不同清洗消毒方法对硬式内镜器械清洗效果的Meta分析  

A Meta-Analysis of Cleaning Effect of Different Cleaning and Disinfection Methods on Rigid Endoscopic Instruments

作　　者：牟岚 田先丽 董琴琴 徐婷 韦怡婧 罗江涛 Mou Lan;Tian Xianli;Dong Qinqin;Xu Ting;Wei Yijing;Luo Jiangtao(Guizhou University of Traditional Chinese Medicine,Guiyang Guizhou 550025,China;The First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine,Guiyang Guizhou 550001,China;The Affiliated Hospital of Guizhou Medical University Guiyang Guizhou 550004,China;Qiannan Traditional Chinese Medicine Hospital,Qiannan Guizhou 558000,China)

机构地区：[1]贵州中医药大学,贵州贵阳550025 [2]贵州中医药大学第一附属医院,贵州贵阳550001 [3]贵州医科大学附属医院,贵州贵阳550004 [4]黔南州中医院,贵州黔南558000

出　　处：《医疗装备》2024年第18期15-19,23,共6页Medical Equipment

摘　　要：目的评价手工清洗、超声清洗及全自动清洗对硬式内镜器械的清洗效果。方法系统检索PubMed、EMbase、theCochraneLibrary、中国生物医学文献数据库(CBM)、中国知网(CNKI)、维普(VIP)、万方(WanFang)等中英文数据库中关于硬式内镜器械不同清洗消毒方法的随机对照试验研究,时间截止至2024年2月,并采用RevMan5.4软件进行Meta分析。结果最终纳入8篇文献,Meta结果显示,超声清洗硬式内镜器械的目测法合格率优于手工清洗,差异有统计学意义(RR=1.13,95%CI:1.02~1.26,P=0.02);超声清洗硬式内镜器械的隐血试验法合格率优于手工清洗,差异有统计学意义(RR=1.27,95%CI:1.11~1.46,P=0.0005);超声清洗硬式内镜器械的ATP生物荧光检测法合格率优于手工清洗,差异有统计学意义(RR=1.12,95%CI:1.04~1.20,P=0.002);超声清洗硬式内镜器械的残留蛋白法合格率与手工清洗相比,差异无统计学意义(RR=1.15,95%CI:0.99~1.32,P=0.06);全自动清洗硬式内镜器械的5倍光源放大镜检测合格率与手工清洗组相比,差异无统计学意义(RR=1.13,95%CI:0.99~1.29,P=0.08)。结论超声清洗与手工清洗相比,超声清洗效果明显优于手工清洗,在一定程度上能有效清除器械死角及管腔等细小污渍,具有提高器械清洗合格率及消毒灭菌质量等优点;而全自动清洗机与手工清洗对硬式内镜器械的清洗效果无明显差异。Objective To evaluate the cleaning effectiveness of manual cleaning,ultrasonic cleaning,and fully automatic cleaning on rigid endoscopic instruments.Methods With the systematic search of the randomized controlled trial study on different cleaning and disinfection methods for rigid endoscopic instruments in PubMed,EMbase,the Cochrane Library,China Biology Medicine disc(CBM),China National Knowledge Network Database(CNKI),VIP database,WanFang database and other Chinese and English databases,the deadline was February 2024,and the meta-analysis was conducted using RevMan5.4 software.Results Finally,8 literatures were included.Meta results showed that the qualification rate with ultrasonic cleaning of rigid endoscopic instruments was superior to manual methods in visual inspection,with statistical significance(RR=1.13,95%CI:1.02-1.26,P=0.02);The rigid endoscopic instruments cleaned by ultrasound were superior to manual cleaning in occult blood test,with statistical significance(RR=1.27,95%CI:1.11~1.46,P=0.0005);The rigid endoscopic instruments cleaned by ultrasound were superior to manual cleaning in ATP bioluminescence detection,with statistical significance(RR=1.12,95%CI:1.04-1.20,P=0.002);There was no statistically significant difference(RR=1.15,95%CI:0.99-1.32,P=0.06)between ultrasonic cleaning and manual cleaning for rigid endoscopic instruments in the residual protein method;There was no significant difference between the automatic cleaning of the hard endoscopic instrument and the manual cleaning on the 5x light source magnifying glass(RR=1.13,95%CI:0.99-1.29,P=0.08).Conclusions Compared with manual cleaning,ultrasonic cleaning quality was significantly better than manual cleaning.To a certain extent,small stains in the blind spots and lumens of instruments could be effectively removed,which had the advantages of improving the qualification rate of instrument cleaning and disinfection and sterilization quality;However,there was no significant difference between the automatic cleaning machine and manual cleaning

关 键 词：硬式内镜器械 清洗 消毒 META分析 

分 类 号：R187[医药卫生—流行病学]