不同清洗用水对复用医疗器械清洗质量的影响

A comparative study of water of different quality in the cleaning of reusable medical instruments

目的探讨采用不同清洗水对复用医疗器械清洗质量的影响。方法选取360组复用医疗器械,根据器械污染程度的不同进行分层便利抽样,分别采用自来水清洗处理(n=100)、软水清洗处理(n=153)、纯水清洗处理(n=107),通过目测法(包含带光源放大镜观察法)和检测ATP值测定清洗效果。结果经目测法和带光源放大镜检测,三组清洗质量合格率差异无统计学意义(P>0.05)。根据ATP测定结果,轻度污染器械的清洗效果优于中度污染和重度污染器械,差异有统计学意义(P<0.01);纯水组清洗合格率高于自来水组和软水组清洗合格率,差异有统计学意义(P<0.05)。结论使用科室对器械预处理质量影响消毒供应器械清洗质量,预处理越好的器械清洗效果越好;采用纯水进行冲洗、洗涤、漂洗的普通器械,其清洗质量优于自来水和软水清洗的器械。

Objective To compare the effectiveness of water of different quality in the clean⁃ing of reusable medical instruments.Methods Totally 360 pieces of reusable medical instru⁃ments were included as the research objects.According to different stratified sampling of contami⁃nated instruments,this study conducted tap water treatment(group A,n=100),soft water treat⁃ment(group B,n=153)and pure water treatment(group C,n=107).The cleaning effect was de⁃tected by visual inspection(magnifier with a light source)and ATP bioluminescence device.Re⁃sults According to the outcomes of assessment by visual inspection(including magnifier with a light source),there was no significant difference in cleaning effect between three groups(P>0.05).According to the outcomes of assessment by ATP bioluminescence,higher quality of cleaning was observed in those instruments with low level of contamination after pre-treatment(P<0.01);The cleaning effect of instrument treated with pure water was better than that of devices treated with soft water and tap water in the process of washing and rinsing(P<0.05).Conclu⁃sion The pre-treatment has an impact on the cleaning quality of reusable medical instruments,which means that better pre-treatment condition is associated with higher cleaning quality.The cleaning quality of medical instruments treated with pure water in whole process is better than that of medical instrument treated by washing and rinsing with tap water and soft water.