不同预处理方法对HBV污染手术器械清洗效果的影响

目的 分析不同预处理方法对HBV污染手术器械清洗效果的影响.方法 抽取HBV污染手术器械600件, 随机平均分配到A、B、C、D四组预处理方法中, 预处理后, 再将四组器械放入全自动清洗消毒器清洗, 清洗结束, 用纯水冲洗器械留取样本, 采用目测、5倍带光源放大镜检查清洁度, 3M ATP荧光法检测有机物残留、酶联免疫吸附试验 (ELISA) 定量检测留取样本中乙型肝炎表面抗原 (HBs Ag) 的阳性率, 评价HBV污染手术器械的清洗效果.结果 600件HBV污染手术器械经A、B、C、D 4种预处理后的清洗目测合格率依次为100.00%、82.67%、100.00%、90.67%;5倍带光源放大镜检测合格率依次为100.00%、78.67%、97.33%、85.33%;ATP荧光检测合格率依次为98.67%、72.67%、96.00%、80.00%;在上述3种检测结果中, A组与B组、D组比较, B组与C组比较, 差异均具有统计学意义 (P<0.01) .ELISA检测HBs Ag的阳性率均为0.结论 全效型多酶清洗液 (1:270) 浸泡10 min预处理器械, 可明显提高HBV污染手术器械的清洗质量, 降低器械损耗.

Cleaning Efficacy of Different Pretreatment Methods on Surgical Instruments Contaminated with Hepatitis B Virus

Objective To analyze the influence of different pretreated methods on cleaning efficacy of surgical instruments polluted by hepatitis B virus (HBV) .Methods 600 HBV-contaminated surgical instruments were selected and divided randomly into 4 groups of pretreatment methods A, B, C and D, after pretreatment, four groups of instruments were washed in the verified automatic cleaning sterilizer. After washing, instruments were washed with pure water, the samples were taken, and the cleanliness of the instruments was inspected visually and by 5-time magnifier that has light source; the cleanliness was test by 3 M ATP fluorescence method; the positive rate of HBs Ag was detected by Quantitative ELISA.Results The visual pass rate of the cleanliness of 600 HBV-contaminated surgical instruments after four types of pretreatment was 100.00%, 82.67%, 100.00% and 90.67% respectively; which was 100.00%, 78.67%, 97.33% and 85.33% by 5-time magnifier that has light source; which was 98.67%, 72.67%, 96.00% and 80.00% by 3 M ATP fluorescence method;With regard to the above three test results, Group A was compared with Group B、Group D and Group B was compared with Group C while the differences were statistically significant (P<0.01) .The positive rate of HBs Ag detected by ELISA was 0. Conclusion Multiple Enzyme Detergent solution (1:270) can significantly improve the cleaning quality of HBV-contaminated surgical instruments, and reduce instruments loss.