表面蛋白质残留测定法在复用医疗器械清洗效果中评价作用

Evaluation of Surface Protein Residue Determination Method in Cleaning Effect of Reusable Medical Devices

目的:探讨表面蛋白质残留测定法在复用医疗器械清洗效果中评价效果。方法:选取2019年6月~2021年6月本院消毒供应中心清洗的复用医疗器械152件为研究对象。采用手工清洗与清洗消毒器清洗两种清洗方法进行联合清洗。然后采用目测联合放大镜法和表面蛋白残留测定法两种评价方法进行评测清洗效果。结果:①抽检的152件结构复杂器械采用目测法联合放大镜法合格的件数为139件,合格率91.45%;蛋白残留1μg以下的111件,合格率73.03%。两种评测法的合格率比较,差异有统计学意义(χ^(2)=3.931,P=0.037)。②目测联合放大镜法检测的不合格器械共13件,其中,手工清洗的8件,清洗消毒器清洗的5件,两种清洗方式不合格率比较无显著性差异(P>0.05)。手工清洗蛋白残留>1μg器械34件,不合格率为82.93%;清洗消毒器清洗蛋白残留>1μg器械7件,不合格率为17.07%。两种清洗方法不合格率有显著性差异(P<0.05)。手工清洗不合格器械表面蛋白残留平均值(3.62±0.34)μg,高于清洗消毒器清洗不合格器械蛋白残留平均值(2.19±0.21)μg,比较有显著性差异(P<0.05)。结论:相对于传统的目测法和放大镜法,表面蛋白残留测定法其准确度更高,能够有效降低误判为合格的复用器械,从而降低院内感染发生率、保证手术的顺利进行。同时,相对于传统检测法,蛋白残留测定法对于手工清洗器械的检出效果更佳,尤其适用那些结构复杂无法机械清洗的手术器械,保证其清洗效果。

Objective:To evaluate the effect of surface protein residue determination in the cleaning effect of reusable medical devices.Methods:Select the reusable medical instruments cleaned by the disinfection supply center of our hospital from June 2019 to June 2021.Manual cleaning and cleaning sterilizer cleaning are used for cleaning.Then the cleaning effect was evaluated by visual inspection combined with magnifying glass method and surface protein residue determination method.Results:①The 152 instruments with complex structure were inspected by visual inspection combined with magnifying glass.The qualified number was 139,and the qualified rate was 91.45%;111 instruments with protein residue less than 1μg were sampled,and the qualified rate was 73.03%.There was significant difference in the qualified rate between the two evaluation methods(χ^(2)=3.931,P=0.037).②There were 13 unqualified instruments detected by visual inspection combined with magnifying glass method,including 8 manually cleaned and 5 cleaned by cleaning sterilizer.There was no significant statistical difference in the proportion of unqualified rate between the two cleaning methods(P>0.05).34 instruments with residual protein>1μg were manually cleaned,accounting for 82.93%of the unqualified instruments;7 instruments with residual protein>1μg were cleaned by the cleaning sterilizer,accounting for 17.07%of the unqualified instruments.There was significant difference in the unqualified rate of the two cleaning methods(P<0.05).The average value of protein residue on the surface of unqualified instruments cleaned by hand was(3.62±0.34)μg,which was higher than that of unqualified instruments cleaned by cleaning sterilizer(2.19±0.21)μg.There was significant statistical difference(P<0.05).Conclusion:Compared with the traditional visual method and magnifying glass method,the protein residue determination method has higher accuracy and can effectively reduce the misjudgment of qualified reusable instruments,so as to reduce the incidence of nosocomial infection and ensure the smooth progress of surgery.At the same time,compared with the traditional detection method,the protein residue determination method has better detection effect for manual cleaning instruments,especially for those surgical instruments with complex structure and unable to be mechanically cleaned,so as to ensure their cleaning effect.