润滑剂溶液使用时间对手术器械清洗质量的影响研究

Impact of usage duration of lubricant solution on quality of cleaning of surgical instruments

目的观察润滑剂溶液使用不同时间的细菌数值,以及对润滑后手术器械清洗质量的影响,加强手术器械质量控制,保证医疗安全。方法将2015年5月回收的手术器械180件,随机分为6组,每组30件;对器械进行冲洗、多酶清洗、漂洗、终末漂洗,目测和ATP生物荧光检测合格后,浸泡于润滑剂溶液4、8、10、12、24h,对不同时间浸泡的润滑剂溶液进行细菌菌落数和器械清洗的质量进行监测。结果浸泡不同时间的润滑剂溶液细菌菌落数随着使用时间的长度而增加;润滑后的器械进行ATP生物荧光检测和细菌培养计数,4、8、10h全部合格;12、24hATP生物荧光检测的不合格数为4件和11件,不合格率分别为13.33%和36.67%;润滑剂溶液细菌培养不合格数为3件和12件,不合格率分别为10.00%和40.00%,明显高于4、8、10h,差异有统计学意义(P<0.05)。结论润滑剂溶液的细菌菌落数随使用时间增加而增长,润滑剂溶液使用10h以上,对器械的清洗质量造成影响。

OBJECTIVE To observe the bacterial colony counts at different time points of use of lubricant solution and the impact on the quality of cleaning of surgical instruments so as to strengthen the control of quality of the surgical instruments and ensure the medical safety.METHODS A total of 180 surgical instruments that were collected in May 2015 were randomly divided into 6groups,with 30 instruments in each group.The surgical instruments were treated with flushing,multienzyme cleaning,and terminal rinsing,then the surgical instruments were respectively soaked in the lubricant solution for 4,8,10,12,and 24 hours after they were tested qualified by the visual inspection and ATP bioluminescence assay.The bacterial colony counts in the lubricant solution and the quality of cleaning of instruments were monitored at the different time points.RESULTS The bacterial colony counts in the lubricant solution were increased with the time of application.The ATP bioluminescence assay and bacterial colony counting were carried out for the lubricated instruments,all of which were qualified after they were soaked in the solution for 4,8,and 10 hours.The ATP bioluminescence assay showed that 4instruments were unqualified after they were soaked in the solution for 12 hours and that 11 instruments were unqualified after they were soaked in the solution for 24hours;the unqualified rates were 13.33% and 36.67%,respectively.The bacterial culture of the lubricant solution showed that 3and 12 instruments were respectively unqualified,and the unqualified rates were 10.00%and 40.00%,significantly higher than those of the instruments that were soaked in the solution for 4,8,and 10hours（P0.05）.CONCLUSIONThe bacterial colony counts in the lubricant solution are increased with the time of use,and the use of lubricant solution for more than 10 hours may influence the quality of cleaning of the instruments.