手术器械预处理时机与清洗质量的关联

Correlation between timing of surgical instrument pretreatment and cleaning quality

目的对比手术器械手术中、手术后和清洗前三个时机的预处理效果和对器械清洗质量的影响。方法分别选取云南省第一人民医院2023年5月-8月手术时长不同的器械共180套,按照预处理时机分为三组,对器械进行预处理,同样操作进行后续清洗流程,通过ATP生物荧光检测法、蛋白残留测定法评价不同预处理时机的器械清洗质量,通过蓝点试验法检测器械锈蚀变化情况。结果ATP生物荧光检测、蛋白残留量检测器械手术中、手术后预处理的清洗合格率均高于清洗前(P<0.001);蓝点试验检测器械手术中、手术后预处理的锈蚀合格率均高于清洗前(P<0.001);手术时间越长,器械的锈蚀率就越高,手术中预处理的器械锈蚀合格率高于手术后和清洗前(P<0.001)。结论手术器械在手术中、手术后立即进行预处理,能够提升清洗质量,减少器械锈蚀,尤其是使用于手术时长大于2h的器械,应在手术中就及时进行预处理。

OBJECTIVE To compare the pre-treatment effects of surgical instruments during the operation,after operation and before cleaning on the quality of instrument cleaning.METHODS A total of 180 sets of instruments used for different surgical durations in Yunnan First People's Hospital from May to Aug 2023 were divided into three groups according to the timing of pre-treatment.After the process of pretreatment at different time,the same subsequent cleaning process was performed.The cleaning quality of the instruments was evaluated by ATP biofluorescence detection and protein residue determination assay.And the changes in instrument corrosion was de-tected by using the blue dot test.RESULTS ATP biofluorescence detection and protein residue detection showed that the cleaning qualification rates of instruments pretreated during and after the operation were significantly higher than those before cleaning(P<0.001).Blue dot test showed that the rates of instruments corrosion pre-treated during and after the operation were higher than before cleaning(P<0.001).The longer the surgery lasted,the higher the corrosion rate of the instrument.And the corrosion rate of the pre-treated instrument during the op-eration was higher than after the operation and before cleaning(P<0.001).CONCLUSION Pre-treatment of surgi-cal instruments immediately after use and operation can improve cleaning quality and reduce instrument corrosion,especially for instruments used in the surgery lasted for more than 2 hours.Pre-treatment should be carried out promptly during use.