不同清洗方法对牙科手机清洗度及损坏性的研究

目的探讨不同清洗方法对牙科手机清洗质量及损坏性的影响。方法将正常使用中的80支牙科手机随机分为试验组和对照组,每组40支,试验组采用热清洗机对手机的外部及内腔进行清洗,对照组采用传统的手工清洗方法,用75%的酒精纱布对手机的外部进行擦拭,然后对手机内腔进行注油润滑、包装、高压蒸汽灭菌后送回临床,固定诊室人员使用,5个月后对手机的损坏率进行统计分析。结果试验组机器清洗法手机损坏率低于对照组手工擦拭法。结论机器清洗法清洗手机不会对手机造成过度损坏反而会降低损坏率。规范的清洗与注油养护,可很好的维护手机的使用功能。     

多种清洗方法对口腔手机灭菌效果影响的分析

目的:探讨目前口腔科手机清洗的方法、灭菌的途径,保障患者的就医安全。方法:采用人工手机清洗润滑剂清洗、超声波清洗机清洗、自动热清洗/消毒机清洗三种方法清洗后,用下排式压力蒸汽灭菌与预真空高压蒸汽灭菌。结果:超声波清洗机清洗后灭菌效果优于人工手机清洗润滑剂清洗与自动热清洗/消毒机清洗(P<0.05);从灭菌的合格率来看,预真空高压蒸汽灭菌效果(91.11%)优于下排式压力蒸汽灭菌(86.67%)。结论:目前采用超声波清洗机清洗和预真空高压蒸汽灭菌是最理想、最有效的方法。     

蒸汽清洗机的应用对牙科手机清洗质量及损坏性研究

摘要 目的 <\b>探讨蒸汽清洗机对牙科手机清洗效果和损坏性的影响。方法 <\b>将正常使用的80支NSK高速手机随机分为实验组和对照组。对照组采用传统的手工清洗→超声清洗→酸化水消毒→注油后包装灭菌处理。实验组采用蒸汽清洗机清洗消毒,其它程序不变。使用ATP生物荧光检测仪观察两组的清洗效果。观察6个月,统计牙科手机损坏率。结果 <\b>ATP生物荧光检测仪检测结果显示,两种清洗方法可均达到厂家提供的清洗质量要求（RLU≤45）,应用蒸汽清洗机的清洗效果明显优于普通的手工清洗方法。统计使用蒸汽清洗机清洗3 000次情况,实验组牙科手机损坏率明显低于对照组,组间差异有统计学意义（P＜0.05）。结论 <\b>采用蒸汽清洗机清洗牙科手机,清洗质量优于手工清洗方法,且器械损坏率低于传统清洗方法。     

不同清洗方法对牙科手机灭菌效果及损耗情况的影响

目的比较全自动热清洗机清洗法和全自动清洗注油养护机清洗法对牙科手机灭菌效果及损耗情况的影响。方法将全新的NSK牙科手机80支根据随机数字表法分为A、B两组各40例，A组采用全自动热清洗机清洗，B组采用全自动清洗注油养护机清洗，每支牙科手机反复清洗、注油、灭菌、使用200次，记录损耗的情况；每组随意抽取18支进行无菌检测。结果80支牙科手机在实验过程中，有20支出现故障，其中11支经维修后继续使用，A组有9支，B组有2支，两组比较差异有统计学意义（X2=5．165，P〈0．05）。无菌检测A组18支手机均无细菌生长，B组18支手机中有1支真菌阳性，两组比较差异无统计学意义（X2=1．029，P〉0．05）。结论两种清洗方法对牙科手机灭菌效果的影响无差异，全自动热清洗机清洗法因内部无法完全干燥增加了牙科手机缺油现象的发生，全自动清洗注油养护机清洗法是一种对牙科手机损耗小的清洗方法。     

牙科手机集中清洗消毒与灭菌管理

目的探讨牙科手机在消毒供应中心合理有效的清洗、消毒及灭菌工作,以保证牙科手机使用前的无菌且功能完好。方法 2011年12月1日-2012年5月20日对使用后的牙科手机进行集中清洗、消毒灭菌工作。结果牙科手机集中清洗消毒与灭菌后,牙科手机生物监测合格率达100%,口腔科临床医护人员对该消毒供应中心的工作质量反馈满意率由90%提高到98%。结论消毒供应中心所进行的牙科手机集中清洗消毒与灭菌管理工作流程有效的保证了牙科手机安全有效的重复性使用。     

牙科手机灭菌方法的探讨

目的观察比较压力蒸汽与化学消毒剂两种灭菌方法对牙科手机腔管的灭菌效果。方法将临床使用后自然污染的牙科手机2000只随机分成两组。初步清洁后分别采用压力蒸汽灭菌或化学消毒剂灭菌处理，每组随机抽样50只进行腔内病原微生物及乙肝表面抗原测定。结果压力蒸汽灭菌可完全杀灭手机腔管病原微生物，化学消毒剂浸泡法的杀菌作用有限。结论压力蒸汽灭菌效果可靠。     

DAC Universal全自动快速清洁消毒机效果评价

目的：DAC Universal是一种新型的牙科手机专用全自动清洗消毒器,探讨DAC全自动小型牙科手机专用清洗和消毒。方法：40把WH TA_98L高速手机,为期一周进行门诊日常养护和消毒,同时采用3M芽胞生物试剂盒检测其灭菌能力。应用：DAC Universal全自动小型手机专用清洗注油消毒器。结果：DAC是裸消毒灭菌机,牙科手机外表面清洁效果基本持平于超声波清洗机,12min完成手机清洗、注油及消毒灭菌。每个周期可养护手机6支且灭菌效果稳定。结论：DAC养护手机过程快速,灭菌有效。     

机械热力清洗频率对牙科手机损耗及清洗效果的影响

目的研究机械热力清洗频率对于牙科手机损耗以及清洗效果的影响。方法纳入180支可机械热力清洗的全新高速牙科手机,随机分为A、B、C 3组,每组60支。每次使用后,采用专用注油机进行清洗注油,包装灭菌。A、B、C组分别每周、每2周和每3周采用一次机械热力清洗后专用注油机清洗注油,包装灭菌的流程。在3、6、9个月时分别从每组随机抽取5支进行部件可视污渍情况检查,监测清洗效果。结果A、B、C 3组手机平均使用次数为A组(56.60±24.77)次,B组(49.70±30.08)次,C组(46.73±35.16)次,使用次数比较差异无统计学意义(P=0.800);9个月中15支手机出现故障,其中A组4支,B组7支,C组4支,3组比较差异无统计学意义(P=0.660);12支简单维修后继续使用,A组1支,B组7支,C组4支,3组比较差异无统计学意义(P=0.100);3支更换轴芯后继续使用,均为A组。3组清洁程度合格率均为100%。结论牙科手机在专用注油机清洗注油基础上每3周采用一次机械热力清洗能保障其内部清洁,并不会增加损耗,可提高工作效率。     

牙科高速涡轮手机使用过氧化氢等离子低温灭菌的效果观察

目的 探讨过氧化氢等离子低温灭菌对牙科高速涡轮手机(简称手机)的灭菌效果及对手机的损耗情况,以增加手机的使用寿命.方法 将门诊口腔科2008年7月1-31日使用脉动真空压力蒸汽灭菌的1 000例次手机为对照组;2008年11月1日-12月10日使用过氧化氢等离子低温灭菌的1 000例次手机为观察组.随机抽取两组各30例次手机行无菌检验,比较两组手机的无菌检验合格率及手机损耗率.结果 两种灭菌法无菌检验结果均为无菌生长,即灭菌合格率100%;使用高压蒸汽灭菌与过氧化氢等离子低温灭菌,手机的损耗率分别为3.7%和1.5%.差异有统计学意义(P<0.01).结论 过氧化氢等离子低温灭菌法灭菌效果安全、可靠,且能延长手机的使用寿命,值得在临床上推广使用.     

气枪二次使用在牙科手机清洗消毒中的应用

目的探讨气枪二次使用在牙科手机清洗消毒中的应用效果。方法该院口腔科共有手机140支,从中随机抽取40支,按照随机数字表法分为对照组和实验组,每组各20支,两组均采用专用手机层架,全自动清洗消毒器,无润滑油模式清洗,实验组将手机清洗后二次使用气枪吹干内腔管路,用喷雾式注油法注油0.01mL;对照组清洗后70℃烘箱烘干,用喷雾式注油法注油0.01mL。比较两组油包现象,并使用物理、化学、生物等监测方法判定灭菌合格率。结果实验组高速运转机与低速运转机水分清除效率均高于对照组,差异均有统计学意义(P0.05);两组手机不同转速分布比例比较,差异无统计学意义(P0.05);实验组手机锈浊率明显低于对照组,差异有统计学意义(P0.05);实验组油包现象明显低于对照组,化学监测合格中化学指示卡合格率高于对照组,差异有统计学意义(P0.05);两组物理监测合格率及生物监测合格率比较,差异均无统计学意义(P0.05)。结论在牙科手机清洗消毒的干燥环节中使用气枪二次吹干,有助于减少油包现象,保证灭菌合格,可提高工作效率,值得临床推广应用。     

Statistical methods for assessing agreement between two methods of clinical measurement

In clinical measurement comparison of a new measurement technique with an established one is often needed to see whether they agree sufficiently for the new to replace the old. Such investigations are often analysed inappropriately, notably by using correlation coefficients. The use of correlation is misleading. An alternative approach, based on graphical techniques and simple calculations, is described, together with the relation between this analysis and the assessment of repeatability.     

Barrier methods of contraception

Barrier methods of contraception make up an essential part of the present contraceptive range, and doctors need to know in detail how to choose and fit them as well as how to instruct patients in their use. This discussion reviews the mode of action of the barrier method and then focuses on the vaginal diaphragm, the cervical or vault cap, the collatex (Today) sponge, condoms, emotionl problems associated with the use of barrier methods, advantages of barrier methods, and future developments. Barrier methods of contraception are only effective if used consistently and carefully. Failure rates vary greatly between studies, but in selected populations the failure rate for the diaphragm with spermicide can be as low as 1.9/100 woman years (wy) and for the condom 3.6 per 100wy (Vessey et al., 1982). If known user failures are removed, the figure for the condom can drop to as low as 0.4 per 100wy (John, 1973), which compares favorably with that of the combined oral contraceptive. Other studies quote failure rates of 10 per 100wy or more. These methods call for considerable participation by the patient at or before each act of intercourse and there is, therefore, great scope for inefficient use, either as a result of poor instruction or because couples find that they interfere with happy, relaxed sexual activity -- or fear that they may do so. Doctors need to understand the feelings of their patients before recommending them. The aim of a barrier method is to prevent live sperm from meeting the ovum. This is accomplished by the combination of a physical barrier with a spermicide. In the case of the condom, the integrity of the physical barrier is the most important factor, although some patients feel more secure with an additional spermicide. The vaginal barriers used at present do not produce a "water-tight" fit, and the principle is that the spermicide is held over the cervix by the barrier. It is also possible that the device acts partially by holding the alkaline cervical mucus necessary for sperm transportation away from the acid vagina where the sperm is delayed and killed. The choice of available vaginal diaphragms is increasing. Despite some suggestion that the "fit" of a diaphragm is not crucial, supported by the argument that the vagina increses greatly in volume during intercourse, the best available figures for reliability are from studies of family planning clinic patients who have traditionally been fitted with great care. There are no good data about the effectiveness of the cervical and vault caps, and it is better to fit a diaphragm if this is possible. The Today polyurethane foam sponge is impregnated with the spermicide nonoxynol-9 and, as marketed, it is for use as often as desired up to 24 hours, plus 6 hours before final removal to ensure all vaginal sperm are killed. Condoms bearing the British Standards Institute Kitemark have been tested to a high standard an in view of the good results that can be obtained it seems likely that most failures are due to inefficient use. Advantages of barrier methods include some portection from sexually transmitted diseases and a reduction in the incidence of pelvic inflammatory disease.