不同干燥方法对消化内镜再处理效果的影响研究  

Effects of different drying methods on gastrointestinal endoscope reprocessing

作　　者：黄婵[1] 娄廼彬[1] 彭秋生[2] 安芳 杨思慧 HUANG Chan LOU Nai-Bing PENG Qiu-Sheng AN Fang YANG Si-Hui(Peking University Peoplels Hospital, Beijing 100044, China)

机构地区：[1]北京大学人民医院消化内科,北京100044 [2]北京大学人民医院检验科,北京100044

出　　处：《中华医院感染学杂志》2017年第20期4787-4790,共4页Chinese Journal of Nosocomiology

摘　　要：目的探讨应用微生物学监测比较乙醇干燥、压缩空气干燥等不同干燥方法对内镜消毒效果的影响。方法分层随机抽样、双盲设计,入选的内镜经专人执行标准化的"预处理-清洗-漂洗-消毒-终末漂洗"后,随机分为三组:A组99条,不进行干燥;B组96条,压缩空气吹干各管腔各30s;C组105条,75%乙醇30ml冲洗内镜各管腔,保持3min,然后用压缩空气吹干各管腔30s。微生物学采样以10ml中和剂注入内镜活检管腔,收集后接种于普通琼脂平皿,于35℃培养48h,计数菌落数。结果各组菌落数为偏态分布,C组菌落数的P70,P80,P90均小于其他两组,差异有统计学意义(P<0.05)。三组微生物学监测合格率分别为A组73.73%、B组77.08%,C组89.52%,C组的微生物学监测合格率高于A组,差异有统计学意义(P<0.05);其中,胃镜经过三种干预处理后微生物学监测合格率,差异无统计学意义;而肠镜经三种干预处理后微生物学监测合格率分别为45.71%,54.28%,88.37%,差异有统计学意义(P<0.05)。共检出病原菌86株,其中革兰阴性菌17株,检出率5.67%,革兰阳性菌68株,检出率22.67%,真菌1例,检出率0.33%;以微球菌与枯草杆菌的检出率最高。结论使用75%乙醇对消毒后的内镜进行干燥可提高内镜再处理流程的消毒效力,乙醇干燥法优于压缩空气干燥法或仅以注射器抽吸水分的方法。OBJECTIVE To investigate the efficacy of different drying methods of ethyl alcohol rinsing and compressed air and drainage with sterilized syringe on gastrointestinal endoscope disinfection by microbiological surveillance.METHODS Stratified random sampling and double-blind（reprocessing operator and laboratory technician）trial were conducted,the enrolled gastrointestinal（GI）endoscopes were randomly assigned to 3 groups after standard process including pre-cleaning,cleaning,rinsing,disinfection and final rinsing by professional.Group A（n=99） had no drying,group B（n=96）was dried with compressed air for 30 seconds to every channel,and group C（n=105） was flushed with 30 ml of 75% ethyl alcohol for 3 min,then all channels were rinsed with compressed air for 30 seconds.The microbiological surveillance were performed by a laboratory technician,which used 10 ml neutralizer to flush the biopsy channel,collected the sample and inoculated on plain agar under an aseptic procedure for 48 hat 35℃,then the colony forming units（CFU）were counted.RESULTS The data of CFU in 3 groups were skewed distribution.The P70,P80 and P90 of CFU in Group C were lower than those of the other two groups,and the difference was significant（P〈0.05）.The microbiological qualification rates of all endoscopes in group A,B and C were 73.73%,77.08% and 89.5%,the qualification rate of group C was higher than that of group A,and the difference was significant（P〈0.05）.There was no significant difference in the microbiological qualification rates of gastroscope after three kinds of interventions,and the microbiological qualification rates of enteroscopy after three kinds of interventions were 45.71%,54.28% and 88.37%,and the difference was significant（P〈0.05）.A total of 86 strains of pathogenic bacteria were detected,including 17 strains of gram-negative bacteria,with the detection rate of 5.67%,68 strains of gram-positive bacteria,with the detection rate of 22.67%,and 1 strain of fungi,with the detection rate of 0.

关 键 词：内镜 再处理流程 消毒 干燥 微生物学监测 

分 类 号：R187.2[医药卫生—流行病学]