59所内镜中心相关医院感染风险因素调查与分析  

Investigation and analysis on the risk factors of nosocomial infections in 59 endoscopic centers

作　　者：朱亭亭[1] 孙惠惠[1] 王佳奇[1] 李涛[1] 张流波[1] 王晓春[2] 庞琳[2] 班海群[1] 

机构地区：[1]中国疾病预防控制中心环境与健康相关产品安全所,北京100021 [2]中国疾病预防控制中心性病艾滋病预防控制中心,北京102206

出　　处：《中华医院感染学杂志》2018年第2期309-312,320,共5页Chinese Journal of Nosocomiology

基　　金：中国疾控中心环境所环境污染健康影响人体生物监测体系建设(131031108000150003)

摘　　要：目的调查我国内镜诊疗服务现状及存在问题,并探讨内镜诊疗过程中可能导致医院感染发生的风险环节,为相关的防治措施制定提供依据。方法采用问卷调查的方式对内镜中心开展调查,调查内容包括内镜中心基本情况、设备情况、经血传播性疾病管理和清洗消毒流程。结果 59所内镜中心单条内镜日均最高诊疗量为4.4人次;超声清洗器和自动清洗消毒机配备率分别为74.6%和45.8%;内镜中心手工清洗内镜、隔夜内镜次日使用前重新清洗消毒、清洗液一次性使用、使用一次性擦拭布进行预处理、区分胃肠镜清洗槽、按钮等配件单独保存和使用一次性活检钳的比例分别为52.5%、91.5%、84.7%、74.6%、96.6%、76.3%和88.1%;胃肠镜诊疗无区分措施的内镜中心比例为5.1%;诊疗前不筛查患者经血传播性疾病的内镜中心比例为45.8%。结论我国内镜中心诊疗任务重,医护人员特别是清洗消毒人员配备不足;内镜中心设备配备较以往有了很大改善,但内镜诊疗和清洗消毒流程中存在许多风险环节,应在标准预防基础上加强风险环节监管。OBJECTIVE To investigate the current situation and existing problems of endoscopic diagnosis and treatment services in China,and to explore the risk of nosocomial infections during endoscopic diagnosis and treatment,so as to provide relevant basis for the prevention and control measures.METHODS The questionnaire survey was conducted on the 59 endoscopic centers.The content included the basic situation of the endoscopic center,the condition of the equipments,the management of blood-borne diseases and the disinfection process.RESULTSIn 59 endoscopic centers,the maximum daily medical treatment for single endoscopy was 4.4.The allocation rates of ultrasonic cleaning device and automatic cleaning disinfection machine were 74.6% and 45.8%.The rates of manual cleaning,recleaned and re-disinfectioned of the overnight endoscopy,cleaning solution used once,pretreatment with disposable wipes,distinguishing the gastrointestinal cleaning tank,separate preservation of buttons and other accessories,and use of disposable biopsy pliers were 52.5%,91.5%,84.74%,74.6%,96.6%,76.3%,and 88.1%,respectively.Totally 5.1%of the endoscopic centers did not take distinctions between endoscopy and colonoscopy,and 45.8% of endoscopic centers did not screen for blood-borne diseases.CONCLUSION The amounts of diagnosis and treatment services are large in China,medical staff,especially cleaning and disinfection staff are inadequate.The equipments of the endoscopic centers are better than ever,but there are risks in the endoscopic treatment,cleaning and disinfection process.Endoscopy centers should strengthen the supervision of nosocomial infections based on the standard prevention.

关 键 词：软式内镜 医院感染 风险环节 现况调查 

分 类 号：R181.3[医药卫生—流行病学]