内镜清洗效果的影响因素分析及其对策

Analysis on Influence Factors of Cleaning Quality for Endoscope and Its Countermeasures

目的:分析苏州市内镜清洗效果的影响因素并提出改进对策。方法:对苏州市28家二级以上医院进行现场查看和问卷调查,并采用ATP生物荧光检测法检测内镜清洗效果。结果:每日工作量>37.7条的清洗不合格率为23.80%明显高于<37.7条的为7.89%(P<0.05);平均清洗消毒时间<8.2 min、>8.2~15.8 min、>15.8 min的三组清洗不合格率经组间比较其差异有统计学意义(P<0.05);内镜的使用年限>8年、>3~8年和<3年,内镜的清洗不合格率也不同(P<0.05);内镜的初洗时间、漂洗时间也影响内镜的清洗效果((P<0.05);但在酶的平均使用量、内镜每日平均使用频率、酶的浓度、清洗时间、漂洗水质等方面均未与内镜清洗效果有关。结论:清洗工作量、平均清洗消毒时间、初洗时间、漂洗时间和内镜的使用年限等因素影响内镜清洗效果。

Objective： To analyze the influencial factors of cleaning quality for endoscope at hospitals of all levels in suzhou, and to propose improving measures. Methods： The current situation of cleaning and disinfection of endoscopy in 28 hospitals in suzhou was investigated using a questionnaire, using ATP fluorescence detection method to detect the cleaning quality. Results： 28 hospitals（100%） all answered the questionnaire. Daily work load of 37.7 or more could reduce cleaning effect and the difference was statistically significant （P〈 0.05 ）; The average time of cleaning and disinfection, service life, primary washing time and rinsing time affected the cleaning quality of endoscopy, the probability of them was less than （P〈 0.05 ）（Such as 0.001, 0.03, 0.003 and 0.04）, respectively, Low enzyme levels, more daily frequency of use, low enzyme concentration, short washing time and untreated rinsing water could reduce cleaning effect, but there was no significant difference （P〉0.05）. Conclusion： It is the fundamental way to ensure all aspects of endoscope cleaning and disinfection.