3种不同清洗方式对眼科显微器械的清洗效果比较

Comparison of Three Different Cleaning Methods for Ophthalmic Microscopic Instruments

目的比较3种不同清洗方式对眼科显微器械的清洗效果。方法选取使用后的眼科白内障包、玻璃体切除包、胬肉包各24个,按区组随机法分为A、B和C组,每组眼科显微器械共200件。A组采用手工清洗+超声波清洗机(超声)清洗,B组采用浸泡+超声清洗+全自动清洗机清洗,C组采用减压沸腾清洗机清洗。通过目测法、三磷酸腺苷(adenosine triphosphate,ATP)荧光检测和蛋白残留测定法对清洗后的器械进行清洗质量评价。结果目测法A、B和C组的清洗合格率分别为90.50%、96.50%和97.50%,差异有统计学意义(P<0.05),损耗率分别为3.00%、0.50%和0.50%,差异无统计学意义(P>0.05);ATP荧光检测A、B和C组的清洗合格率分别为87.00%、99.00%和99.50%,差异有统计学意义(P<0.05);蛋白残留测定A、B和C组的清洗合格率分别为83.50%、96.00%和97.00%,差异有统计学意义(P<0.05)。组间两两比较显示,A组清洗合格率与B、C组比较差异均有统计学意义(α’=0.0167,均P<0.0167),B组清洗合格率与C组比较差异无统计学意义(α’=0.0167,P>0.0167)。结论眼科显微器械采用浸泡+超声清洗+全自动清洗机清洗和减压沸腾清洗机清洗均可达到良好的清洗效果,且器械耗损较小,减压沸腾机的清洗效率更高。

Objective To compare the efficacies of three different cleaning methods for ophthalmic microscopic instruments.Methods Twenty-four cataract surgery instrument sets,24 vitrectomy instrument sets and 24 pterygium surgery instrument sets were randomly divided into three groups,with 200 microscopic instruments in each group.The groups A,B and C were cleaned by manual cleaning+ultrasound,immersion+ultrasound+automatic cleaning machine,and vacuum boiling cleaning machine,respectively.The cleaning quality was evaluated by visual inspection,ATP fluorescence detection and protein residue detection.Results In groups A,B and C,the qualification rates evaluated by visual inspection were respectively 90.50%,96.50%and 97.50%(P<0.05),and the wastage rates were respectively 3.00%,0.50%and 0.50%(P>0.05).The qualification rates evaluated by ATP fluorescence detection were respectively 87.00%,99.00%and 99.50%,and those evaluated by protein residue detection were respectively 83.50%,96.00%and 97.00%in groups A,B and C(P<0.05).The qualification rates in group A were significantly different from those in group B or C(α’=0.0167,P<0.0167),while those in group B were not significantly different from those in group C(α’=0.0167,P>0.0167).Conclusion Both immersion+ultrasound+automatic cleaning machine and vacuum boiling cleaning machine,especially vacuum boiling cleaning machine,can achieve a good efficacy and reduce the wastage for cleaning ophthalmic microscopic instruments.