某内镜中心软式内镜高水平消毒效果分析  

Analysis of high-level disinfection effect of flexible endoscopes in an endoscope center

作　　者：张菊[1] 李小静[1] 鲁伟 李刚[2] 黄燕春[3] 叶晓琴 杨俊华[1] 马莉[5] 张燕华[6] ZHANG Ju;LI Xiaojing;LU Wei;LI Gang;HUANG Yanchun;YE Xiaoqin;YANG Junhua;MA Li;ZHANG Yanhua(Department of Nosocomial Infection Management,the First People’s Hospital of Longquanyi District of Chengdu,West China Longquan Hospital Sichuan University,Chengdu,Sichuan 610100,P.R.China;Department of Proctology,the First People’s Hospital of Longquanyi District of Chengdu,West China Longquan Hospital Sichuan University,Chengdu,Sichuan 610100,P.R.China;Department of Clinical Laboratory,the First People’s Hospital of Longquanyi District of Chengdu,West China Longquan Hospital Sichuan University,Chengdu,Sichuan 610100,P.R.China;Endoscopy Center,the First People’s Hospital of Longquanyi District of Chengdu,West China Longquan Hospital Sichuan University,Chengdu,Sichuan 610100,P.R.China;Department of Urology,West China Hospital,Sichuan University,Chengdu,Sichuan 610041,P.R.China;Nosocomial Infection Management Department,Chongzhou People’s Hospital,Chengdu,Sichuan 611230,P.R.China)

机构地区：[1]成都市龙泉驿区第一人民医院(四川大学华西医院龙泉医院)医院感染管理科,成都610100 [2]成都市龙泉驿区第一人民医院(四川大学华西医院龙泉医院)肛肠科,成都610100 [3]成都市龙泉驿区第一人民医院(四川大学华西医院龙泉医院)检验科,成都610100 [4]成都市龙泉驿区第一人民医院(四川大学华西医院龙泉医院)内镜中心,成都610100 [5]四川大学华西医院泌尿外科,成都610041 [6]崇州市人民医院医院感染管理科,成都611230

出　　处：《华西医学》2021年第3期353-357,共5页West China Medical Journal

基　　金：四川省预防医学会医院感染预防与控制研究基金(SCGK201820);四川省医学会基金资助项目(Q19024);四川省中医药管理局中医药科研专项课题(2020LC0026);四川省中医药信息学会舒适化医疗(新晨基金)专项科研课题(20200117)。

摘　　要：目的评估成都市龙泉驿区第一人民医院内镜中心软式内镜高水平消毒效果,探索软式内镜清洗消毒重点环节,为内镜中心下一步工作重点提供理论保障和技术支持。方法对成都市龙泉驿区第一人民医院内镜中心高水平消毒后的19条软式内镜的管腔、注水注气口和活检口进行采样监测,共对108条次的软式内镜采集标本307份。比较不同软式内镜、不同采样部位消毒效果;并比较不同软式内镜微生物检出情况。结果胃镜、肠镜和十二指肠镜的消毒合格率分别为79.22%、86.21%和100.00%,差异无统计学意义(P=0.721)。内镜管腔、注水注气口和活检口的消毒合格率分别为87.04%、93.00%和94.95%,差异无统计学意义(χ2=4.585,P=0.101)。胃镜、肠镜和十二指肠镜的管腔、注水注气口和活检口的合格率分别为84.42%、93.10%、100.00%,92.96%、92.59%、100.00%,94.29%、96.30%、100.00%,不同软式内镜各部位的消毒效果差异无统计学意义(P>0.05)。细菌学鉴定显示,细菌学超标的28份标本中,革兰阳性菌16株(57.1%),革兰阴性菌12株(42.9%)。结论软式内镜清洗消毒效果存在一定缺陷,应严格按照软式内镜清洗消毒技术规范要求处理内镜,进一步提高软式内镜的消毒效果。Objective To evaluate the high-level disinfection effect of flexible endoscopes in the Endoscopy Center of the First People’s Hospital of Longquanyi District of Chengdu,explore the key links of flexible endoscope cleaning and disinfection,and provide theoretical guarantee and technical support for the next step of the endoscope center work.Methods We sampled and monitored the lumens,water and air injection ports and biopsy ports of 19 flexible endoscopes after high-level disinfection in the Endoscopy Center of the First People’s Hospital of Longquanyi District of Chengdu.A total of 307 specimens were collected from 108 flexible endoscopes.We compared the disinfection effects of different flexible endoscopes and different sampling sites,and compared the microbial detection status of different flexible endoscopes.Results The qualified rates of disinfection of gastroscopes,colonoscope and duodenoscopy were 79.22%,86.21%and 100.00%,respectively,and the difference was not statistically significant(P=0.721).The qualified rates of disinfection of the endoscopic lumen,water and air injection port and biopsy port were 87.04%,93.00%and94.95%,respectively,and the difference was not statistically significant(χ2=4.585,P=0.101).The qualified rates of the lumen,water and air injection port and biopsy port of gastroscope,colonoscope and duodenoscope were 84.42%,93.10%,100.00%,92.96%,92.59%,100.00%,94.29%,96.30%,100.00%,respectively.There was no statistically significant difference in the disinfection effect of various parts of different flexible endoscopes(P>0.05).Bacteriological identification showed that of the 28 specimens with excess bacteriological standards,16 gram-positive bacteria(57.1%),and 12 gram-negative bacteria(42.9%)were found.Conclusion The cleaning and disinfection effect of flexible endoscopes has certain defect.Endoscope should be treated in strict accordance with the technical specifications for cleaning and disinfection of the flexible endoscope to further improve the disinfection effect of the flexible

关 键 词：内镜中心 软式内镜 高水平消毒 监测 

分 类 号：R187[医药卫生—流行病学]