不同清洗方法对腹腔镜手术器械灭菌效果的影响

Effects of three different cleaning methods on the sterilization effect of laparoscopic surgical instruments

目的探讨不同清洗方法对腹腔镜手术器械清洗和灭菌效果的影响。方法选择2010年5月-2012年2月使用后的腹腔镜手术器械2 499件,将其随机分为A组833件、B组833件、C组833件,分别采用单纯手工清洗方法、手工加酶清洗方法、加酶超声清洗方法,清洗效果监测采用目测检查,3组器械均采用高压蒸汽灭菌器灭菌,灭菌后采用营养琼脂培养法对腹腔镜手术器械进行细菌学检测,数据采用SPSS13.0软件进行统计分析。结果清洗效果合格率A、B、C 3组分别为93.9%、97.4%、100.0%,C组清洗合格率明显优于B组和A组,差异有统计学意义(P<0.05);器械灭菌后A、B、C 3组细菌学检测合格率依次为95.7%、97.2%、100.0%,C组细菌学检测合格率明显优于B组和A组,差异有统计学意义(P<0.05)。结论超声联合多酶清洗显著提高器械的清洗质量,可作为一种有效、安全、简便的清洗方法在临床中广泛应用。

OBJECTIVE To discuss the effects of three different cleaning methods on the sterilization effect of laparoscopic surgical instruments.METHODS A total of 2,499 laparoscopic instruments used from May 2010 to Feb.2012 were randomly divided into three groups：group A（833pieces,manual cleaning only）,group B（833pieces,manual cleaning with enzymatic detergent）and group C（833pieces,ultrasonic washer with enzymatic detergent）.All the instruments were visually inspected for cleaning effect and sterilized with steam sterilizers.Bacteriological test was performed with nutrient agar method to culture bacteria for 72 hours.Data collected were processed with SPSS13.0.RESULTS For group A,B and C,the rate of qualified cleaning was respectively93.9%,97.4%and 100%,and the pass rate of bacteriological test was respectively 95.7%,97.2%,100.0%.As for the two kinds of rate,group C was better than group A and B（P〈0.05）.CONCLUSION Ultrasonic washer combined with enzymatic detergent can greatly improve the cleaning quality of medical instruments and should be widely used as an effective,safe and convenient cleaning method.