麻醉机回路消毒机消毒效果及安全性分析

Analysis of Disinfection Effect and Safety on Anesthesia Machine Using Circuit Disinfection Device

【目的】研究麻醉机回路消毒机消毒效果及安全性。【方法】对2017年6月至2018年5月本院麻醉科正常使用的38台循环紧闭式麻醉机经麻醉机回路消毒机消毒前3个月和消毒后3个月的菌落总数、麻醉机污染部位、患者感染发生率及金属腐蚀情况进行比较。【结果】消毒前3个月的麻醉机污染率为28.95%(11/38),显著高于消毒后3个月的污染率7.89%(3/38)(P<0.01)。消毒前3个月与消毒后3个月的麻醉机吸气端、钠石灰罐出口、钠石灰管入口污染率比较差异均无显著性(P>0.05);消毒前3个月的麻醉机呼气端污染率为18.42%(7/38),显著高于消毒后3个月的5.26%(2/38)(P<0.01),消毒前3个月的患者肺部感染率为9.00%(9/100)、呼吸道感染率为14.00%(14/100),显著高于消毒后3个月的2.00%(2/100)和3.00%(3/100)(P<0.05)。消毒72 h后的碳钢重量显著低于消毒前(P<0.05);消毒前和消毒72 h后铝、铜、不锈钢重量比较差异均无显著性(P>0.05)。【结论】使用10%过氧化氢超声雾化消毒麻醉机呼吸回路可取得可靠的消毒效果,从而降低麻醉机污染率与患者呼吸道感染率,提高治疗的安全性,适宜在临床中推广使用。

【Objective】To investigate the disinfection effect and safety on anesthesia machine using circuit disinfection device.【Methods】Our hospital had 38 close-circulated anesthesia machines that normally run during June 2017 to May 2018.Those anesthesia machines were sterilized by the device called anesthesia machine circuit loop sterilizer.The total number of colonies,the contaminated sites of the anesthesia machine,the incidence of patient infection and the metal corrosion at 3 months before and after anesthesia machine disinfection were recorded and compared.【Results】The rate of anesthesia machine contamination was 28.95%(11/38)3 months before disinfection,which was significantly higher than the contamination rate of 7.79%(3/38)3 months after disinfection.The difference was statistically significant(P<0.01).There were no significant differences in the contamination rates between the inhalation end of the anesthesia machine,the outlet of the sodium-lime tank and the inlet of sodium-lime tube at 3 months before disinfection and 3 months after disinfection(P>0.05).The exhalation contamination rate of the anesthesia machine 3 months before disinfection was 1SA2%(7/38),which was significantly higher than that of 5.26%(2/38)showed at 3 months after disinfection(P<0.01).The lung infection rate in patients 3 months before disinfection was 9.00%(9/100)and the respiratory infection rate was 14.00%(14/100),which was significantly higher than 2.00%(2/100)and 3.00%(3/100),irrespectively,at 3 months after disinfection(P<0.05).The weight of carbon steel 72h after disinfection was significantly lower than that before disinfection(P<0.05).However,here was no significant difference in the weight of aluminum,copper and stainless steel 72h before and after disinfection(P>0.05).【Conclusion】The use of 10%hydrogen peroxide by ultrasonic atomization disinfection of anesthesia machine can obtain a reliable disinfection effect,thereby reducing the contamination rate of anesthesia machine and patient respiratory infection,while improving the safety of anesthesia machine usage.