两种方法清洗腹腔镜器械质量的比较

Comparison of cleaning quality for laparoscopic apparatuses between two cleaning methods

目的比较两种清洗方法清洗腹腔镜器械的质量,探讨有效的腹腔镜器械清洗方法。方法将2011年1月~2012年5月首都医科大学附属北京佑安医院开展的222台腹腔镜手术的254件腹腔镜器械分为观察组与对照组,每组各127件。对照组采用手工清洗法,观察组采用机械清洗法。清洗后分别采用目测、白纱布法、ATP检测法检测及隐血检测方法检查器械,比较两组器械的清洗合格率及隐血阳性率。结果经目测与白纱布法检测,两组腹腔镜器械均符合合格标准,合格率为100.00%,两组差异无统计学意义（P〉0.05）。通过ATP法检查,对照组的清洗合格率为57.48%,观察组的清洗合格率为91.34%,观察组的清洗合格率明显高于对照组,差异有统计学意义（P〈0.05）。观察组隐血阳性率为7.87%,明显低于对照组（40.16%）,差异有统计学意义（P〈0.05）。结论机械清洗方法提高了腹腔镜器械的清洗质量,保证灭菌效果,对预防和控制院内感染具有很重要的作用。

Objective To compare cleaning quality of two kinds of cleaning methods for laparoscopic instruments, and investigate the effective method of laparoscopic instruments cleaning. Methods From January 2011 to May 2012, in Beijing You＇an Hospital, 254 laparoscopic surgical instruments, which were used in 222 laparoscopic surgery were divided into observation group and control group, with 127 parts in each group. The control group was performed by hand washing method, and the observation group was given the mechanical cleaning method. After cleaning, equipments were checked by visual inspection, white gauze method, ATP method detection and detection of occult blood. The equipment cleaning qualified rate and the positive rate of two groups were compared. Results Laparoscopic instruments of two groups were in line with the standard of qualified by visual inspection and white gauze inspection method, the pass rates of two groups were 100.00%, the difference was not statistically significant（P〉0.05）. Through ATP method, the pass rate of control group was 57.48%, and the pass rate of observation group was 91.34%, the difference was statistically significant（P〈0.05）. The occult blood positive rate of observation group was 7.87%, it was significantly lower than that of control group（40.16%）, the difference was statistically significant（P〈0.05）. Conclusion Mechanical cleaning method can improve the cleaning quality of laparoscopic instruments, and ensure the sterilization effect, which has a very important role in the prevention and control of nosocomial infection.