角膜塑形镜储存盒四种消毒方法抗菌效果的比较

Comparative on antibacterial effect of four disinfection methods of the orthokeratology len storage boxes

目的比较角膜塑形镜盒不同消毒方式的抗菌作用及抗菌期限,旨在为角膜塑形镜验配、试戴及日常长期使用中镜盒的消毒护理提供科学依据。方法选取2019年10月至12月爱尔眼科医院集团旗下4家医院(长沙爱尔眼科医院、长沙湘江爱尔眼科医院、重庆爱尔眼科医院、南昌爱尔眼科医院)共360片角膜塑形镜试戴片作为研究对象,根据不同医院将其分为A组(长沙爱尔眼科医院)、B组(长沙湘江爱尔眼科医院)、C组(重庆爱尔眼科医院)和D组(南昌爱尔眼科医院),每组各90片。A、B、C组均先用500 mg/L含氯消毒液浸泡消毒30 min,然后A组用灭菌生理盐水冲洗,B组用当天开启使用的品牌饮用纯净水冲洗,C组采用当日煮沸自然存放的凉白开水冲洗,D组先用除蛋白酶护理液浸泡消毒30 min后,再用灭菌生理盐水冲洗。四组试戴片镜盒分别在存放7 d(T_(1))、存放14 d(T_(2))、存放21 d(T_(3))、存放28 d(T_(4))的4个时间段取出,检测并比较四组的微生物阳性率。结果四组在4个时间点(T_(1)、T_(2)、T_(3)、T_(4))的微生物检测阳性率比较,差异均有显著统计学意义(P<0.001)。C组在4个时间点(T_(1)、T_(2)、T_(3)、T_(4))的微生物检测阳性率均高于A、B、D组,差异有统计学意义(P<0.008);A、B、C组T_(4)时的微生物检测阳性率均高于本组T_(1)时,差异有统计学意义(P<0.05);D组T_(2)、T_(3)、T_(4)时的微生物检测阳性率与本组T_(1)时比较,差异均无统计学意义(P>0.05)。结论角膜塑形镜储存盒采用灭菌生理盐水、纯净水、除蛋白酶护理液三种消毒清洗方式均能有效抑制微生物的生长,灭菌生理盐水、纯净水两种清洗消毒方法储存时间建议不超过21 d(3周)。经除蛋白酶护理液清洗消毒的试戴片镜盒,微生物在4周内没有明显的增长趋势。凉白开水冲洗方法不推荐使用。选择安全有效的消毒方法,能够避免试戴片者发生院内交叉感染。

Objective To compare the antibacterial effect and duration of different disinfection methods of orthokeratology lens boxes,in order to provide scientific basis for orthokeratology lens box disinfection and nursing in daily long-term use.Methods From October to December 2019,a total of 360 orthokeratology lens test pieces from 4 hospitals of Aier Eye Hospital Group(Changsha Aier Eye Hospital,Changsha Xiangjiang Aier Eye Hospital,Chongqing Aier Eye Hospital,Nanchang Aier Eye Hospital)were selected as the research objects.According to different hospitals,they were divided into group A(Changsha Aier Eye Hospital),group B(Changsha Xiangjiang Aier Eye Hospital),group C(Chongqing Aier Eye Hospital)and group D(Nanchang Aier Eye Hospital),with 90 pieces in each group.Group A,B and C were soaked and disinfected with 500 mg/L chlorine-containing disinfectant for 30 min,then group A was rinsed with sterilized normal saline,group B was rinsed with brand drinking purified water used on the same day,and group C was rinsed with cold boiled water naturally stored on the same day.Group D was soaked and sterilized with protease removing nursing solution for 30 min,and then washed with sterilized normal saline.The lens boxes of the four groups were taken out at the storage periods of 7 days(T_(1)),14 days(T_(2)),21 days(T_(3))and 28 days(T_(4)),respectively.The positive rate of microorganisms in the four groups was detected and compared.Results There were significant differences in the positive rate of microbial detection among the four groups at four time points(T_(1),T_(2),T_(3),T_(4))(P<0.001).The positive rates of microbial detection in group C were higher than those in group A,B and D at four time points(T_(1),T_(2),T_(3),T_(4)),and the differences were statistically significant(P<0.008).The positive rate of microbial detection in group A,B and C at T_(4)was higher than that at T_(1),and the difference was statistically significant(P<0.05).There were no significant differences in the positive rates of microbial detection at T_(2),T_(3)and T_(4)in group D compared with T_(1)(P>0.05).Conclusion The storage boxes of orthokeratology lens can be effectively inhibited by sterilized normal saline,purified water and proteinase removing nursing solution.The storage time of sterilized normal saline and purified water is recommended not to exceed 21 days(3 weeks).After cleaning and disinfecting the lens box of wearing glasses by removing protease nursing solution,there is no obvious increase trend of microorganism within 4 weeks.The method of cooling water washing is not recommended.The safe and effective disinfection method can avoid nosocomial cross infection of wearing glasses.