不同时段非热力清洗消毒手术器械效果及评价方法的研究

Non-thermal cleaning and disinfection effect of surgical instruments in different time after used and evaluation methods

目的探讨非热力清洗消毒手术器械使用后不同放置时间、预处理方法对清洗效果的影响及不同评价清洗效果的比较。方法对120件使用后普通手术器械分为A、B两组,每组各60件,在清洗前A组给予保湿处理,B组自然放置,根据放置时间分为〈2、2-6、〉6h,均采用初洗＋酶泡＋超声波洗＋手洗＋酸化水浸泡消毒＋纯水冲洗的清洗方法,采用矫正视力法和隐血试纸法检查各组清洗后的效果;采用SPSS15.0软件进行统计分析。结果矫正视力法显示,A、B组放置时间越长,清洗后阳性率越高（χ2=10.909,20.297,P〈0.05）;组间比较,使用后手术器械放置时间2-6、〉6h,B组阳性率分别为85.0%、60.0%,均高于A组的55.0%、25.0%（P〈0.05）;隐血试纸法在〈2、2-6、〉6h检查阳性率分别为15.0%、55.0%、92.5%,均高于矫正视力法的2.5%、30.0%、57.5%（P〈0.05）。结论手术器械使用后放置时间越长、清洗效果越差,在清洗前给予保湿处理能提高清洗效果,采用隐血试纸法检查清洗效果优于矫正视力法。

OBJECTIVE To explore the non-thermal cleaning and disinfection effect of surgical instruments in different time after used and in different pretreatment methods, and to compare the different evaluation methods of cleaning effect. METHODS A total of 120 normal surgical instruments were divided into group A and group B, each group included 60 pieces, group A was given moisturize prior to cleaning, and group B was placed naturally. According to the time were divided into 〈2h, 2h-6h and 〉6h, all were cleaned by initial cleaning ＋ enzyme ＋ ultrasonic washing ＋hand wash＋ acidified water immersion disinfection ＋ pure water flushing. Vision correction method and paper occult blood test were used to check the cleaning effect. SPSS15.0 software was used for staffstical analysis. RESULTS The longer the storage time, the higher positive rate wsa found after cleaning in both group A and group B by vision correction method（x^2 = 10. 909, 20. 297, P〈0.05）. If placing time exceeds 2-6h and more than 6h, the positive rate of group B were 85. 0% and 50. 0%, which higher than that in group A （55.0% and 25.0%, P〈0.05）. The positive rate of paper occult blood test were higher than that of vision correction method in any time （15% vs. 2.5%; 55.0% vs. 30%; 92.5% vs. 57. 5%, P〈0. 05）. CONCLUSION The longer the storage time of surgical instruments after used, the poor of cleaning effect. The moisturizing treatment before cleaning can improve the cleaning effect. The check cleaning effect of paper occult blood test is superior to the vision correction method.