软式消化内窥镜改良生物荧光法非常规监测点清洗质量检测研究  

Study on positive detection of cleaning quality of unconventional monitoring points by bioluminescence method in flexible digestive tract endoscopes

作　　者：樊莉铭 李晨旭 张珉浩 王萍 Fan Liming;Li Chenxu;Zhang Minhao;Wang Ping(Endoscopy Center,Zhongshan Hospital,Fudan University,Shanghai 20003,China;Endoscopy Center,Shanghai Geriatric Medical Center,Shanghai 201104,China)

机构地区：[1]复旦大学附属中山医院内镜中心,上海200032 [2]上海市老年医学中心内镜中心,上海201104

出　　处：《中国医学装备》2024年第4期160-163,共4页China Medical Equipment

基　　金：上海市护理学会科研课题(2016M5-B02)。

摘　　要：目的:研究通过增加消化内窥镜非常规监测点,全面提高消化内窥镜清洗质量检测能力和质量控制水平。方法:选取2022年9-11月复旦大学附属中山医院内镜中心用于临床检查的160根普通软式消化内窥镜,通过随机抽样法分别采用传统三磷酸腺苷(ATP)生物荧光法检测和改良ATP生物荧光法检测方式进行消化内窥镜清洗质量检测,每种检测方式80根。传统ATP检测方式使用ATP表面测试棒采样内窥镜先端部20 cm处外表面与使用ATP水质测试棒采样从内窥镜先端部收集注入钳子管道内腔的40 ml无菌水进行检测;改良ATP检测方式在传统ATP检测方式的基础上在钳子管道出口内表面增加1个非常规监测点,使用无菌采样拭子对消化内窥镜钳子管道出口5 cm处内表面,由里向外旋转取样进行检测,对比两种检测方式的清洗质量。结果:在传统ATP检测方式检测结果合格的情况下,改良ATP检测方式在非常规监测点发现消化内窥镜清洗质量阳性物。传统ATP检测方式检测不合格检出率为5.00%(4/80),改良ATP检测方式不合格检出率为25.00%(20/80),其差异有统计学意义(x^(2)=12.549,P<0.05)。结论:增加软式消化内窥镜钳子管道出口非常规监测点,能明显地增加消化内窥镜清洗不合格的检出率,有助于提高消化内窥镜清洗质量控制水平。Objective:To comprehensively improve the positive detection rate of digestive tract endoscopes cleaning quality by increasing the number of unconventional monitoring points for digestive tract endoscopes.Methods:A total of 160 ordinary flexible digestive tract endoscopes used for clinical examination in the Endoscopy Center of Zhongshan Hospital Fudan University from September to November 2022 were selected,and the cleaning quality of the digestive tract endoscopes was tested by traditional adenosine triphosphate(ATP)detection method and modified ATP detection method,which were used by random sampling method,with 80 endoscopes for each detection method.In the traditional ATP detection method,an ATP surface test rod was used to sample the outer surface of the endoscope tip at 20 cm and 40 ml of sterile water injected into the inner cavity of the pliers pipe was collected from the tip of the endoscope using an ATP water quality test rod.The modified ATP detection method was based on the traditional ATP detection method,an unconventional monitoring point was added to the inner surface of the forceps pipe outlet,and a sterile sampling swab was used to detect the inner surface of the tube outlet 5 cm away from the outlet of the pipes of the endoscope forceps,and the sample was rotated from the inside to the outside for detection.The cleaning quality of the two testing methods was compared.Results:In cases that the results of the traditional ATP detection method were qualified,the modified ATP detection method found positive substances for the cleaning quality of digestive tract endoscopes at unconventional monitoring points.The unqualified rate of the traditional ATP detection method was 5%(4/80),and the unqualified rate of the modified ATP detection method was 25%(20/80),the difference was statistically significant(x^(2)=12.549,P<0.05).Conclusion:Increasing the unconventional monitoring point at the outlet of the flexible endoscope forceps can significantly increase the detection rate of unqualified endoscope cleanin

关 键 词：三磷酸腺苷(ATP)生物荧光法 软式消化内窥镜 非常规监测点 清洗质量 内窥镜消毒合格率 

分 类 号：R197.39[医药卫生—卫生事业管理]