微波联合氯己定用于金属器械快速灭菌的实验研究

目的寻求金属器械快速灭菌的方法，满足手术过程中急需器械的灭菌需求。方法将336件金属手术器械人工染菌后放入微波炉专用塑料盒中(7件／盒)，分别加入0．5％氯己定溶液、蒸馏水各300ml加盖，置入家用微波炉(2盒／次，14件)，使用高火档(输出功率650W)，3、5min分别消毒24次，消毒后分别按常规采样做无菌检测，观察灭菌效果。结果家用微波炉加蒸馏水作用3min灭菌合格率为88．09％，5min灭菌合格率为95．24％；加0．5％氯己定溶液消毒3min灭菌舍格率为93．45％，5min灭菌合格率达100．00％。结论金属器械经家用微波炉(输出功率为650W)与0．5％氯己定溶液协同作用5min，即可完全灭菌，解决手术过程中急用金属器械的消毒灭菌问题。     

口腔器械常用消毒灭菌方法效果比较

目的检测几种常见口腔器械消毒灭菌方法的效果,为临床消毒护理工作提供参考。方法选取本院口腔科使用后的器械,包括车针、探针、根管锉,共计120件,每类器械随机取10件作为对照组,仅清洗干燥处理;其余随机分为3组,每组每样各10件,器械清洗后分别采用0.5%碘伏表面擦拭消毒(擦拭组)、20g/L戊二醛浸泡消毒(浸泡组)、高温高压蒸汽灭菌(高温组),对比各组消毒效果。结果对照组和擦拭组菌落数(591.10±23.36)、(557.31±27.16)cfu,合格率分别为0和16.7%;而浸泡组和高温组器械表面细菌培养结果均为阴性。结论常规清洗后采用戊二醛浸泡和高温高压蒸汽灭菌消毒效果较好,但是戊二醛存在一定的毒性,推荐使用高温高压蒸汽灭菌法对口腔器械进行消毒灭菌。     

思维导图模式在提升消毒供应中心器械灭菌质量改进中的应用效果

目的 探讨思维导图模式在提升消毒供应中心器械灭菌质量改进中的应用效果。方法 选择2021年 4月-2022年7月在我院消毒供应中心进行灭菌的手术器械为研究对象,2021年4月-11月灭菌的300件器械设为对 照组,2021年12月-2022年7月灭菌的300件器械设为观察组。对照组按照消毒供应中心的灭菌流程对器械进行 常规灭菌,观察组在常规灭菌流程的基础上增加了思维导图模式,比较两组器械包装完好情况、器械完整性及 医护满意度。结果 观察组包装合格率为100.00%,高于对照组的的97.00%（ P ＜0.05）;观察组器械完整率、满 意度评分均高于对照组（ P ＜0.05）。结论 思维导图模式在提升消毒供应中心器械灭菌质量改进中的应用效 果确切,可有效提高器械包装合格率及器械完整性,医护人员对于器械灭菌质量的满意度较高。     

用3%过氧化氢预处理金属吸引头提高清洗质量

目的探讨3%过氧化氢浸泡预处理对神经外科金属吸引头管腔清洗质量的效果,为提高器械清洗质量提供依据。方法将200件神经外科金属吸引头随机分为对照组和实验组各100件。对照组流动水冲洗管腔15 s后喷洒保湿剂,实验组采用3%过氧化氢溶液浸泡5 min后再按照对照组方式处理。两组器械干燥后采用5倍放大镜检查、白通条检测、ATP检测合格率。结果实验组3种方法检测合格率显著高于对照组(均P0.05)。结论用3%过氧化氢溶液浸泡预处理能有效提高金属吸引头管腔的清洗质量。     

医疗器械清洗后放置时间与污染度的关系

目的 探讨复用医疗器械清洗后放置时间与污染度的关系,为提高灭菌质量提供最佳的包装时间.方法 将清洗后检测合格的360件复用关节器械裸露放置于消毒供应中心器械检查包装区,随机分成6组各60件,分别放置15 min、30 min、1h、2h、3h、4h后采用ATP生物荧光技术进行污染度监测.结果 器械放置15 min、30 min、1h、2h、3h、4h合格率分别为100％、96.7％、83.3％、58.3％、33.3％、16.7％,不同时间合格率比较,差异有统计学意义(P＜0.01).放置15 min、30 min与放置1h合格率比较,差异无统计学意义(均P＞0.00313);其他时间合格率显著低于1h合格率(均P＜0.00313).结论 清洗后的器械不宜超过1h包装.     

手术皮肤消毒剂灭菌效果临床观察

目的 了解手术室常用皮肤、黏膜消毒剂的消毒、灭菌效果,寻找高效、安全的消毒剂.方法 将160例择期手术患者分为8组各20例,分别采用3%碘酊75%乙醇、1.5%碘酊75%乙醇、1%活力碘、0.5%活力碘、0.1%活力碘、75%乙醇、0.5%氯己定和0.1%氯己定消毒手术部位,观察消毒效果.结果 8种(组)消毒剂的杀菌率分别为100.0%、100.0%、100.0%、89.9%、83.2%、83.9%、89.7%和82.8%;合格率分别为100.0%、100.0%、100.0%、90.0%、90.0%、80.0%、90.0%和75.0%.结论 3%碘酊75%乙醇、1.5%碘酊75%乙醇、1%活力碘消毒效果好,但前2种(组)对皮肤、黏膜刺激性较大,待干时间长,适用于无菌要求高的择期手术;1%活力碘分别对皮肤、黏膜刺激性小,安全性可靠,省时方便,为较理想的消毒剂.     

凡士林纱条小包装微波灭菌的研究

为解决凡士林纱条灭菌难、保管难的问题 ,将凡士林纱条用聚丙烯塑料制成小包装 ,采用输出功率为 90 0W的微波炉进行灭菌。结果微波灭菌 8m in其灭菌率为 10 0 % ,>8m in包装袋易发生粘连 ,<8min其灭菌效果欠佳 ;凡士林纱条无菌保存期夏季为 7周 ,冬季为 10周。该方法彻底改变了盒装凡士林纱条易污染、浪费大、保管难的弊端 ,具有投资小、简便易行、携带方便、使用安全等优点     

酶清洗联合除锈液浸泡用于再生医疗器械除锈

目的 探讨酶清洗联合除锈液浸泡用于再生医疗器械除锈的效果.方法 将生锈的再生医疗器械600件(卵圆钳和换药镊各300件)随机分为常规组和实验组各300件,两组均采用1:7除锈液除锈,常规组将生锈的再生医疗器械各关节打开后浸泡于20℃除锈液10 min.实验组将器械用40℃左右温水冲洗后先置入1:200全效酶清洗液(温度40℃)3～5 min,再放入50～80℃除锈液10 min.两组取出后按要求置于清洗篮筐内,采用清洗机标准流程清洗,灭菌后检查复锈率.结果 常规组器械清洗合格率47.3％,灭菌后复锈率5.6％;实验组器械清洗合格率99.0％,灭菌后复锈率2.0％.两组清洗合格率比较,差异有统计学意义(P＜0.01).结论 锈蚀器械经酶清洗处理后再用50～80℃除锈液浸泡,辅以外力刷洗,除锈效果及器械干净程度优于常规清洗方法,复锈率低于常规方法.     

不同方法消毒口腔高速手机效果的比较研究

目的探讨不同方法消毒口腔高速涡轮手机的效果.方法将90支使用后的口腔高速涡轮手机随机分为1、2、3三个消毒组,分别采用2%戊二醛溶液擦拭浸泡30 min、环氧乙烷气体消毒60 min及预真空高压蒸汽消毒10 min的方法消毒;消毒前、后对手机表面及其内部水、气管腔采样进行细菌学检测.结果三组消毒后手机表面灭菌率分别为99.99%、100.00%和100.00%.手机内部水、气管腔冲洗液细菌检测2%戊二醛溶液消毒灭菌率为31.96%,环氧乙烷为100.00%,预真空高压蒸汽灭菌法为100.00%.结论高压蒸汽灭菌法消毒手机耗时短、效果好,可作为口腔高速手机消毒的首选方法.     

卡式高压蒸汽灭菌器用于连台腹腔镜手术器械快速灭菌的效果观察

目的 探讨连台腹腔镜手术器械快速、有效的灭菌方法.方法 将使用后的腹腔镜器械分别采用卡式高压蒸汽灭菌器灭菌9 min,2%戊二醛浸泡10 h、1 h,3种方法各灭菌50例次,比较其灭菌效果.结果 2%戊二醛浸泡1 h其合格率为80.0%,而卡式高压蒸汽灭菌与2%戊二醛浸泡10 h灭菌合格率均达100%,显著优于2%戊二醛浸泡1 h(均P＜0.05).结论 卡式高压蒸汽灭菌器在保证灭菌效果的前提下,缩短了腹腔镜连台手术的等待时间,有利于腹腔镜手术的开展.     

Variability in catheter microwave sterilization techniques in a single clinic population

PURPOSE: We designed a survey to assess the microwave sterilization technique practiced by patients at our clinic who perform clean intermittent catheterization. MATERIALS AND METHODS: A 23-question survey addressing urinary catheter use and home sterilization techniques was mailed to 129 patients. A followup survey was mailed to 47 respondents who reported using a microwave oven to sterilize the catheters to assess the microwave technique further. RESULTS: Of the 129 initial surveys 84 (64%) were returned, while 40 (85%) of the 47 followup questionnaires on microwave sterilization were returned. All patients surveyed have used clean intermittent catheterization for at least 1 year and 75% have used it more than 5 years. Of the respondents 80% perform clean intermittent catheterization 4 to 5 times daily, although sterilization frequency varies from daily to less than once weekly. Of the respondents 71% reported no difficulty with microwave sterilization, although 31 (63%) reported a history of catheter melting during microwaving. Of the respondents 35% reported using a rotation table, all used a heat sink containing 1/2 to 4 cups of water, 39% used 500 to 1,000 W., 37% used greater than 1,000 W., 73% set the microwave for 6 minutes, others set it for 3 to 30 minutes and 98% used a power setting described as high, full, 10 or 100%. CONCLUSIONS: Significant variation exists in the cleaning and sterilizing techniques used by our patients, although they were given uniform written and verbal instructions. It is unclear from the data in the literature how this variation affects sterilization.     

MICROWAVE STERILIZATION OF POLYETHYLENE CATHETERS FOR INTERMITTENT SELF-CATHETERIZATION

A standard household 650 W microwave oven was used to sterilize polyethylene catheters of the type used for intermittent self-catheterization. The Catheters were infected with Proteus sp. bacteria and microwaved at 650 W for periods of 2, 4, 6 and 8 minutes. The effect of microwaving was assessed by determining the resultant colony counts following catheter culture. It was determined that 6 minutes of microwaving were required to achieve sterility. It is suggested that use of a microwave oven is a reliable and cost-effective method of sterilizing polyethylene catheters for intermittent self-catheterization.     

The application of microwave techniques in multiple immunostaining and in situ hybridization

Summary: We describe simple, rapid, reliable and sensitive microwave-based methods for both multiple immunostaining and in situ hybridization. This technique involves treating sections with a 10 min period of microwave oven heating. the ability of microwave oven heating to retrieve cytoplasmic and nuclear antigens, block antibody cross-reactivity and inactivate peroxidase and alkaline phosphatase enzymes has resulted in the development of a simple and generally applicable method of multiple immunostaining in which two or more antigens can be detected within the same section using primary antibodies raised in the same species combined with a sensitive three layer staining protocol involving peroxidase anti-peroxidase (PAP) and alkaline phosphatase anti-alkaline phosphatase (APAAP) complexes. the application of microwave oven heating as a pretreatment of cryostat sections prior to in situ hybridization using digoxigenin-labelled cRNA and cDNA probes resulted in improved probe access to target nucleic acid sequences, stronger hybridization signals, reduced hybridization times, maintenance of excellent tissue morphology and outstanding reliability. Thus, the application of microwave oven heating has overcome many of the difficulties associated with current protocols used in these two techniques. These new methodologies have general applicability and will be of significant benefit to both research scientists and clinical pathologists alike.     

The physical and antimicrobial effects of microwave heating and alcohol immersion on catheters that are reused for clean intermittent catheterisation

INTRODUCTION: Due to worldwide different health insurance policies, patients are often forced to reuse the catheters when performing Clean Intermittent Catheterisation (CIC). We have compared the physical qualities and the antimicrobial effects of two methods of reusing catheters: microwave heating and storage of the catheters in a 70% alcohol solution. The studies were performed during different lengths of time. MATERIALS AND METHODS: Three types of catheters (a standard polyvinylchloride catheter, a special polyvinylchloride catheter with flexible Ergothan tip and a prelubrified catheter), normally intended for single use, were submitted to the effect of a microwave oven (Multitech 215 High Grade and Whirlpool M220 750 W and 1000 W with rotating plate) or preservation in a 70% alcohol solution. To study the effects of microwave heating, a recipient of water was placed in the oven to spread the microwaves and to absorb the heat. The catheters were placed in a resealable plastic bag (Ziploc. To study the effects of preservation in a 70% alcohol solution, the catheters were immerged in the solution for different lengths of time. Thereafter were the physical qualities of the catheters evaluated by using the technique of Differential Scanning Calorimetry (DSC). The antimicrobial effect of the method was evaluated after grafting the catheters with pathogenic E. coli, P. aeruginosa or S. aureus strains. RESULTS: Microwave heating up to 12 minutes at 750 W caused only minimal changes in the physical qualities of all the catheters. However, there was only an antimicrobial effect of the microwave heating on E. coli and not on P. aeruginosa or S. aureus. If the catheter remained longer than 45 minutes in a 70% alcohol solution, the physical qualities of the catheter changed either minimal in the special polyvinylchloride catheter with flexible Ergothan top but changed significantly in the prelubrified catheter). However, already after 5 minutes of immersion in the 70% alcohol solution there was a complete antimicrobial effect on E. coli, P. aeruginosa and S. aureus in all catheters. CONCLUSIONS: It should be recommended to patients on CIC to use a sterile packed and not previously used catheter. In this study we have shown that immersing the catheters in a 70% alcohol solution during 5 minutes can effectively disinfect the catheter without jeopardising the physical qualities. Thereafter, the catheters could be placed in a resealable (e.g. Ziploc bag without being rinsed under water, in order that the few drops of alcohol cause alcohol vapours within the closed plastic bag and maintain the antimicrobial effect.     

3.0T闭合式MR引导微波消融治疗肝转移瘤的可行性

目的探讨3.0T闭合式MR仪引导微波消融治疗肝转移瘤的可行性。方法采用3.0T闭合式MR仪引导,对14例肝转移瘤(23个病灶)行微波消融术,记录技术成功率、消融参数、手术时间及并发症,术后1个月评价局部疗效。结果技术成功率100%,术中消融功率(65.65±4.11)W,单病灶消融时间(13.92±6.36)min,总手术时间(68.48±19.50)min。2例(2/14,14.29%)发生少量胸腔积液;未见肝脓肿、膈肌穿孔及黄疸等严重并发症。术后1个月肝转移瘤完全消融率91.30%(21/23)。结论 3.0T闭合式MR仪引导下微波消融治疗肝转移瘤安全、可行。     

Urinary catheter sterilization with microwave oven

Studies were conducted utilizing a home microwave oven to sterilize catheters commonly used for intermittent self-catherization. Red rubber urinary catheters were inoculated with common clinical uropathogens and were placed in sealed brown paper bags or Ziploc plastic freezer bags and microwaved at full power for various timed intervals. Differences were noted in killing time for some strains or species of bacteria. Twelve minutes at full power appeared to be sufficient time for complete sterilization of most catheters placed in plastic bags. Cold spots were noted in the oven; suggestions are made for placing the bags in certain areas to achieve complete sterilization of contaminated catheters. Repeat sterilization did not affect the integrity of catheters or the plastic bags. A water heat sink of constant volume was employed during the sterilization process. Six catheters could be sterilized at one time. This convenience allows patients reuse of catheters and provides less chances of self-inoculation due to reuse of contaminated catheters for intermittent self-catherization.     

肝区微波照射所致肝脏损害的实验观察

目的 观察家兔肝区用不同时间与功率组合的2450 MHz微波照射后肝脏的损伤，为应用微波作肝脏缺血再灌注损伤保护的预处理摸索适宜条件。方法 参照临床理疗常用时间与功率，用2450 MHz微波的不同功率与照射时间对家兔肝区进行照射，24h后采血查肝功能变化并开腹肉眼观察肝脏改变。结果 采用临床常用的照射时间与功率对家兔肝区进行微波照射可造成肉眼可见的肝脏坏死。当功率为20w，照射时间为20min时．肝脏无明显肉眼损害．但血中ALT，AST及LDH有一定程度的升高。结论 功率为20W的2450MHz微波照射肝区20min无肉眼可见肝脏损害．但有一定程度的肝功能损害。     

A modified microwave oven in the treatment of chronic lymphedema of the extremities

Summary Among the clinical methods in the treatment of chronic lymphedema of the extremities, heating and bandaging treatment has been most successful in our experience with more than 2000 cases. The microwave oven was developed in our clinic in 1983. There was, however, problems yet to be solved: 1) the power output was not high enough, thus, it could not reach the maximal therapeutic temperature; 2) A puncture technique was necessary to take the local tissue temperature. To improve on these deficiencies, a new generation microwave was developed. Forty cases have been treated with this new apparatus with an effective response rate of 100% after one course of treatment. These patients showed a significant (p < 0.0) reduction in the circumference and volume of extremities. The elasticity of the soft tissue was restored.     

Development of heating method by microwave for sterilization of bone allografts

The purpose of this study was to develop a disinfection method using a microwave apparatus to treat large bone allografts. Heating of a bone allograft is an effective method for the disinfection of bacteria or inactivation of viruses. However, the size of the bone we can treat is limited, and following the popular method of using a bathtub is a lengthy process. The experimental system described here was designed using a microwave oven, an optical-fiber thermometer, and a power regulator. Large and small specimens, a femoral head, and a metatarsal were harvested from a bovine femur. The influence of size and the electrical or thermal characteristics of the specimens were assessed regarding temperature distribution after microwave irradiation. The effects of humidity or hot-air supply were also assessed. The average temperature of the bovine femoral head became 80°C throughout the 15min of microwave irradiation, although the temperature in the metatarsal did not attain uniformity. Microwave irradiation with a hot-air supply realized a uniform distribution of temperature at 83.0° ± 0.4°C in the metatarsal within 15min. Use of microwave irradiation enables quick heating for disinfection of large allograft bones when a hot-air supply was used as well.