手术室腔镜4种消毒灭菌方法的效果评价

Disinfection and Sterilization of Endoscope Using in Operating Room: Effects of Four Methods and Their Evaluation

目的探讨手术室内镜安全、高效、实用的消毒方法。方法观察医院手术室使用后的腹腔镜和鼻内镜,共120例,随机分为A、B、C、D 4组,分别使用高温高压、环氧乙烷、过氧化氢等离子体及2%碱性戊二醛进行消毒灭菌,并对使用后及4种方法消毒灭菌后的内镜取样行细菌培养,观察菌落数,比较4种消毒方法的灭菌效果。结果内镜清洗前各部件均有不同程度的污染,菌落数从0至无法计数;使用后清洗前各组内镜的平均菌落数差异无统计学意义(P>0.05);各组内镜4种方法消毒灭菌后的平均菌落数差异无统计学意义(P>0.05)。结论4种消毒方法的效果等同;过氧化氢等离子体是一种高效、安全、环保的消毒方法;2%碱性戊二醛浸泡30 min可作为环氧乙烷、高温高压消毒灭菌的补充。

OBJECTIVE To discuss which sterilization methods of endoscope using in operating room are safe, highly effective and practicable. METHODS Totally 120 peritoneoscopes and rhinoscopes were divided randomly into four groups named A, B, C and D, which used four different sterilizing methods in high pressure, ethylene oxide, plasma hydrogen peroxide and soak with 2% alkaline glutaraldehyde, respectively. To evaluate their sterilization effects, we compared number of cultural bacterial colonies derived from the endoscope before cleaning and after cleaning. RESULTS All parts of endoscopes existed contamination in certain degree. The number of bacterial colonies ranged from zero to infinity. The average number of colonies after using and before cleaning had no statistical significance（P〉0.05）. After sterilization, the average number of colonies among each group had no statistical significance（P〉0. 05）. CONCLUSIONS The effects of the four sterilization methods are uniform. Plasma hydrogen peroxide is a highly effective, safe and with environmental protection method. Soak for 30 minutes with 2% alkaline glutaraldehyde is a supplementary method when using high pressure or ethylene oxide methods.