人工清洗与超声机系列清洗对医疗器械洗涤效果的观察

医疗器械重复使用进行消毒灭菌之前,必须先清洗.彻底清洗污染在器械上的有机物是保证消毒灭菌成功的关键.为提高医疗器械清洗质量、预防与控制医院感染,我院于2007年10月购买了超声波清洗消毒器,代替了人工刷洗器械,提高了洗涤质量,现将两种不同清洗方法进行效果分析.     

医疗器械的清洗与去污

医疗器械是指医学领域内用于临床诊断治疗的各种器械、医学试验和临床检验的各种器材。所有的医疗器械重复使用进行消毒或灭菌之前,都必须先清洗。器械清洁是保证灭菌成功的关键[1]。长期以来人们对需要进行消毒或灭菌的医疗器械,只重视消毒、灭菌,而忽视清洗。众所周知清洗不彻底而残留的有机物,将影响消毒因子的穿透性,从而影响消毒灭菌的效果。此外,细菌死亡所产生的热原质耐高温,132℃不能彻底灭活,必须在清洗过程中去除。由此可见,消毒灭菌不能代替清洗[2]。清洗的目的是去除器械上大量污染的有机物、细菌与热原质,提高消毒灭菌的效果…     

STERIS清洗消毒机使用体会

目的医疗器械使用后彻底清洁处理，预防和控制医院感染，保证消毒灭菌效果。方法STERIS清洗消毒机清洗。结果大大提高工作效率，清洗质量提高，有效提高医务人员的自身防护。结论有效的清洗方法，才能达到最佳的清洗质量，确保器械的灭菌成功，并控制医院感染。     

医院消毒供应中心再生医疗器械清洗质量管理

再生医疗器械清洗是消毒供应中心(CSSD)工作的重要环节,清洗质量是消毒灭菌的重要保证,彻底清洗是保证灭菌成功的关键,实现再生医疗器械清洗质量标准化、规范化、科学化至关重要. 1 加强人员培训与管理 开展培训,对用后的再生器械应及时进行初步处理,减少微生物的繁殖与扩散,防止附着在再生器械血液、体液于结而影响清洗质量.     

2种医疗器械清洗方法效果比较

医疗器械灭菌前的彻底清洁是保证灭菌成功的前置条件，目前有条件的医院都选用全自动清洗消毒机清洗器械，既节省人力、提高工作效率，也减少工作人员受污染的机会。我们也从2008年开始使用全自动清洗消毒机，我们分析采取不同的控制方法对器械进行清洗灭菌的影响，以保证患者的医疗安全，现报道如下。     

消毒供应中心对复用器械清洗灭菌的研究

目的对复用医疗器械清洗灭菌的研究。方法对432件外科手术器械随机分成4组,手工清洗回收的器械与全自动清洗机清洗相结合,做隐血试验和复用医疗器械洗涤残存血污检测。结果使用多酶清洗液后隐血试验结果要比未使用前效果好,对有机物污染或污染物已变干的医疗器械用多酶清洗液浸泡>2 min可达到清洗效果。结论对污染血污的复用医疗器械的清洗彻底是保证消毒和灭菌成功的关键。     

手术器械清洗存在的问题与管理对策

手术器械使用后清洗不彻底,使残留的有机物妨碍消毒灭菌因子与微生物的有效接触,形成细菌或芽胞的保护膜而影响灭菌效果.因此彻底清洗污染器械是保证灭菌成功的关键. 1 影响手术器械清洗质量的相关因素 1.1 不严格执行相关制度和操作规程 虽然制定有清洗的规范制度和操作规程,但仍有些人按照个人的工作习惯违反操作规程.     

消毒供应中心处理复用器械清洗灭菌的研究

〔目的〕对复用医疗器械清洗灭菌的研究。〔方法〕对432件外科手术器械随机分成4组,手工清洗回收的器械与全自动清洗机清洗相结合,做隐血试验和复用医疗器械洗涤残存血污检测。〔结果〕使用多酶清洗液后隐血试验结果要比未使用前效果好,对有机物污染或污染物已变干的医疗器械用多酶清洗液浸泡大于2分钟可达到清洗效果。〔结论〕对污染血污的复用医疗器械的清洗彻底是保证消毒和灭菌成功的关键。     

鲁沃夫碱性酶清洗剂在供应室应用

重复使用的医用诊疗器械清洗质量是消毒与灭菌质量的重要保证.任何残留的有机物,如血块、脓液、蛋白质、黏液均会妨碍微生物消毒物质的有效接触,而且会产生细菌的保护影响灭菌效果.我院供应室从2010年1月选用鲁沃夫碱性酶清洗剂清洗,有效、快速清洗器械上凝固的血液,保证清洗质量,现报道如下.     

浅谈医疗器械的清洗与消毒

1概要医疗器械是指医学领域内所使用的各种器械,包括用于临床诊断治疗的各种器械、医学试验和临床检验的各种器材。重复使用的受污染医疗器械必须通过清洗、消毒和灭菌而再生。而受污染医疗器械的清洗与消毒是医院再生物品工作中的重中之重,有效控制医院感染的蔓延、节省再生物品投入资金、保证物品灭菌质量的重要环节。2清洗消毒的重要性清洗的意义在于:处理可重复使用器械的清洁状态,有利与保持其功能并防止对病人意外的伤害,同时去除大量污染的有机物、细菌与热原,减少随后灭菌的难度。良好的清洗对必须消毒的物品是最基本的要求,对必须…     

Associations Between Social Media Engagement and Vaccine Hesitancy

There has been a surge in vaccine hesitancy following the Coronavirus pandemic. This study measured the prevalence of and identified factors associated with vaccine hesitancy and social media use. An online survey was administered (n?=?1050) between May and July 2021. Chi-square tests were used to examine bivariate associations with vaccine hesitancy (partially vaccinated and unvaccinated participants). Logistic regression was used to identify associations between social media use and vaccine hesitancy. Chi-square tests showed women (69.7% vs 28.2% men, p_adjusted?=?.002), African American participants (52.3% vs 17.8% white, p_adjusted?<?.001), high school diploma (54.4% vs 38.6% college degree, p_adjusted?<?.001), political unaffiliated (15.8% vs 14.5% republican, p_adjusted?<?.001), Muslim (10.0% vs 0% Jewish, p_adjusted?<?.001), and never married/single (53.9% vs 17.0% married, p_adjusted?<?.001) were more likely to be vaccine hesitant. Controlling for all demographic variables (age, race, gender, and education), more frequent use of social media for reading news was associated with lower vaccine hesitancy (OR 0.35, 99% CI 0.20, 0.63, p?<?0.001). However, using social media as a source of vaccine information without any other trusted source (health department, doctor, CDC,) was associated with higher odds of being vaccine hesitant (OR 2.00, 99% CI 1.15, 3.46, p?=?0.001). People who use social media without referencing trusted sources may be particularly vulnerable to disinformation or vaccine hesitant persons are more likely exposed to non-trusted social media sites as their only information source.

     

固体清洗剂和多酶清洗剂清洗手术器械的效果比较

目的比较固体清洗剂和液体多酶清洗剂清洗手术器械的效果,并进行成本分析,为消毒供应中心提供新的清洗技术选择。方法将消毒供应中心4台清洗消毒机随机平分为实验组和对照组,实验组使用固体清洗剂,对照组使用液体多酶清洗剂对手术器械进行清洗。对两组手术器械的清洗效果,采用目测(裸眼和10倍光源放大镜）、ATP生物荧光检测和蛋白残留检测方法进行效果评价,并对两组的清洗成本以及产生的医疗废弃物进行统计分析。结果肉眼裸视评价清洗效果,实验组合格率为97.70%（4 678/4 788）,对照组为92.01%（5 075/5 516）;10倍光源放大镜评价清洗效果,实验组合格率为94.30%（2 546/2 700）,对照组为88.72%（2 453/2 765）;实验组合格率均高于对照组,差异具有统计学意义（P=0.000）。ATP荧光检测法评价清洗效果,实验组合格率为84.41%（996/1 180）,对照组为86.83%（1 042/1 200）,两组差异无统计学意义（P=0.092）。实验组蛋白残留检测阳性率为3.71%（26/700）,对照组为16.31%（106/650）,实验组蛋白残留检测阳性率比对照组低,差异有统计学意义（P=0.000）。实验组清洗成本为对照组的2/3;实验组产生医疗废弃物（塑料薄膜）0.40 kg,对照组（空桶）为12.30 kg。结论固体清洗技术可以高效去除手术器械的蛋白污染,并降低清洗成本,减少医疗废物的产生,是值得推广的新型清洗技术。     

医院感染阴沟肠杆菌多重耐药基因分析 FREE

目的了解医院感染阴沟肠杆菌的耐药性及其耐药基因,为防控感染提供依据。方法对40株临床分离的阴沟肠杆菌,以纸片扩散法和琼脂稀释法进行药敏试验,聚合酶链反应(PCR)及序列分析法分析12种耐药相关基因。结果40株阴沟肠杆菌仅对亚胺培南和美罗培南高度敏感,敏感率均为100.00%;对头孢吡肟耐药率较低,为15.00%;对其他15种抗菌药物耐药率较高,为42.00%～92.50%。共检出8种耐药基因,分别为TEM 1、SHV 2a、CTX M 3、CTX M 9、AmpC、aac(3′) Ⅰ、IntⅠ1、sul1,大多数菌株携带sul1+IntⅠ1型基因;耐药谱共分为A～I 9型,以C和D型为主。抗菌药物耐药谱分型和基因分型有一定相关性。结论阴沟肠杆菌呈现多重和高度耐药性,耐药机制复杂且呈多种耐药机制共同作用。     

Obésité : que nous dit l’épidémiologie ?

In most developed and developing countries, a regular increase of the prevalence of obesity has been documented during the last decade(s) of the xxth century. The last figure from the USA is for the first time discordant with this general trend by showing a clear slowing down since year 2000. In children likewise, a rapid increase in the prevalence of obesity took place in the second half of the xxth century but recent publications from France, Switzerland, UK, USA also report a stabilization of childhood overweight and obesity prevalences. The experience of developing countries clearly shows the impact of socioeconomic status improvement and urbanization on the prevalence of obesity. In developed countries like France, a striking element was the diffuse nature of the adult obesity epidemic observed from the 1990s. The general improvement of living conditions after the Second World War probably explains the diffuse nature of the epidemics. Specifically, the changes in the nutritional status of children that happened at that time have long lasting consequences for adult obesity epidemics. Indeed, a new current in epidemiology, lifecourse epidemiology, has prompted over the past decade a new approach of the pathophysiology of chronic diseases, including obesity. Lifecourse epidemiology considers factors affecting the susceptibility to diseases over the whole life with critical periods during developmental phases. Critical periods for the susceptibility to obesity have been documented in prenatal life, during the first 6 months of postnatal life and from 3 years on starting at the time of the adiposity rebound. Parental obesity is involved at each of the critical periods. The transgenerational transmission of obesity is explained by genetic factors, shared lifestyle but also epigenetics especially during the early developmental periods. The slowing down of the childhood obesity epidemics observed in several developed countries may signal that factors affecting the early susceptibility to obesity have recently changed.     

Sexual dysfunctions in women with chronic pelvic pain. A modified sex-therapeutic model

Pelvic pain in women is frequently associated with sexual disturbances: inhibited sexual desire, excitement disorders (dyspareunia) and orgasmic dysfunctions. Women with chronic pelvic pain have a disturbed relationship with their own body. They lost the ability of living the body as a place of sensual joy and mutual communication. The goal of therapy is not only relieving from pain, but also that the women should learn (again) to enjoy life as much as the capacities allow this. Therapeutic measures include guidance and appropriate treatment: a biopsychosocially oriented approach. Formal psychotherapy, implying the working trough of deep, unconscious conflicts, anxieties, and angers from childhood, is not necessary and mostly not possible. Also formal sextherapy or psychosexual therapy (Kaplan) is not indicated. This paper describes the different steps of an appropriate and modified sextherapy on psychosomatic and psychodynamic lines. Difficulties, risks and chances of each step are demonstrated; a careful physical examination, information, counselling and emotional support, physical and psychological rest, drug therapy, the way of individual counselling and sexual enrichment program, couple sexual counselling and sextherapeutical sessions. Through these steps the woman can be accompanied to a new life style. The participation in a self-help group for women with emancipatoric goals opens some women's eyes for yet unused capacities and talents. Through these sessions both partners can learn how to live up a new partnership.     

痰涂片显微镜检查与培养结果的相关性分析 FREE

目的分析痰涂片显微镜检查（镜检）与培养结果的相关性。方法痰标本在进行细菌培养之前行涂片革兰染色、镜检;对培养出来的细菌进行革兰染色、镜检,对二者镜下染色的性质和形态进行比对;二者一致者作为病原菌进行下一步的鉴定和药敏试验。结果786份合格标本共检出病原菌540株,阳性率68.70%,其中革兰阳性球菌185株,革兰阴性杆菌316株,真菌39株。痰涂片镜检与培养鉴定结果的符合率为72.01%（566/786）,其诊断敏感性为77.78%,特异性为59.35%,阳性预测值为80.77%,阴性预测值为54.89%。结论痰涂片镜检结果与培养结果具有较高的符合率,痰涂片镜检可以提高痰标本病原菌的检出率。