改良全管道灌流器对副送水内镜消毒效果的影响

 目的 探讨改良的全管道灌流器对副送水内镜清洗消毒的效果。方法 选取某院消化内镜清洗消毒工作站患者使用后的奥林巴斯副送水肠镜，采用随机数字表法将其随机分为3组：A组和C组各30根，B组32根。A组使用改良前的普通灌流器，且未对副送水管道进行特殊处理；B组使用改良前的普通灌流器，但使用外接连接管（MAJ-855），对每个清洗消毒步骤均使用30 mL注射器对副送水管道手工注气注液最少3次；C组使用改良后的全管道灌流器。3组内镜均按照标准步骤进行清洗消毒及干燥，比较3组内镜各管道的消毒合格率，清洗消毒工作人员（以下简称洗消员）手工操作时间以及躯体疲劳程度。结果 A组内镜整体消毒合格率为30.0%，B组为78.1%，C组为100.0%。3组内镜整体消毒合格率比较，差异有统计学意义（χ²=36.414，P<0.001）。3组内镜的送气送水管道和钳子管道的消毒合格率比较，差异均无统计学意义（均P>0.05）。3组内镜副送水管道的消毒合格率比较，差异有统计学意义（χ²=33.473，P<0.001）。洗消员清洗消毒手工操作时间A、B、C组分别为：（4.81+0.63）、（6.72+0.42）、（4.88+0.66）min，3组比较差异有统计学意义（F=105.149，P<0.001）。洗消员清洗消毒3组内镜的躯体疲劳量表评分A、B、C组分别为：（4.67+1.32）、（5.83+0.91）、（4.33+1.03）分，洗消员清洗消毒3组内镜的躯体疲劳量表评分比较，差异有统计学意义（F=15.348，P<0.001）。结论 改良的全管道灌流器可提高副送水管道的消毒合格率，节约洗消员的手工操作时间，降低洗消员的躯体疲劳程度。

Influence of improved whole-pipe irrigation device on the disinfection effect of endoscope with auxiliary water supply

Objective To explore clean and disinfection effect of improved whole-pipe irrigation device on endoscope with auxiliary water supply. Methods The Olympus colonoscopes with auxiliary water supply used by patients in a digestive endoscope cleaning and disinfection workstation in a hospital was selected and randomly divided into three groups according to random number table method:group A, B, and C were 30, 32, and 30 respectively. Group A used the pre-improvement conventional irrigation device, and didn't perform special treatment to the auxi-liary water pipe; group B used the pre-improvement conventional irrigation device, but used the external connecting pipe (MAJ-855), for each cleaning and disinfection step, 30mL syringe was used to manually inject gas and liquid into the auxiliary water pipe for at least three times; group C used the improved whole-pipe irrigation device. Three groups of endoscopes were cleaned, disinfected and dried according to the standard steps, disinfection qualification rate of each pipe of three groups of endoscopes, as well as manual operation time and degree of physical fatigue of cleaning and disinfection staff and were compared. Results The overall qualified rate of endoscope disinfection in group A, B, and C were 30.0%, 78.1%, 100.0% respectively. There was significant difference in the overall disinfection qualified rate of endoscopes among three groups (χ²=36.414, P<0.001). There was no significant difference in the disinfection qualified rate of endoscopic air and water supply pipe and forceps pipe among three groups (all P>0.05). There was significant difference in the disinfection qualified rate of endoscopic auxiliary water supply pipe among three groups (χ²=33.473, P<0.001). The manual operation time of cleaning and disinfection staff in group A, B, and C were (4.81+0.63), (6.72+0.42), and (4.88+0.66) minutes respectively, difference was statistically significant (F=105.149, P<0.001). The scores of physical fatigue scale of cleaning and disinfection staff for endoscope cleaning and disinfection in group A, B, and C were (4.67+1.32), (5.83+0.91), and (4.33+1.03) respectively, difference was significant among three groups (F=15.348, P<0.001). Conclusion The improved whole-pipe irrigation device can improve the disinfection qualification rate of auxiliary water supply pipe, save the manual operation time of cleaning and disinfection staff and reduce their physical fatigue.