消毒及灭菌次数对眼科手术器械循环疲劳性能的影响分析

Effect of Disinfection and Sterilization Times on the Cyclic Fatigue Performance of Ophthalmic Surgical Instruments

目的:分析消毒及灭菌次数对眼科手术器械循环疲劳性能和处理效果的影响。方法:选择2022年1月~2023年12月在龙岩市第二医院消毒供应室进行高温高压蒸汽灭菌消毒处理的100件眼科手术器械,以随机抽样法将其分为两组,对照组50件,研究组50件,为对照组进行1次消毒灭菌处理,为研究组进行3次消毒灭菌处理,对比两组的无菌合格率、折断时旋转圈数、器械断端长度、每日工作小时数、消毒灭菌费用、器械损坏率。观察两组断裂器械的断端显微结构。结果:研究组无菌合格率为100%,对照组与其相同,差异无统计学意义(P>0.05)。研究组的折断时旋转圈数比对照组多,器械断端长度比对照组长,器械损坏率比对照组高,差异有统计学意义(P<0.05)。研究组的每日工作小时数比对照组多,消毒灭菌费用比对照组高,差异有统计学意义(P<0.05)。对照组的断口类型为韧性断口,断裂时可以清晰可见微观空洞,且断口表面有大量的韧窝均匀分布;研究组断口类型与其相同,且存在韧窝,但断面有较强的多面立体感,存在薄片状的脆性沉淀相。结论:增加消毒及灭菌次数对眼科手术器械的灭菌效果无明显影响,但可影响器械循环疲劳性能,增加时间和经济成本,提高器械损坏风险。

Objective:To analyze the effect of disinfection and sterilization times on the cyclic fatigue performance and treatment effect of ophthalmic surgical instruments.Methods:100 ophthalmic surgical instruments that were sterilized by high temperature and high pressure steam in the disinfection and supply room of Longyan Second Hospital from January 2022 to December 2023 were selected and randomly divided into two groups,50 in the control group and 50 in the study group.The control group was sterilized once and the study group was sterilized three times.The sterility qualification rate,the number of rotations when broken,the length of broken ends of instruments,the number of working hours per day,the cost of disinfection and sterilization,and the damage rate of instruments in the two groups were compared.The microstructure of the broken ends of the fractured instruments in the two groups was observed.Results:The qualified rate of sterility in the study group was 100%,which was the same as that in the control group,and the difference was not statistically significant(P>0.05).In the study group,the number of rotations during fracture was more than that in the control group,the length of the broken end of the instrument was longer than that in the control group,and the damage rate of the instrument was higher than that in the control group,the difference was statistically significant(P<0.05).The daily working hours of the study group were more than those of the control group,and the cost of disinfection and sterilization was higher than that of the control group,the difference was statistically significant(P<0.05).The fracture type of the control group was ductile fracture,and micro voids could be clearly seen during fracture,and a large number of dimples were evenly distributed on the fracture surface;The fracture type of the study group is the same as that of the control group,and there are dimples,but the fracture surface has a strong multi-faceted three-dimensional sense,and there are flake like brittle precipitates.Conclusion:Increasing the number of disinfection and sterilization has no significant effect on the sterilization effect of ophthalmic surgical instruments,but it can affect the cyclic fatigue performance of instruments,increase the time and economic cost,and increase the risk of instrument damage.