三种不同检测方法在消毒供应中心硬式内镜清洗效果评价中的应用比较

Comparison of Three Different Detection Methods in Evaluation of the Cleaning Effect of Rigid Endoscope in Disinfection Supply Center

目的:探讨三种不同检测方法在消毒供应中心硬式内镜清洗效果评价中的应用。方法:回顾性分析2021年11月~2022年8月本院消毒供应中心清洗硬式内镜器械180套,均行目测法、带光源放大镜(5倍)观察法及三磷酸腺苷(ATP)生物荧光检测,比较三组检测阳性率差异,比较三组中合格样本ATP含量差异。结果:三组器械表面、管腔内、钳齿处检测阳性率整体比较,差异有统计学意义(P<0.05);其中目测法、带光源放大镜(5倍)观察法器械表面、管腔内、钳齿处检测阳性率均低于ATP生物荧光检测(P<0.05);目测法、带光源放大镜(5倍)观察法检测阳性率比较,差异无统计学意义(P>0.05);三组器械表面、管腔内、钳齿处的ATP含量整体比较,差异均有统计学意义(P<0.05);器械表面、管腔内、钳齿处的ATP含量比较,目测法、带光源放大镜(5倍)观察法均大于ATP生物荧光检测(P<0.05);管腔内、钳齿处的ATP含量比较,目测法大于带光源放大镜(5倍)观察法(P<0.05)。结论:ATP生物荧光检测法可有效测定器械表面细菌数量,实用性强,能够客观评价硬式内镜清洗效果,有助于提高硬式内镜清洗消毒质量。

Objective:To explore the application of three different detection methods in the evaluation of the cleaning effect of rigid endoscope in disinfection supply center.Methods:From November 2021 to August 2022,180 sets of hard endoscopic instruments cleaned in the disinfection and supply center of our hospital were retrospectively analyzed.Visual inspection,magnifying glass with light source(5 times)observation and ATP bioluminescence detection were performed.The difference in positive rate of detection among the three groups and the difference in ATP content of qualified samples among the three groups were compared.Results:The positive rate of instrument surface,lumen and forceps was significantly different among the three groups(P<0.05).The positive rate of instrument surface,lumen and forceps detected by visual inspection and magnifying glass with light source(5 times)was lower than that detected by ATP bioluminescence(P<0.05).There was no significant difference in positive rate between visual inspection method and magnifying glass with light source(5 times)observation method(P>0.05).There were statistically significant differences in ATP content on the surface,lumen and forceps of the three groups(P<0.05).The ATP content on the surface of the device,in the lumen and at the teeth of the forceps was higher than that detected by the visual inspection method and the magnifying glass with light source(5 times)(P<0.05).The content of ATP in the lumen and the teeth of the forceps was higher by visual inspection than by magnifying glass with light source(5 times)(P<0.05).Conclusion:ATP bioluminescence detection method can effectively determine the number of bacteria on the surface of instruments,and has strong practicability.It can objectively evaluate the cleaning effect of rigid endoscope,and help to improve the cleaning and disinfection quality of rigid endoscope.