苏州市34所医疗机构全自动内镜清洗消毒机清洗和消毒效果评价  

Cleaning and disinfection effects of automated endoscope reprocessors in 34 medical institutions of Suzhou

作　　者：赵瑶[1] 郭新怡 杨波 陆建英[3] 汪茜雅[3] 金美娟[1] 丁蔚[1] 李慧[1] 许圆 孙湘 ZHAO Yao;GUO Xin-yi;YANG Bo;LU Jian-ying;WANG Xi-ya;JIN Mei-juan;DING Wei;LI Hui;XU Yuan;SUN Xiang(The First Affiliated Hospital of Soochozw University,Suzhou,Jiangsu 215006,China;不详)

机构地区：[1]苏州大学附属第一医院感染管理处,江苏苏州215006 [2]苏州市疾病预防与控制中心,江苏苏州215006 [3]苏州大学附属第一医院消化内镜中心,江苏苏州215006

出　　处：《中华医院感染学杂志》2025年第2期281-285,共5页Chinese Journal of Nosocomiology

基　　金：苏州市医院协会感染管理专项重点资助项目(SZSYYXH-2023-ZD5)。

摘　　要：目的了解医疗机构全自动内镜清洗消毒机(AER)的清洗效果和消毒效果,以期为医疗机构在使用和维护AER上提供数据支持。方法2023年9月—2024年4月对苏州市所有配备AER的医疗机构进行现场采样和检测,使用三磷酸腺苷(ATP)生物荧光检测法检测AER清洗前后内镜表面和附件的清洗效果,使用蛋白残留法检测AER清洗前后内镜管腔的残留蛋白量,使用滤膜法检测内镜的消毒效果和AER内终末漂洗用水的情况,比较AER和手工两种方式消毒对内镜合格率的影响。结果共检测了34家医疗机构,43条消化内镜(胃镜27根,肠镜16根),内镜在AER清洗前后管腔的蛋白残留量平均值为51.82μg、35.38μg,表面ATP检测平均值为214 RLU、64 RLU,附件ATP检测平均值为126 RLU、32 RLU。ATP评价胃镜表面清洗前后合格率、内镜附件清洗前后合格率有统计学差异(P<0.05),管腔的蛋白残留在清洗前后未发现差别。使用AER消毒胃镜和肠镜的合格率分别为96.30%和87.50%,手工清洗消毒的胃镜和肠镜的合格率分别为100.00%和87.50%,使用AER和手工两种方式对消化内镜消毒后合格率未发现统计学差异。AER和手工的终末漂洗用水合格率分别为87.50%、80.00%。结论三级医疗机构的AER配置率较高,使用AER和手工两种方式对消化内镜消毒的效果无统计学差异,ATP生物荧光检测法和蛋白残留法评价AER清洗消化内镜效果尚可。建议多关注使用AER消毒的内镜和AER终末漂洗用水质量的定期监测。OBJECTIVE To observe the cleaning and disinfection effects of automated endoscope reprocessors(AER)in medical institutions so as to provide data support for improvement and maintenance of AER.METHODS On-site sampling and testing were carried out for all of the medical institutions equipped with AER in Suzhou from Sep.2023 to Apr 2024.The cleaning effect on surfaces and attachments of endoscopes was detected by using adenosine triphosphate(ATP)bioluminescence detection method before and after they were cleaned with AER;the level of residual protein on lumen of endoscopes was detected by protein residue method before and after they were cleaned with AER;the disinfection effect on the endoscopes and the quality of terminal rinse water were detected by filter membrane method.The impact on the qualified rate of disinfection of endoscopes was observed and compared between the AER and the manual method.RESULTS A total of 34 medical institutions were enrolled in the study,involving 43 pieces of gastrointestinal endoscopes(27 pieces of gastroscopes,16 pieces of enteroscopes).The average volume of residual protein on lumen of the endoscopes was 51.82μg before the cleaning with AER,35.38μg after the cleaning with AER;the average value of ATP test for the surfaces was 214 RLU before the cleaning with AER,64 RLU after the cleaning with AER;the average value of ATP test for the attachments was 126 RLU before the cleaning with AER,32 RLU after the cleaning with AER.There were significant differences in the qualified rates of cleaning of gastroscope surfaces and endoscope attachments evaluated by ATP before and after the cleaning with AER(P<0.05);there was no significant difference in the residua protein volume on the lumen before and after the cleaning with AER.The qualified rate of disinfection of the gastroscopes with AER was 96.30%,the enteroscopes 87.50%;the qualified rate of cleaning and disinfection of the gastroscopes with manual method was 100.00%,the enteroscopes 87.50%;there was no significant difference in the qual

关 键 词：内镜 全自动内镜清洗消毒机 清洗消毒效果 三磷酸腺苷生物荧光检测法 蛋白残留法 终末漂洗用水 

分 类 号：R197.39[医药卫生—卫生事业管理]