轴节类器械不同清洗方法的效果观察

Comparison of different cleaning methods for coupling medical apparatus

目的探讨轴节类医疗器械的有效清洗方法,保证再生器械灭菌质量。方法将回收的450件轴节类器械随机分为A、B、C三组各150件,每组组织剪、止血钳、持针器各50件。器械在流动水下充分冲洗后,A组用全自动清洗消毒机清洗;B组浸泡于多酶清洗剂10min,人工刷洗后再用全自动清洗消毒机清洗;C组用超声机加酶清洗后人工刷洗,进而手工漂洗再高温煮沸。结果三组清洗后目测合格率及潜血试验阳性率比较,差异有统计学意义(均P<0.01),其中C组潜血试验阳性率显著低于A、B组(均P<0.0125)。三组清洗后器械咬合面、关节处潜血试验阳性率比较,差异有统计学意义(均P<0.01),C组上述部位潜血试验阳性率显著低于A、B组(均P<0.0125)。结论超声清洗机加酶清洗后进行手工刷洗,可有效去除残留物,是轴节类器械较理想的清洗方法。

Objective To explore effective cleaning methods for cleaning coupling medical apparatus,and to ensure sterilization quality of regeneration equipment. Methods A total of 450 contaminated coupling medical apparatus were randomized into three groups,with 50 pairs of tissue scissors,50 pairs of hemostatic forceps,and 50 needle holders in each group.After being flushed with running water,apparatus in group A were cleaned by using automatic washer disinfector;those in group B were soaked in multi-enzyme solution for 10 min and were cleaned with automatic washer disinfector after manual brushing;samples in group C received cleaning with multi-enzyme by using ultrasonic cleaner,and then manual brushing,manual rinsing,and high-temperature boiling were employed. Results The qualification rates of visual observation and positive rates of occult blood test showed significant diffe-rences among the three groups（P〈0.01 for both）,with the positive rate of occult blood test in the group C significantly lower than the other two groups（P〈0.0125 for both）.The positive rates of occult blood test at occlusal surface and joints had statistical differences among the three groups（P〈0.01 for both）,with those in the group C significantly lower than the group A and B（P〈0.0125 for all）. Conclusion Ultrasonic cleaning with multi-enzyme followed by manual brushing,can effectively eradicate residue,which is an ideal method for cleaning coupling medical apparatus.