不同清洗方法对医疗器械清洗效果的研究

Comparison of different methods in cleaning medical instruments

目的:通过对医疗器械进行血液污染,比较不同清洗方法去除医疗器械上血液的效果,得出有效的清洗方法,确定正确的清洗操作规程。方法:采用标准污染方法,把新鲜血液污染后的外科剪按照1h、2h、3h、4h、5h5个时间段分别放置,每个时间段将样本分为4组,每组200把,共4000个样本。在器械质量、水质、水温、机械清洗程序、器械装载量等因素确定可比的条件下,对5组样本分别采用4种清洗方法,进行潜血阳性率比较。实验数据采用χ2检验进行统计学分析。结果:多酶机洗清洗方法在污染器械放置1～3h内清洗,与冲洗+酶泡方法对比,无统计学差异(P>0.5),与多酶浸泡清洗方法对比,有统计学差异(P<0.001)。放置4h的4组标本对比均有统计学差异(P<0.05-0.001);放置5h多酶机洗的阳性率也明显增加,各组对比均无统计学差异(P>0.05)。结论:机械清洗法效果优于人工清洗法,清洗前先冲洗提高清洗效果,污染器械放置2h以上将增加清洗难度。

Objective：To compare different cleaning methods in removing blood contamination.Methods：Totally 4000 surgery scissors were divided into 5 groups,which were cleaned 1h,2h,3h,4h,5h after contaminated by fresh blood.In every group,four cleaning methods were used.The instruments quality,water quality and temperature,machine cleaning procedure and instrument loadage were controlled.The occult blood positive rate were compared.Results：There was no difference（P0.5） between multienzyme machine cleaning method and rinse and enzyme soak method,and was significant difference between multienzyme machine cleaning method and enzyme soak method（P0.001） in1-3h.There was significant difference among 4 groups in 4h（P0.05-0.001）.In 5h,positive rate increased evidently in multienzyme machine cleaning method and there was no difference among 4groups（P0.05）.Conclusion：The effect of machine cleaning is better than hand cleaning.Rinsing before cleaning can improve cleaning effect.Instruments are difficult to clean after being contaminated more than 2h.