器械清洗后放置时间和环境与污染度的相关性研究

Study on the correlation between storage time as well as environment and the pollution degree of surgical instruments after cleaning

目的通过对不同方式清洗后的手术器械放置时间、环境与污染度关系的研究,寻求灭菌前科学的包装时间,确保清洗灭菌质量。方法随机选取使用后污染的胃肠手术器械960件设计为A、B、C、D四组(每组240件):A、C组为手工清洗器械,B、D组为机械清洗器械,A、B组存放洁净环境,C、D组存放普通环境。每组在清洗后6个时间点用ATP生物荧光测试仪检测。比较洁净环境下不同清洗方式、不同放置时间;比较普通环境下不同清洗方式、不同放置时间;比较手工清洗方式下不同环境、不同放置时间;比较机械清洗方式下不同环境、不同放置时间;回归分析影响器械清洗合格的因素。结果不同放置环境及不同存放时间,机械清洗均优于手工清洗(P<0.05)。存放时间、放置环境及清洗方式均为器械清洗发生不合格的危险因素(P<0.05),其B值和相对危险度(OR)分别为-1.32,0.27;-2.31,0.10;2.21,9.15。合格率、清洗方式、存放时间及放置环境之间有一致性倾向(2=66.03,P=0.00)。结论清洗后的器械应及时包装,如需搁放,普通环境应在2小时内、10万级的洁净环境应在6小时内完成包装,以确保清洗质量。

Objectives To explore scientific packaging time and focus on the correlation between storage time as well as environment and the pollution degree of surgical instruments after cleaning in different ways.Methods 960 contaminated surgical instruments were divided into group A,group B,group C and group D.The surgical instruments from group A and group C were cleaned by manual cleaning.While the surgical instruments from group B and group D were cleaned by machine cleaning.At the same time,all the instruments from group A and B were stored in clean environment.As a comparison,the ones from group C and D were stored in common environment.All the surgical instruments were sampled with ATP bioluminescence tester at 6 time points after cleaning.The risk factors of the pollution degree and relationship were analyzed.Results Machine cleaning was better for manual cleaning（P〈0.05）.The risk factors of instrument-contaminated including time,environment and cleaning methods（P〈0.05）.It had conformance tendency between the percent of pass,cleaning methods,environment and time（χ^2=66.03,P=0.00）.Conclusion In clinical work,the surgical instruments after cleaning should be packed in time.The surgical instruments stored in common environment are supposed to be packed in 2 hours,and which stored in clean environment should be packed in 6 hours to ensure the high quality of cleaning.