不同检测方法对复用手术器械清洗效果的评价研究  

Evaluation of Cleaning Effect of Reused Surgical Instruments by Different Detection Methods

作　　者：杜丽[1,2] 杨晶雪[1] 张馨心[1] 李俐[1] 肖佳庆[1] Du Li;Yang Jingxue;Zhang Xinxin(Heilongjiang Provincial Center for Disease Control and Prevention,Harbin,Heilongjiang,150030,China)

机构地区：[1]黑龙江省疾病预防控制中心,黑龙江哈尔滨150030 [2]中山大学附属第七医院,广东深圳518107

出　　处：《黑龙江医学》2024年第13期1564-1566,共3页Heilongjiang Medical Journal

基　　金：黑龙江省卫生健康委科研课题(2019-176)。

摘　　要：目的:采用细菌内毒素检测方法对复用手术器械的清洗效果进行评价,探索不同检测方法检测不同种类手术器械清洗合格率的差异。找到不同种类复用手术器械的最佳检测方法,提高清洗质量,降低成本,以防止医院感染的发生。方法:将手术器械分为咬合齿类、光滑类和管腔类三组,使用目测法、放大镜法、残留蛋白试验、三磷酸腺苷(ATP)生物荧光法、细菌内毒素法进行器械清洗后的检测。结果:用肉眼裸视法与放大镜观察法检测手术器械68份。目测法合格率为98.53%,放大镜法合格率为94.12%。其中44份样品进行了残留蛋白检测和51份样品进行了ATP生物荧光法检测,合格率分别为81.82%和86.27%。细菌内毒素法检测65份样品,合格率为75.38%,其中管腔类器械合格率最低为33.33%。结论:手术器械清洗效果的5种评价方法的灵敏度依次为细菌内毒素法、残留蛋白试验、ATP生物荧光法、放大镜法和目测法。同类器械的清洗合格率除ATP法外差异无统计学意义,不同检测方法显示内毒素法结果差异均有统计学意义。Objective:To evaluate the cleaning effect of reused surgical instruments by bacterial endotoxin test,and explore the difference of cleaning qualified rate of different kinds of surgical instruments by different detection methods.To find the best detection method of different kinds of reusable surgical instruments,improve the cleaning quality and reduce the cost,so as to prevent the occurrence of nosocomial infection.Methods:Surgical instruments were divided into three groups:occlusal teeth,smooth teeth and lumen.Visual test,magnifying glass method,residual protein test,adenosine triphosphate(ATP)bioluminescence method and bacterial endotoxin method were used to detect the instruments after cleaning.Results:68 surgical instruments were detected by naked eye and magnifying glass observation.The qualified rate of visual test method was 98.53,and that of magnifying glass method was 94.12%.Among them,44 samples were detected for residual protein and 51 samples were detected by ATP bioluminescence method,and the qualified rates were 81.82%and 86.27%,respectively.65 samples were detected by bacterial endotoxin method,and the qualified rate was 75.38%,among which the qualified rate of lumen instruments was the lowest,which was 33.33%.Conclusion:The sensitivity of four methods for evaluating the cleaning effect of surgical instruments are bacterial endotoxin test,residual protein test,ATP bioluminescence method,magnifying glass and visual test in turn.There is no significant difference in cleaning qualified rate of similar instruments except ATP method,but there are statistical differences in results of endotoxin method among different detection methods.

关 键 词：手术器械 细菌内毒素 清洗质量 

分 类 号：R187.4[医药卫生—流行病学]