内镜清洗消毒方法的研究

目的 探讨内镜实用有效的清洗消毒方法，为制定内镜的清洗消毒操作规范提供科学依据。方法 观察4所医院胃镜使用后清水与加酶清洗，2％戊二醛浸泡消毒7min及自动清洗消毒机的清洗消毒效果。结果 加酶清洗组观察301例，其清洗、消毒合格率分别为76％和99％，清水清洗组观察155例，其清洗、消毒合格率分别为59％和95％，两组差异显著；4所医院清洗消毒效果的差别有统计学意义；自动清洗消毒机观察64例，其消毒合格率仅为17％，远低于手工清洗。结论 彻底清洗与加酶清洗非常重要；胃镜加酶清洗，2％戊二醛浸泡消毒7min，即可达到内镜消毒标准；手工清洗的消毒效果优于国产自动清洗消毒机，应加强对后者的管理。

Methods for Cleaning and Disinfecting of Endoscope

OBJECTIVE To try to find out the practical and reliable methods in cleaning and disinfecting endoscope in order to provide scientific basis for drafting cleaning and disinfecting rules of endoscope. METHODS To survey the disinfected efficacy using or not using enzyme of cleaning plus 2% glutaraldehyde immersion for 7 minutes in 4 hospitals and disinfected efficacy of automated washer/disinfector for endoscope in 2 hospitals in Beijing. RESULTS Qualified rates of cleaning and disinfecting were 76% and 99% in 301 cases of endoscope cleaned with enzyme and were 59% and 95% in 155 cases of endoscope cleaned with only water respectively. The difference between two groups was significant (P<0.01). The qualified rate in 4 hospitals was not the same (P<0.01). The qualified rate of endoscope cleaned and disinfected with machine was only 17% and much lower than that with handwork. CONCLUSIONS It is very important for endoscope to clean thoroughly and with enzyme. Gastroscope cleaned using enzyme plus 2% glutaraldehyde immersion for 7 minutes achieves standard for disinfection. Cleaned and disinfected efficacy of endoscope by handwork was better than by machine. So it should be strengthened the management of home-made automated washer/disinfector in hospitals.