中国22省(区、市)针对硅油附着眼科手术器械清洗现况的调查分析  

Investigation on cleaning of silicone oil attached ophthalmic surgical instruments in 22 provinces(regions,municipality)in China

作　　者：唐媛[1] 黄小琼 张琪琪 陈茹 马思文 张佩华 陈燕燕[1] Tang Yuan;Huang Xiaoqiong;Zhang Qiqi;Chen Ru;Ma Siwen;Zhang Peihua;Chen Yanyan(School of Ophthalmology and Optometry,Wenzhou Medical University,Wenzhou 325000,China;Nursing Department,Eye Hospital,Wenzhou Medical University,Wenzhou 325000,China)

机构地区：[1]温州医科大学眼视光学院(生物医学工程学院),325000 [2]温州医科大学附属眼视光医院护理部,325000

出　　处：《中国实用护理杂志》2021年第26期2041-2046,共6页Chinese Journal of Practical Nursing

基　　金：国家卫生计生委科学研究基金——浙江省医药卫生重大科技计划重点项目(WKJ-ZJ-1727);温州市科学技术局基础性科研项目(Y2020128);温州医科大学附属眼视光医院护理专项课题(YNHL1201901)。

摘　　要：目的:调查分析我国医院针对硅油附着眼科手术器械的清洗现况,为制订硅油附着眼科手术器械的标准清洗流程提供参考和建议。方法:2019年11月至2020年1月,采用分层抽样法,选择我国22省(区、市)共61所医院,采用自行研制调查表了解医院针对硅油附着眼科手术器械的现场处理、预处理及常规清洗情况。结果:18.033%(11/61)的医院术中将硅油附着眼科手术器械与其他器械混合放置,11.475%(7/61)的医院术毕未擦拭硅油等肉眼可见污染物;18.033%(11/61)的医院未实行预处理,4.000%(2/50)的医院使用0.9%氯化钠作为预处理溶液;54.098%(33/61)的医院涉及超声波清洗,32.787%(20/61)的医院清洗时水温为31~37℃,4.918%(3/61)的医院水温>37℃;预处理和常规清洗时,分别有38.000%(19/50)和54.902%(28/51)的医院选择酶清洗剂,专科医院在器械与清洗剂的接触时间方面较综合医院更规范(P<0.001);冲洗、漂洗、终末漂洗阶段分别有29.412%(15/51)、11.765%(6/51)和3.922%(2/51)的医院用水不符合要求,分别有17.647%(9/51)、13.725%(7/51)和13.725%(7/51)的医院未记录3个阶段的用水时长。结论:综合医院和专科医院针对硅油附着眼科手术器械的清洗均存在未进行现场处理和预处理、清洗参数控制不当、水质与用水时长难以保证等问题。需尽快制订硅油附着眼科手术器械清洗流程规范,以保证清洗质量,避免术后眼部并发症的发生。Objective:To investigate the cleaning status of silicone oil attached ophthalmic surgical instruments in China,so as to provide reference and suggestions for the standard cleaning process of silicone oil attached ophthalmic surgical instruments.Methods:61 hospitals in 22 provinces(regions,municipality)in China were selected as the objects of investigation.The on-site treatment,pretreatment and routine cleaning of silicone oil attached ophthalmic surgical instruments were investigated by questionnaire from November 2019 to January 2020.Results:18.033%(11/61)hospitals had mixed silicone oil attached ophthalmic surgical instruments and other instruments intraoperatively,11.475%(7/61)hospitals didn′t wipe silicone oil and other visible contaminants postoperatively.18.033%(11/61)hospitals didn′t carry out pretreatment and 4.000%(2/50)hospitals used saline as pretreatment solution;54.098%(33/61)hospitals were involved in ultrasonic cleaning.32.787%(20/61)hospitals had water temperature 31-37℃and 4.918%(3/61)hospitals had water temperature>37℃during the cleaning process;During pretreatment and routine cleaning,38.000%(19/50)hospitals and 54.902%(28/51)hospitals selected enzymatic detergent respectively,the contact time between instruments and detergent in specialized hospital was more standardized than that in general hospital(P<0.001);In flushing,rinsing and final rinsing,there were 29.412%(15/51)hospitals,11.765%(6/51)hospitals and 3.922%(2/51)hospitals used water that didn′t meet the requirements.17.647%(9/51)hospitals,13.725%(7/51)hospitals and 13.725%(7/51)hospitals didn′t record the time of flushing,rinsing and final rinsing.Conclusions:There are still some problems in the cleaning of silicone oil attached ophthalmic surgical instruments in specialized and general hospitals,such as no on-site treatment and pretreatment,improper control of cleaning parameters,and difficulty in ensuring water quality and water time.It is necessary to formulate the cleaning process specification of silicone oil attached o

关 键 词：医疗器械 眼科学 硅油 清洗 调查 

分 类 号：R473.77[医药卫生—护理学]