不同清洗消毒方式对消化内镜副送水管道的消毒效果与效率的对比研究  

Comparative study of cleaning effectiveness and efficiency of different cleaning and disinfection methods on auxiliary water inlet of gastrointestinal endoscope

作　　者：胡宗益 杨怀洁[2] 李瑾 刘青萌 范秀晶 张晓清 吴小杰 HU Zong-yi;YANG Huai-jie;Li Jin;LIU Qing-meng;FAN Xiu-jing;ZHANG Xiao-qing;WU Xiao-jie(Department of Gastroenterology,The Third Affiliated Hospital of Guangzhou Medical University,Guangzhou 510150,Guangdong,China;Department of Endoscopy,The People’s Hospital of China Three Gorges University,Yichang 443009,Hubei,China;Department of Pediatrics,The People’s Hospital of China Three Gorges University,Yichang 443009,Hubei,China)

机构地区：[1]广州医科大学附属第三医院消化内科,广东广州510150 [2]三峡大学人民医院内镜中心,湖北宜昌44300 [3]三峡大学人民医院儿科,湖北宜昌443009

出　　处：《生物医学工程与临床》2023年第5期670-674,共5页Biomedical Engineering and Clinical Medicine

基　　金：广东省护士协会2021年科研课题(gdshsxh2021a217)。

摘　　要：目的探讨不同清洗设备和方法对消化内镜副送水管道的消毒效果与效率的影响。方法消化内镜使用后,按标准流程清洗、消毒管道,取9条内镜随机分为3组(使用90次,冲洗90次,每组取样30次),未冲洗消毒副送水管道的消化内镜为空白对照组;其余两组按照《WS507-2016软式内镜消毒技术规范》进行常规清洗消毒,按消化内镜厂家建议采用30 mL注射器连接厂家原装接头冲洗的管道为常规冲洗组,采用内镜副送水管道改进灌流装置冲洗消毒者为改良灌流组。记录清洗时间后对3组内镜进行采样后细菌培养。结果常规冲洗组和改良灌流组均未检出细菌。而对照组管道8个标本有细菌检出,检出率26.7%。3组间细菌检出率比较,差异有统计学意义(P<0.05)。细菌培养提示排前3位的菌种分别为嗜麦芽窄食单胞菌3例、鲍曼不动杆菌2例、肺炎克雷伯菌2例。常规冲洗组洗消内镜时间为(18.37±0.88)min,改良灌流组时长为(15.00±0.00)min,两组对比,差异有显著统计学意义(P<0.001)。结论消化内镜副送水管道规范化清洗消毒值得临床重视。采用消化内镜副送水管道全管道灌流装置,可以获得可靠、高效的消毒效果。Objective To study the effects of different cleaning equipment and methods on the cleaning effectiveness and efficiency of the gastrointestinal endoscopy auxiliary water inlet.Methods After the using of gastrointestinal endoscope,the clamp tubes were cleaned and disinfected according to standard procedure,a total of 9 tubes were randomly divided into 3 groups(use 90 times,wash 90 times,30 samples pergroup),and unwashed gastrointestinal endoscopy auxiliary water inlet was set as control group.The other two groups were cleaned and disinfected routinely according to WS507-2016 Technical Specification for Disinfection of Soft Endoscope.According to recommendations of endoscopy manufacturers,30 mL syringes were connected to original flushing inlet of manufacturer as conventional flushing group,and the one cleaned with modified perfusion device of endoscope auxiliary water inlet was modified perfusion group.The cleaning time was recorded,and the three groups of endoscopes were sampled for bacterial culture.Results There was no bacteria detected in conventional flushing group and modified perfusion group,while bacteria was detected in 8 specimens of control group,with detection rate of 26.7%.There was significant difference of detection rate of bacteria in 3 groups.The bacterial culture results showed that the top 3 strains were Stenotrophomonas maltophilia in 3 cases,Acinetobacter baumannii in 2 cases and Klebsiella pneumoniae in 2 cases.The endoscopic decontamination time was(18.37±0.88)minutes in conventional flushing group and(15.00±0.00)minutes in modified perfusion group,and the difference between 2 groups was statistically significant(P<0.001).Conclusion It is demonstrated that standardized cleaning and disinfection of auxiliary water inlet of gastrointestinal endoscope is worthy of clinical attention.The reliable and efficient disinfection effect can be obtained by using the full-pipe perfusion device of the auxiliary water supply pipeline of digestive endoscope.

关 键 词：消化内镜副送水管道 清洗 消毒 院内感染 

分 类 号：R187[医药卫生—流行病学]