四种方法预清洗咬骨钳效果比较

Comparison of effects of four pre-cleaning methods on rongeurs

目的提高消毒供应中心对骨科手术器械的清洗效率。方法将临床应用后的384件双关节咬骨钳随机分成A、B、C、D组各96件。A组采用1∶270多酶液浸泡+单舱清洗消毒机清洗;B组采用单舱清洗消毒机清洗;C组采用超声清洗机+单舱清洗消毒机清洗;D组采用蒸汽清洗机+单舱清洗消毒机清洗。结果 A、B、C、D组双关节咬骨钳清洗后采用放大镜检测法合格率分别为60.42%、83.33%、97.92%、100%,差异有统计学意义(P<0.01);ATP生物荧光检测合格率分别为55.21%、78.12%、96.88%、97.92%,差异有统计学意义(P<0.01),其中A组显著低于另三组(均P<0.0071)、C组与D组比较差异无统计学意义(P>0.0071);D组预洗不用多酶液,用水量及耗时显著少于另三组(均P<0.05)。结论采用蒸汽清洗机预洗有助于提高单舱清洗消毒机对骨科咬骨钳的清洗消毒效果,同时减少用水量及多酶液。

Objective To improve the cleaning efficiency of orthopedic surgical instruments in disinfection supply center.Methods A total of 384 double-joint rongeurs after clinical use were randomized into 4 groups：A,B,C and D,with 96 in each.They were cleansed with four different cleaning methods：soaking with 1：270 polyenzyme＋ single-cabin cleaner and sterilizer in group A;single-cabin cleaner and sterilizer in group B;ultrasonic cleaner ＋ single-cabin cleaner and sterilizer in group C;and steam cleaner＋single-cabin cleaner and sterilizer in group D.Results The qualified rate of cleaning based on magnifying glasses was60.42%in group A,83.33%in group B,97.92%in group C and 100%in group D,being significantly different（P〈0.01）.The qualified rates tested by adenosine triphosphate（ATP）bioluminescence assay were 55.21%,78.12%,96.88% and 97.92%,respectively（P〈0.01）,with group A being significantly lower than the other three groups（P〈0.0071 for all）,but no significant difference between group D and C（P〉0.0071）.Water consumption and cleansing time were significantly less/shorter in group D than the other three groups（P〈0.05 for all）.Conclusion Pre-cleaning with steam cleaner prior to single-cabin cleaner and sterilizer can improve the cleaning effect on rongeurs,and reduce consumption of water and polyenzyme.