重度异物残留内镜器械多酶超声机洗最佳时间的临床观察

The Clinical Observation of The Best Time of Multi-enzyme Combined with Ultrasonic Washing for Endoscopic Equipments with Severe Residual Foreign Body

目的探寻重度污染、高脂、高蛋白残留内镜器械多酶+超声机洗最佳浸泡清洗时间,以期提高清洗效率和质量,规避器械性医源感染。方法选择术后腔镜器械1260件,以多酶液+超声清洗的不同时间随机分为空白对照组和6个实验组,每组180件;对照组采用多酶浸泡后超声机洗法:分手工粗洗,多酶浸泡,超声清洗,水洗,检测清洗质量5个步骤完成;实验各组采用多酶+超声机同时浸洗法:将多酶浸泡,超声清洗两个步骤重叠,其余与对照组相同。同时实验1组浸洗6min,实验2组9min,实验3组12min,实验4组15min,实验5组18min,实验6组21min,清洗后对比7个组间器械清洗后轴节、齿槽、内腔表面污渍、残留蛋白质和微生物含量等清洗效果指标。结果人工目测:对照组和6个实验组清洗合格率均大于95%;实验检测:对照组清洗后合格率65.55%,明显低于其他6个实验组,差异有统计学意义(P<0.05);实验1,2,3,4组的合格率随浸洗时间延长而增加;实验5、6组器械清洗后合格率保持95%以上,与浸洗时间无明显相关性。结论重度异物残留内镜器械多酶+超声机洗最佳浸泡清洗时间为15min。

Objective To search for the best soak cleaning time of multi-enzyme combined with ultrasonic washing for endoscopic equipments with severe pollution,high-fat,high-protein residues,in order to improve the cleaning efficiency and quality and to avoid iatrogenic infections about instruments. Methods 1260 postoperative endoscopic instruments were randomly divided into a control group and five experimental groups,each group of 180,according to the different times of multi-enzyme combined with ultrasonic cleaning. The control group was used ultrasonic machine washing method after multi-enzyme soaking and the whole cleaning process was divided six steps which were manual rough washing,multi-enzyme soaking,ultrasonic cleaning,washing and testing the quality of cleaning. All the experimental groups were used multi-enzyme ＋ ultrasound machine washing at the same time,in other words,overlapping the multi-enzyme soaking and ultrasonic cleaning,and the rest steps were the same as the control group. While the immersion time for each experimental group,from group 1 to group 6,was 6 min,9 min,12 min,15min,18 min,21min. Contrasting the cleaning effect indexes such as stains,residual protein and microbial content consisting in axle section,alveolar,inside cavity surface of the equipments after cleaning between the seven groups. Results Artificial visual： the cleaning pass rates of the control group and six experimental groups were more than 95%. Laboratory testing： the pass rate after cleaning of the control group was 65. 55%,significantly lower than the other six experimental groups,the difference was statistically significant（ P〈0. 05）; Pass rates of the experimental groups,1,2,3,and 4,increased with the extension of soaking time; The instrument-cleaning pass rates of experimental group 5and 6 remained above 95%,which had no significant correlation with the immersion time.Conclusion The best soak cleaning time of multi-enzyme combined with ultrasonic washing for endoscopic equipments with severe residual pollution was 15 min.