内镜手工清洗消毒研究及自动清洗消毒机消毒效果抽样调查  

Multicenter study on gastroscope disinfection and sample survey of automated washer/disinfectors

作　　者：张泰昌[1] 于中麟[2] 巩玉秀[3] 武迎宏[4] 李六亿[5] 袁洽劻[6] 胡继红[7] 吕超英[8] 武沪萍[9] 刘宾[10] 杨昭徐[11] 兰宇[12] 

机构地区：[1]首都医科大学宣武医院,北京100053 [2]首都医科大学附属友谊医院 [3]卫生部医政司 [4]北京大学人民医院 [5]北京大学第一医院 [6]中国预防医学科学院消毒检测中心 [7]卫生部临床检验中心 [8]北京市卫生局医政处 [9]首都医科大学附属红十字朝阳医院 [10]首都医科大学附属同仁医院 [11]首都医科大学附属天坛医院 [12]北京积水潭医院

出　　处：《中华消化内镜杂志》2002年第5期261-264,共4页Chinese Journal of Digestive Endoscopy

摘　　要：目的 了解消化内镜清洗消毒现状,选择实用可靠的内镜清洗消毒方法。方法 在北京部分三级甲等医院进行内镜清洗时加或不加酶洁液、2％戊二醛7min消毒效果的测试;并抽查国产自动清洗消毒机的消毒效果。结果 测试部分:使用酶洁液清洗组301例,2％戊二醛浸泡消毒7min,不长菌例数为283例（94、02％）;不使用酶洁液组155例,2％戊二醛浸泡消毒7min,不长菌例数为137例（88.39％）。以清洗消毒后每条胃镜≤20个非致病细菌数为合格标准,使用酶洁液组合格为298例（99.00％）,不使用酶洁液组147例（94.84％）,两组清洗消毒效果差异有统计学意义（P<0.01）。抽查部分:清洗消毒机135例,清洗消毒3 min后不长菌为4例（11.43％）,以清洗消毒后每条胃镜≤20个非致病细菌数作为合格标准,合格为5例（14.29％）;清洗消毒机 Ⅱ29例,清洗消毒 3min,不长菌为2例（6.90％）,合格例数为6例（20.69％）;清洗消毒机Ⅱ20例,更换消毒液,清洗消毒3 min 2次,不长菌为17例（85.00％）,合格例数为18例（90.00％）。结论 内镜使用后各个部分的彻底清洗是保证消毒质量的重要环节,清洗过程中使用酶洁液明显增加了清洁度,在此基础上2％戊二醛浸泡消毒7min可达到内镜消毒标准。Objective To select a practical and reliable method in cleaning and disinfecting endo-scope, and to investigate the efficacy of endoscope disinfection. Methods A study was done on the disinfection efficacy using or not using enzyme cleaning plus 2% glutaraldehyde immersion, and disinfection efficacy of automated washer/disinfectors for endoscopes at tertiary hospitals in Beijing. Results In 301 cases of en-doscopes cleaned with enzyme ( Epizyme rapid multi enzyme cleanse) and immersed in 2% glutaraldehyde for 7 minutes, culture was negative in 283 cases (94. 02% ) ; in 155 cases without enzyme cleaning but with immersion for 7 minutes in 2% glutaraldehyde, culture was negative in 137 cases (88. 39 % ). Taking 20 or less bacteria per endoscope as the eligibility criterion, there were 298(99.00% ) and 147(94. 84% ) cases eligible in enzyme treated and enzyme untreated group respectively , P < 0.01. Sample survey of cleaning and disinfection efficacy of automated washer/disinfector : (1) Machine I in 35 cases, after cleaning and disinfection for 3 minutes, culture was negative in 4 cases ( 11. 43 % ) , taking 20 or less bacteria per endoscope as the eligibility criterion, 5 cases were eligible (14. 29%). (2) Machine II in 29 cases, after cleaning and disinfection for 3 minutes,culture was negative in 2 cases ( 6. 90% ) , taking 20 or less bacteria per endoscope as the eligibility criterion, 6 cases were eligible ( 20.69% ). (3) Machine II in 20 cases, after cleaning and disinfection for 6 minutes, culture was negative in 17 cases ( 85. 00% ) , taking 20 or less bacteria per endoscope as the eligibility criterion, 18 cases were eligible ( 90. 00% ) . All results of the auto-mated washer/disinfectors fell short of the sterilization standard. Conclusions Thorough cleaning of every part of the endoscope is necessary to ensure disinfection efficacy. The use of enzymes in the cleaning process enhances the cleanness; on that basis, immersion in 2% glutaraldehyde for 7 minutes achieves adequate sterilization. The currently

关 键 词：手工清洗消毒 研究 自动清洗消毒机 消毒效果 抽样调查 

分 类 号：R187.3[医药卫生—流行病学]