2019-2021年绍兴市某医院软式消化内镜清洗消毒现况调查  

Current status of cleaning and disinfection of flexible digestive endoscopes in a hospital of Shaoxing from 2019 to 2021

作　　者：杨飞 杨琴 叶玲玲 汪宇林 包海燕 YANG Fei;YANG Qin;YE Ling-ling;WANG Yu-lin;BAO Hai-yan(Shaoring City Keqiao District Hospital of Traditional Chinese Medicine,Shaozing,Zhejiang 312030,China)

机构地区：[1]绍兴市柯桥区中医医院医共体总院内镜中心,浙江绍兴312030

出　　处：《中华医院感染学杂志》2023年第17期2716-2720,共5页Chinese Journal of Nosocomiology

基　　金：浙江省科研基金项目(2019LF0209)。

摘　　要：目的分析软式消化内镜清洗消毒工作现状及效果,为促进内镜管理工作质量不断提升提供参考依据.方法调查2019-2021年绍兴市柯桥区中医医院软式消化内镜清洗消毒工作现状,随机对完成清洗和消毒的待用内镜进行有机物和病原菌残留情况检查,分析内镜清洗和消毒工作质量.结果2019-2021年软式消化内镜清洗消毒人员中护士、清洗时间>60 s、清洗用水使用过滤水和纯化水、消毒时间>5 min、终末漂洗方法中手动喷淋、干燥方法使用75%乙醇冲洗后吹干、存储方式为无菌巾包裹后平置以及可追溯记录的占比均升高(P<0.05);2019-2021年软式消化内镜内腔面、外腔面和活检孔端口有机物检测合格率各年度比较差异无统计学意义;2019-2021年胃镜和肠镜检出菌落数逐渐减少(P<0.05);2021年胃镜微生物学抽检合格率均高于2019年(P<0.05),2020年和2021年肠镜微生物学抽检合格率高于2019年(P<0.05);2019-2021年软式消化内镜抽检病原菌分布情况未见明显变化.结论2019-2021年医院软式消化内镜清洗和消毒工作清洗人员、清洗方式、清洗时间、储存方式和消毒记录等逐渐趋于规范化,且有机物和病原菌残留抽检合格率均不断升高.OBJECTIVE To investigate the current status of cleaning and disinfection of flexible digestive endoscopes and observe the effects so as to improve the quality of management of endoscopes.METHODS A survey was conducted for the current status of cleaning and disinfection of flexible digestive endoscopes in Shaoxing City Keqiao District Hospital of Traditional Chinese Medicine from 2019 to 201.The residues of organics and pathogens on the endoscopes for which the cleaning and disinfection were finished were randomly examined.The quality of cleaning and disinfection of the endoscopes was observed.RESULTS The result of the survey for the current status of cleaning and disinfection of the flexible endoscopes showed that the proportions of nurses,cleaning duration more than 60 s,filtered water and purified water used for cleaning,disinfection duration more than 5 min,manual spraying for terminal rinsing,rinsing with 75%ethanol and then drying,flat placement after wrapping with aseptic towels and traceable records were increased from 2019 to 201.There were no significant differences in the qualified rates of detection of organics on the inner cavity surface,outer cavity surface and biopsy port of the flexible digestive endoscopes among the years from 2019 to 2021.The bacterial colony counts of the gastroscopes and colono scopes were gradually decreased from 2019 to 2021(P<0.05),the qualified rate of microbiological sampling inspection of gastroscopes was higher in 2021 than in 2019(P<0.05);the qualified rate of microbiological sampling inspection of colonoscopes was higher in 2020 and 2021 than in 2019(P<0.05).There was no significant change in the distribution of pathogens cultured form the flexible digestive endoscopes from 2019 to 2021.CONCLUSION The cleaning personnel,cleaning methods,cleaning time,storage method and disinfection record tend to be standardized,and the qualified rates of spot examination of the organics and pathogen residues are constantly elevated.

关 键 词：消化内镜 软式内镜 消毒 三磷酸腺苷荧光检测 细菌培养 现况调查 

分 类 号：R197.39[医药卫生—卫生事业管理]