腹腔镜器械清洗方法的探讨

Exploration of cleaning methods for laparoscopes

目的研究在手术多、清洗人员少、器械不能及时处理的情况下,清洗前保湿处理以及清洗流程对硬式内镜清洗效果的影响。方法对同类手术的下台器械进行3组相对应的处理和清洗流程,设置为A、B、C 3组:A组为下台后立即保湿处理(管腔器械内充满保湿剂)+酶洗+水洗+加酶超声+水洗,B组为下台后酶洗+水洗+加酶超声+水洗,C组为下台后水洗;使用目测法和白纱布法试验检测所有清洗后的器械,使用ATP检测仪器检测污染相对严重的管腔清洗后的情况。结果目测评判,A、B、C 3组的合格率分别为100.0%、100.0%、91.4%;白纱布试验,A、B、C 3组的合格率分别为100.0%、95.9%、50.5%;管腔ATP检测,A、B、C 3组的合格率分别为100.0%、89.4%、2.4%。结论对于不能及时处理的器械尤其是复杂的管腔类器械,清洗前做好保湿以保证清洗效果是确保器械清洗质量以及消毒灭菌效果的关键因素。

OBJECTIVE To study the impact of moisturizing treatment before cleaning and cleaning procedures on the cleaning consequence of rigid endoscope under the circumstances of many surgeries,insufficient cleaning staff,and untimely treatment of the instrument.METHODS Three different sets of corresponding treatments and cleaning procedures for machines applied in the similar operations were adopted and divided into group A,B,and C.Group A was immediately dealt with moisturizing treatment（lumen devices fully filled with humectants） plus enzyme washing plus water washing plus enzyme and ultrasound plus water washing;group B was treated with enzyme washing plus water washing plus enzyme and ultrasound plus water washing;group C was only treated with water washing.All the cleaned instruments were tested by visual observation method and white gauze method,the condition of the lumen devices contaminated seriously was detected by ATP checking machine.RESULTS The qualification rates of group A,B,and C were judged by visual observation,100.0%,100.0%,and 91.4%,respectively;by the white gauze method,100.0%,95.9%,and 50.5%,respectively;by lumen ATP test,were 100.0%,89.4%,and 2.4%,respectively.CONCLUSION For the devices that can not be handled in time,especially for the complex lumen devices,keeping the devices moisturized before cleaning is the key factor to ensure the cleaning effect as well as the effect of sterilization and disinfection.