医疗器械沾染血迹后的保存方式和清洗方式对清洗质量的影响

Effects of different preservation and cleaning methods on blood-contaminated medical instrument

目的探讨不同保存方式和清洗方式对沾染血迹的医疗器械清洗质量的影响。方法以人工染血的止血钳800把作为研究对象,随机分为湿式保存组和干式保存组,每组各400把,分别于人工染血后不同时间(1、2、4、6及12 h)取出80件,再随机分为机械清洗组和手工清洗组,每组各40件,取各组清洗后的器械进行隐血试验,评价清洗质量。结果放置4 h内,两组保存条件下采用机械清洗和手工清洗的清洗效果差异无统计学意义(P>0.05),放置6 h和12 h,湿式保存组中两组清洗方式差异无统计学意义(P>0.05),干式保存组中机械清洗阳性率(5.0%和20.0%)显著低于手工清洗阳性率(72.5%和92.5%),差异有统计学意义(P<0.01)。结论湿法保存可以提高染血器械的清洗效果,配以机械清洗可以更有效降低阳性率,实施集中管理,选择合适的保存方式和清洗方法,可有效保证医疗器械的清洗质量。

Objective To explore the effects of different preservation methods and cleaning methods on blood contaminated medical instruments. Methods Totally 800 pieces of hemostats with artificial blood stains were used and randomized into 2 preservation groups （wet group and dry group） with 400 pieces in each group. Eighty pieces were taken out in different time （ 1 h, 2 h, 4 h, 6 h, 12 h） and random ized into 2 cleaning groups （ mechanical cleaning group and manual cleaning group） with 40 pieces in each group. Occult blood test was taken to examine the effect of all the instruments after washing and the quality of cleaning was evaluated. Results Within 4h, two preserva tion groups cleaned with mechanical and manual methods showed no significant difference （P 〉0. 05 ）. At 6h and 12h, two cleaning methods （mechanical and manual） showed no significant difference （P 〉 0.05 ） in wet group; in dry group, the positive rate of mechanical groups （5.0% and 20.0% ） was significantly lower than that of manual groups （72.5 % and 92.5 % ） （P 〈 0.01 ）. Conclusion Wet preservation can improve the cleaning effect of the blood contaminated medical instruments ; meanwhile, mechanical Cleaning can effectively reduce the positive rate. The quality of cleaning can be improved by applying the centralized management and selecting the appropriate preservation and cleaning method.