硬式内镜不同清洗流程与检测方法的效能研究

Study on the Effectiveness of Different Cleaning Procedures and Testing Methods for Rigid Endoscope

目的研究硬式内镜不同清洗流程与检测方法的效能,寻求最佳的清洗及检测方案。方法收集我院因手术污染的硬式内镜300套,随机分为对照组(60套)和实验组(240套),按组件材质分为不可浸泡硬式内镜和可浸泡硬式内镜。实验组可浸泡硬内镜按照清洗方法不同分为实验A、B、C、D亚组,每亚组各60套。采取10倍带光源放大镜、蛋白残留检测棒、ATP生物荧光检测仪分别对所有硬式内镜清洗效果进行检测。结果放大镜检测、蛋白残留检测、ATP检测显示实验D组清洗合格率最高,均明显高于对照组(P﹤0.05);蛋白残留检测与ATP检测显示实验组不可浸泡硬式内镜清洗质量明显高于对照组(P﹤0.05);放大镜检测效能低于蛋白棒检测、ATP检测(P﹤0.05);蛋白残留检测与ATP检测效能比较,无统计学意义(P﹥0.05),Kappa系数为0.5839,具备一致性。结论不可浸泡硬式内镜采用多酶原液预处理,可浸泡硬式内镜采取超声喷淋联合全自动清洗消毒机清洗,能够提升清洗合格率;ATP生物荧光测试具有较高的可信度,方便快捷。

Objective To study the effectiveness of different cleaning procedures and testing methods of rigid endoscope, so as to seek the best cleaning and testing scheme. Methods A total of 300 rigid endoscopes contaminated by surgery in our hospital were collected and randomly divided into the control group(60 sets) and the experimental group(240 sets). According to the component materials, the rigid endoscopes were devided into non-immersible and immersible rigid endoscope. The experimental group of immersible endoscope was divided into subgroups A, B, C and D according to different cleaning methods, with 60 sets in each subgroup. The cleaning effect of all endoscope was detected with 10 times magnifying glass with light source, protein detection rod and ATP bioluminescence detector. Results 10 times magnifying glass detection, protein residue detection and ATP test showed that Subgroup D showed the highest qualification rate, which was obviously higher than the control group(P<0.05). For nonimmersible rigid endoscope, protein residue detection and ATP test showed that the cleaning quality of the experimental group was better than that of the control group(P﹤0.05). The efficiency of magnifying glass detection was lower that of protein residue detection and ATP test(P﹤0.05). There was no significant difference between the efficacy of protein residue detection and ATP test(P﹥0.05),with Kappa coefficient of 0.5839. Conclusion Non-immersible rigid endoscope should be pretreated with multi-enzyme solution, and immersible rigid endoscope should be cleaned by ultrasonic spraying combined with automatic cleaning and disinfection machine, which can greatly improve the qualified rate of cleaning. ATP bioluminescence test has high reliability and convenience in evaluating the clean quality of rigid endoscope.