超声波加酶清洗与传统手工清洗联合低温灭菌在内镜器械清洗中的效果比较

Comparison of Effect of Ultrasonic Wave and Enzyme and Traditional Handwork Cleaning Combined with Low Temperature Sterilization in the Cleaning of Endoscopic Instruments

目的探讨超声波加酶清洗联合低温灭菌在硬式内镜器械清洗中的运用价值。方法选择2017年9—12月在该院消毒供应中心清洗并灭菌的硬式内镜器械共536件作为对象,采用随机数字表法将所有器械分为手工清洗组和超声波清洗组各268件器械,各组均有腹腔镜、椎间孔镜和钛夹钳128件、36件、104件。手工清洗组采用传统手工清洗方法,超声波清洗组采用超声波加酶清洗方法。两组清洗后均予以低温灭菌。采用3M protect检测法、咽拭子培养法评价器械清洗合格率和灭菌合格率。结果超声波洗组腹腔镜、椎间孔镜、钛夹钳清洗合格率分别为98.44%、91.67%、94.23%,均高于手工清洗组,差异有统计学意义(χ~2=8.569、4.600、5.915,P<0.05)。超声波清洗组和手工清洗组中腹腔镜、椎间孔镜和钛夹钳灭菌合格率均为100.00%。结论相比于传统手工清洗结合低温灭菌,超声波加酶清洗结合低温灭菌,可以取得更好的清洗效果,值得医院消毒供应中心在器械清洗中推广运用。

Objective To study the application value of ultrasonic wave and enzyme and traditional handwork cleaning combined with low temperature sterilization in the cleaning of endoscopic instruments. Methods 536 pieces of hard endoscope instruments for cleaning and sterilization in our hospital from September to December 2017 were selected and randomly divided into two groups with 268 pieces in each, both groups had 128 pieces of laparoscopes, 36 pieces of intervertebral foraminoscopies and 104 pieces of titanium clamps, and the handwork cleaning group used the traditional handwork cleaning method, while the ultrasonic wave group used the ultrasonic wave and enzyme, and both groups were for low temperature sterilization after cleaning, and the cleaning qualified rate and sterilization qualified rate were evaluated by the 3M protect test method and pharynx swab culture method. Results The cleaning qualified rates of laparoscopy, intervertebral foraminoscopy, titanium clamp in the ultrasonic wave cleaning group were respectively98.44%, 91.67%, 94.23%, which were higher than those in the handwork cleaning group, and the differences were statistically significant（χ2=8.569, 4.600, 5.915, P〈0.05）, and the sterilization qualified rates of laparoscopy, intervertebral foraminoscopy, titanium clamp in the ultrasonic wave group and in the handwork cleaning was respectively 100.00%and 100.00%. Conclusion The cleaning effect of ultrasonic wave and enzyme combined with low temperature sterilization in the cleaning of endoscopic instruments is obvious, which is worth promotion and application in the hospital disinfection supply center.