消毒剂对高病毒载量患者所用内镜的消毒效果及安全性研究  

Efficacy and safety of a disinfectant for the disinfection of endoscopy used by patients with high viral load

作　　者：崔璨[1] 丁惠国 黄晶[1] 张月宁 宋燕明 周树丽[1] 封莉 张世斌 李磊 Cui Can;Ding Huiguo;Huang Jing;Zhang Yuening;Song Yanming;Zhou Shuli;Feng Li;Zhang Shibin;Li Lei(Infection Management Department,Beijing Youan Hospital,Capital Medical University,Beijing 100069,China;Department of Hepatology and Gastroenterology,Beijing Youan Hospital,Capital Medical University,Beijing 100069,China)

机构地区：[1]首都医科大学附属北京佑安医院感染管理处,100069 [2]首都医科大学附属北京佑安医院肝病消化中心,100069

出　　处：《国际病毒学杂志》2020年第2期144-148,共5页International Journal of Virology

摘　　要：目的对比新型过氧乙酸复合消毒剂与戊二醛对高病毒载量慢性乙型肝炎、丙型肝炎及艾滋病患者所用消化内镜残留病毒及细菌的杀灭效果。方法选取血清中乙型肝炎病毒(hepatitis virus,HBV)DNA≥10^5 IU/mL,丙型肝炎病毒(hepatitis C virus,HCV)RNA≥10^5 IU/mL或人类免疫缺陷病毒(humanimmuno deficiency virus,HIV)RNA≥10^4 copies/mL的接受消化内镜诊疗的24名患者,将同一病种患者随机分组至实验组(过氧乙酸消毒组)或对照组(戊二醛消毒组),检测4个不同时点消化内镜HBV-DNA、HCV-RNA、HIV-RNA、细菌染菌量及三磷酸腺苷(adenosine triphosphate,ATP)生物荧光定量数值。结果实验组与对照组消毒后消化内镜内、外表面均未检出HBV-DNA、HCV-RNA及HIV-RNA。实验组与对照组消毒后细菌菌落数差异无统计学意义(Z=0.718,P=0.473),消毒合格率均为100%。实验组与对照组清洗消毒前后ATP含量变化差异无统计学意义(Z=1.334,P=0.182)。实验组的内镜处置人员对消毒剂产生的不良反应少于对照组。结论新型过氧乙酸复合消毒剂与戊二醛均能达到国家标准规定的高水平消毒要求,过氧乙酸消毒时间更短,对消人员造成的不良影响更小。Objective To compare the efficacy of a new compound peracetic acid disinfectant with glutaraldehyde in killing residue viruses and bacteria of digestive endoscopes used by chronic hepatitis B,hepatitis C and AIDS patients with high viral load.Methods Twenty-four patients with HBV-DNA≥10^5 IU/ml,HCV-RNA≥10^5 IU/ml or human immunodeficiency virus(HIV)-RNA≥10^4 copies/ml were randomly divided into the experimental group(the new compound peracetic acid disinfection group)or the control group(glutaraldehyde disinfection group)according to the diseases.HBV-DNA,HCV-RNA,HIV-RNA,bacterial colony and adenosine triphosphate(ATP)bioluminescence on the digestive endoscopes they used were measured in four different point of time.Results No HBV-DNA,HCV-RNA and HIV-RNA was detected on the inner and outer surface of digestive endoscopes after disinfection in the experimental group and the control group.There was no significant difference in bacterial colony between the experimental group and the control group(Z=0.718,P=0.473).The qualified rate of disinfection was 100%.There was no significant difference in ATP contents before and after disinfection between the experimental group and the control group(Z=1.334,P=0.182).The adverse reactions of the cleaning personnel to the disinfectant in the experimental group were less than those in the control group.Conclusions The new compound peracetic acid disinfectant and glutaraldehyde can reach the requirements of the national standard of disinfection.The time of treatment with the new compound peracetic acid disinfectant was shorter with less adverse effect on the cleaning personnel.

关 键 词：消化内镜 新型过氧乙酸复合消毒剂 灭菌 传染病患者 

分 类 号：R51[医药卫生—内科学]