牙科手机消毒与灭菌现状调查

Current status of disinfection and sterilization for dental handpieces in the hospitals

目的了解目前口腔专科医院、综合医院口腔门诊中使用的牙科手机种类、消毒与灭菌处理方法及消毒与灭菌效果。方法2000～2001年随机抽取同一城市中口腔专科医院、具有口腔门诊的三级医院、二级医院、一级医院各10所,调查医院口腔门诊中正在使用的所有牙科手机的类型及消毒与灭菌处理方式。随机抽取医院口腔门诊中1个诊室内使用后污染的牙科手机,按照卫生部《消毒技术规范》规定的方法进行细菌菌落总数检测,通过活菌培养计数,观察细菌污染情况;通过检测乙型肝炎表面抗原(HBsAg),间接判断乙型肝炎病毒(HBV)污染存在的可能性;通过对消毒与灭菌处理后牙科手机的无菌检测,判断灭菌效果。结果使用无防回吸牙科手机占临床使用牙科手机比例的941%(959/1019),有防回吸功能的牙科手机占59%(60/1019)。采用消毒剂擦拭消毒法处理临床使用后牙科手机的比例为629%(214/340),其中2617%无菌检测阴性;采用消毒剂浸泡法的比例为100%(34/340),其中5588%无菌检测阴性;采用压力蒸汽灭菌法的比例为271%(92/340),其中8043%无菌检测阴性。使用后牙科手机均存在细菌污染,HBsAg抗原性检测阳性率为167%。结论应取代无防回吸功能的牙科手机或使用有防回吸功能的综合治疗台;必须灭菌处理临床使用后污染的牙科手机;

Objective To understand current status of the uses of dental handpieces, methods of disinfection and sterilization and their effectiveness in dental care hospitals and out patient departments of stomatology in general hospitals Methods Ten dental care hospitals and departments of staomatology in general hospitals at varied levels were rndomly sampled during 2000 to 2001 to investigate the uses of dental handpieces and means of their disinfection and sterilization One used dental handpiece from each hospital or department of stomatology in general hospital selected was detected for possible contamination of bacteria by aerobic bacterial count and Coliform bacterial examinations and hepatitis B surface antigen (HBsAg) on it, based on “The Technical Standards for Disinfection” set by the Ministry of Health of China, and the effectiveness of its disinfection and sterilization was evaluated as well Results Anti suction handpieces were used only in 5 9 % of the hospitals or deprtments, 94 1% of them without anti suction devices Cleansing disinfection was applied for used dental handpieces in 62 9 % of the dental care hospitals and the departments of stomatology, with an effective rate of 26 17%, immersing disinfection in 10 0 %, with an effective rate of 55 88 %, and autoclave in 27 1 %, with an effective rate of 80 43% Used dental handpieces in the hospitals and departments of stomatology in general hospitals were all contaminated by bacteria and HBsAg could be detected in 1 67 % of them Conclusions Dental handpieces without anti suction should be replaced soon by those with it or comprehensive dental unit with anti suction device should be used Used dental handpieces must be sterilized effectively before next use Awareness on prevention from cross infection should be improved for dental care professional staff and operation of sterilization should be standardized