全国经食道超声心动图检查医院感染管理现状调查  

Current status of healthcare-associated infection management for transesophageal echocardiography:a nationwide investigation

作　　者：吴联萱 贾会学[1] 姚希[1] 张冰丽 李六亿[1] WU Lianxuan;JIA Huixue;YAO Xi;ZHANG Bingli;LI Liuyi(Department of Infection Management-Disease Prevention and Control,Peking University First Hospital,Beijing 100034,China)

机构地区：[1]北京大学第一医院感染管理-疾病预防控制处,北京100034

出　　处：《中国感染控制杂志》2025年第3期329-335,共7页Chinese Journal of Infection Control

摘　　要：目的了解全国经食道超声心动图(TEE)检查医院感染管理现状,为超声诊疗感染防控相关指南和标准的制定提供科学依据。方法分层抽样调查国内14个省(自治区、直辖市)162所医疗机构,设计统一的调查问卷,采用现场调查的方法,对各医院TEE检查室进行实地调查,根据现场调查结果填写问卷。结果调查162所医疗机构,其中114所医疗机构开展TEE检查,开展率为70.4%,大部分医疗机构由超声医学科(66.7%)和心内科(36.0%)承担TEE检查工作,91.0%的医疗机构感染控制部门安排了专人负责该项检查的医院感染管理工作。32.4%(36所)的TEE检查时会使用超声探头隔离膜,以灭菌级隔离膜为主。整体TEE探头高水平消毒或灭菌率为79.3%,19.8%选择中水平消毒,但据配备的探头数、患者检查的间隔时间和探头消毒方法推断,有效高水平消毒的比率仅有67.6%。最常使用的探头灭菌、高水平消毒和中低水平消毒方法分别是过氧化氢低温灭菌、邻苯二甲醛浸泡消毒和季铵盐湿巾擦拭消毒。92.8%的检查室探头消毒后会储存在专用储存柜(箱)中。32.4%的检查室能做到每例患者之间对TEE探头以外其他超声设备进行清洁与消毒,都为中水平消毒。大部分检查室的手卫生设施和通风设施齐全,59.5%的操作者手卫生依从率>90%,一次性使用医用橡胶检查手套的佩戴和每例患者之间更换的情况较理想,但是每例患者之间更换床上用品以及诊疗操作者工作服的更换情况并不理想。结论全国大型医疗机构普遍开展了TEE检查,TEE探头高水平消毒率仍有待提升,适用的消毒方法仍需进一步讨论和研究。TEE探头以外其他超声设备消毒意识仍需提升,操作者的手卫生依从性、患者检查床床上用品和诊疗操作者工作服及时更换的意识有待提高。Objective To understand the current status of healthcare-associated infection(HAI)management for transesophageal echocardiography(TEE)examination in China,and provide a scientific basis for formulating guidelines and standards for infection prevention and control in ultrasound diagnosis and treatment.Methods A stratified sampling survey was conducted in 162 medical institutions(MIs)in 14 provinces(autonomous regions,municipalities)in China.A unified questionnaire was designed,and on-site surveys were conducted in the TEE examination room of each MI,with questionnaires filled out based on the results of the on-site survey.Results 162 MIs were surveyed,out of which 114(70.4%)carried out TEE examination.TEE examination was undertaken by ultrasound medicine department(66.7%)and cardiology department(36.0%)in most MIs,and 91.0%of HAI departments had specially-assigned infection prevention and control professional to responsible for the management of HAI rela-ted to examination.32.4%(n=36)of TEE examinations used ultrasound probe isolation sleeves,mainly sterilized isolation membranes.The overall high-level disinfection or sterilization rate of TEE probes was 79.3%,19.8%of MIs chose medium-level disinfection.However,based on the number of equipped probes,the interval between patient examination,and the disinfection method of probes,it was inferred that the proportion of effective high-level disinfection was only 67.6%.The most commonly adopted sterilization,high-level disinfection and medium-low le-vel disinfection methods for probes were low-temperature hydrogen peroxide sterilization,o-phthalaldehyde disinfection and quaternary ammonium wiping disinfection,respectively.92.8%of examination rooms stored the probes in special storages cabinets(boxes)after disinfection.32.4%of examination rooms cleaned and disinfected ultrasound devices other than TEE probe between each patient examination,all were with medium-level disinfection.Most exa-mination rooms equipped complete hand hygiene(HH)facilities and ventilation,59.5%of

关 键 词：经食道超声心动图 超声探头 清洗消毒 医院感染防控 抽样调查 

分 类 号：R197.323[医药卫生—卫生事业管理]