内镜清洗消毒效果检测分析

Detection of effect on cleaning and disinfecting endoscope

目的探讨如何更有效地做好内镜清洗消毒的规范化管理,预防和控制由内镜检查所造成的医源性感染,提高医疗质量,确保医疗安全。方法回顾性调查分析2005年1月～2006年12月随机抽检的该院人工清洗后用NCX12-III型自动超声雾化内镜消毒机清洗消毒(2%戊二醛)处于临用状态的支气管镜、胃镜和肠镜及其配件的监测采样结果,按不同的监测方法把调查资料分为A(内腔采样)和B(外表面采样)2组。结果监测待用内镜47件,采取标本94份,每组47份,A组各镜合格率均为100%;B组有2份标本菌落数超标,总合格率95.74%,各镜合格率分别为胃镜94.74%、肠镜92.31%、纤维支气管镜100%。结论内镜的规范化清洗是保证消毒质量的关键,对内镜的消毒效果监测建议采用内腔采样和外表面采样相结合的方法进行标本采集,以便正确评价内镜的清洗消毒质量。

[Objective] To approach the effective standardized management for cleaning and disinfection of endoscope, in other to prevent medical infection by using endoscope examination, enhance the medical care and assure the medical safety. [Methods] The results of random check up the cleaned and disinfected endoscopes and their accessories were reviewed that be ready by using NCX12-Ⅲ automatic ultrasonic nebulization endoscopecleaning and disinfecting machine（2% glutaric dialdehyde） to treat-artificial cleaning endoscope during Jan. 2005 and Dec. 2006. According to the check up methods, the same investingated samples were divided into group A （endoscope inner sampling） and group B （endoscope surface sampling）. [Results] 47 pieces of endoscope were investigated and samples 94 pieces were picked, each group 47 pieces. All endoscopes in group A won 100% qualification rate, but there were two samples of group B in excess of clony numbers, the sum qualification rate was 95.74%, with the gastroscope 94.74%, enteroscope 92.31%, and bronchofibroscope 100%. [ Conclusion ] The standardized management for cleaning and disinfection of endoscope is the most important key to assure disinfection quality of endoscopes. Both endoscope inner sampling and surface sampling methods are suggested on detection and check up the effect of disinfection of endoscope, to correctly valuate the cleaned and disinfected quality of endoscope.