污染内镜处理法:即床侧清洗→消毒(消毒时间:30min)→初洗→HBV专用全自动内镜清洗洗消机处理(消毒时间:10min)→干燥,耗时49min。两组均在清洗消毒前后行生物监测并记录。结果两组胃镜在使用后污染率比较差异无统计学意义(P>0.05),HBs Ag结果分布差异无统计学意义(P>0.05),通过不同消毒方法后生物学监测比较差异亦无统计学意义(P>0.05),但两组内镜每条消毒处理时间相差30min。结论乙肝患者使用后的胃镜HBV污染力不高,两种高水平消毒均能对HBV进行灭活,对乙肝患者使用过的内镜可采用一般高水平消毒,节约消毒时间与成本,提高工作效率。Objective A control study comparing the effect of two high-level digestive endoscope sterilization methods on HBV inactivation was conducted to investigate the optimal high-level sterilization method of digestive endoscope with HBV contamination. We also aimed to provide clinical evidence regarding on the optimal sterilization duration of digestive endoscope with HBV contamination. Methods Digestive endoscopes were randomized into general high-level sterilization group and special high-level sterilization group by randomized odd and even number. According to Technical Specification of Cleaning and Disinfection of Endoscope ,general high-level sterilization includes the following steps： bedside treatment→primary cleaning→HBV specific automatic cleaning and disinfection machine（ disinfection duration： 10min） → desiccation,time consuming： 19 min. Special high-level sterilization includes the following steps： Bedside treatment→disinfection（ disinfection duration： 30min） →primary cleaning→HBV specific automatic cleaning and disinfection machine（ disinfection duration： 10min） →desiccation,time consuming： 49 min. Biological monitoring was recorded in both groups before and after the cleaning and disinfection. Results There were no differences in contamination rate,HBs Ag distribution as well as the biological monitoring results between the two groups（ P〉0. 05）. However,regarding on the treatment time of each gastroscope,there is a 30 min difference. Conclusion The contamination rate of gastroscope after being used among patients with HBV infection was not high and both methods can inactivate HBV. General high-level sterilization can be taken for the reason that it is both time and cost-efficient and can improve working efficiency.

关 键 词：消化胃镜 乙肝病毒 消毒 

分 类 号：R512.62[医药卫生—内科学]