4种氧气湿化瓶和通气管干燥方法的效果比较

目的使各临床科室的备用氧气湿化瓶及通气管在有效期内细菌学检查合格率达到100％，符合《消毒技术规范》和《医院消毒卫生标准》的要求，预防患者院内呼吸道感染。方法在不同的时间段采用4种不同的干燥方法：干燥箱烘干法、无菌纱布擦干法和高压气枪吹干法、高压蒸汽灭菌锅余热干燥法，分别对500个氧气湿化瓶、通气管进行处理，观察其成本、时间、优缺点，并通过细菌学检验4种方法的处理效果。结果在4种干燥方法中，高压蒸汽灭菌锅余热干燥法价格低廉，取材方便，干燥彻底，保障了消毒氧气湿化瓶及通气管的消毒效果，经比较，细菌值少于其它3种干燥法（p〈0．05）；经细菌学检查，经处理的备用氧气湿化瓶及通气管在有效期内的细菌值均为0，合格率为100％。结论由于改进了消毒氧气湿化瓶及通气管的干燥方法，使氧气湿化瓶干燥彻底，避免了消毒后氧气湿化瓶及通气管的再次污染，同时降低了护理人员的劳动强度，缩短了氧气湿化瓶的干燥时间，提高了工作效率。     

优化流程法对氧气湿化瓶消毒保存的效果观察

目的研究两种不同的消毒包装方法对氧气湿化瓶的消毒效果和保存期限影响,选择一个最佳消毒包装方案,降低医院感染的发生率。方法采用棉拭涂抹采样和细菌定量检测方法,对集中清洗消毒包装常规流程法和集中消毒包装优化流程法消毒保存氧气湿化瓶的效果进行了对比观察。结果经优化流程法消毒干燥后的氧气湿化瓶消毒合格率100%,保存7 d后的氧气湿化瓶保持良好率98.3%。经常规流程法消毒干燥后的氧气湿化瓶消毒平均合格率为95%,保存7 d后的氧气湿化瓶保持良好率平均为75%。结论优化流程法对氧气湿化瓶的消毒和保存效果明显优于常规流程法,前者消毒效果有保证,保存期限长。     

巧用医用瓶口贴密封保存备用氧气湿化瓶

使用后的氧气湿化瓶要经过消毒、冲洗、干燥、保存4个环节,任何环节操作不当都将引起湿化瓶的再污染,一旦污染重新消毒不但增加护理人员的工作量,也增加消毒成本,甚至导致病人呼吸道感染.医院《消毒技术规范》要求消毒晾干后的氧气湿化瓶应密封保存备用,但没有明确指出包装材料类型和具体方法.护理人员在临床工作中发现,医用瓶口贴的口径与小口氧气湿化瓶的口径大小适宜,适合密封保存消毒干燥后备用的小口氧气湿化瓶.现介绍如下.     

消毒后的氧气湿化瓶快速干燥法的改进

由于氧气湿化瓶的材质不宜采用热力干燥,传统的湿化瓶干燥法有两种。一种是自然晾干法,一种是75%乙醇干燥法。上述两种方法均有弊端。自然晾干法所需时间长,且与天气及季节有关,不能满足临床需要。同时干燥时间过长,可使湿化瓶上细菌繁殖,又使湿化瓶接受外来的污染,这样使消毒的湿化瓶达不到消毒要求或是消毒后湿化瓶有效期缩短。     

医用95%乙醇用于湿化瓶干燥方法的效果探讨

[目的]探讨医用乙醇用于湿化瓶干燥法操作的实用性和可行性.[方法]将100 mL～200 mL医用95%乙醇灌入清洗干净后的湿化瓶内充分摇匀后再倒入下一个湿化瓶内,此法直到最后一个湿化瓶,用Y型架晾干.[结果]有效缩短了湿化瓶的干燥时间,且干燥彻底,便于及时密封包装保存,大大减少了湿化瓶在空气中暴露的时间,保障了氧气湿化瓶的消毒效果,符合消毒技术规范要求.[结论]医用95%乙醇用于湿化瓶干燥,可以缩短湿化瓶的自然晾干时间,便于后期的保存.     

氧气湿化瓶快速干燥的方法

吸氧是临床常用的护理技术操作之一。卫生部消毒技术规范明确要求：连续使用的氧气湿化瓶必须每日更换消毒，用毕终末消毒，干燥保存。临床上氧气湿化瓶使用后需要浸泡在2000PPN爱尔施消毒液中30min，取出晾干后备用。     

湿化瓶常规消毒后加用75％酒精浸泡的效果观察

目的探讨氧气湿化瓶经常规消毒后加用75％酒精浸泡的消毒效果和保存期限。方法实验组湿化瓶用过氧乙酸消毒并予以灭菌蒸馏水冲净后加用75％酒精浸泡15min，然后自然晾干，对照组常规采用过氧乙酸消毒并予以灭菌蒸馏水冲净晾干，分别于消毒后30min、1d、3d、5d和7d5个时间段进行肉眼观察和细菌学检测。结果2组湿化瓶5个时间段的肉眼观察结果差异有显著性意义（p〈0．01），2组湿化瓶在消毒后30min细菌学检测均无细菌生长，实验组在消毒后1d、3d和5d细菌总数均〈10cfu/件，且未检出致病菌，显著优于对照组（p〈0．01）。结论湿化瓶经常规消毒后加用75％酒精浸泡有效地确保了消毒效果和保存期限，有利于控制医院感染的发生。     

氧气湿化瓶消毒晾干架的制作及应用效果

目的探讨氧气湿化瓶消毒晾干架的制作方法及应用效果。方法设计并制作氧气湿化瓶消毒晾干架,将224个未消毒的氧气湿化瓶随机分为两组,每组112个,试验组在消毒、晾干过程中使用氧气湿化瓶消毒晾干架(简称晾干架),对照组不使用晾干架。比较两组在保存期间的细菌监测合格率和相应的护士工作耗时。结果试验组保存4¹0d的细菌监测合格率高于对照组(P<0.05),试验组相应的工作耗时少于对照组(P<0.01)。结论氧气湿化瓶消毒晾干架能有效延长保存期,减少了护士的工作强度,有较好的实用价值。     

氧气湿化瓶消毒晾干架的研制及应用

目的：解决氧气湿化瓶在消毒、晾干过程中耗时长、效率低、易再次污染的问题，观察延长保存期的效果。方法选择某院病区集中消毒的氧气湿化瓶60个，按照随机数字表分为观察组和对照组各30个。观察组使用自行设计的氧气湿化瓶消毒晾干架进行消毒、晾干；对照组采用传统方法，将氧气湿化瓶放在大塑料桶内一一灌满消毒液消毒。比较两组工作效率、贮存不同时间段内细菌采样合格率。结果观察组氧气湿化瓶贮存4，7，10 d 细菌采样合格率均为100．0％，对照组分别为60．0％，36．7％，20．0％；两组比较差异均有统计学意义（χ2值分别为15．000，27．805，40．000；P＜0．01）。观察组将30个氧气湿化瓶灌满消毒液需要（1．4±0．3）min，消毒后冲洗时间（2．1±0．3）min，晾干时间（1．2±0．3）h，较对照组缩短，两组比较差异均有统计学意义（t值分别为2．0452，46．4468，42．3848；P＜0．05）。结论应用自制氧气湿化瓶消毒晾干架，消毒、晾干、贮存氧气湿化瓶的效果优于传统法，对降低医院感染发生率、降低护理人员劳动强度、提高工作效率均有重要的意义。     

氧气湿化瓶消毒后保存期的研究

目的通过对氧气湿化瓶化学消毒后保存期进行研究，以明确其保存有效期。方法将240个氧气湿化瓶化学消毒后分别保存于5个临床科室，保存时间180 d,每月进行细菌学监测。结果氧气湿化瓶化学消毒后保存30、60、90、120、150、180 d细菌监测结果均≤20 CFU/件，未检出致病菌,合格率100%。结论氧气湿化瓶化学消毒后用保鲜袋单独包装，做好保存环境管理，其保存期最少6个月。     

消毒后备用湿化瓶的干燥方法及存放时间探讨

氧气湿化瓶是输氧装置的一部分,使用率高,是一个极易带菌的感染源,其造成的医院内感染已被临床所证实[1],但其保存方法在护理操作中尚未规范化[2]。根据《医院感染管理规范》要求,氧气湿化瓶及其管道,用毕应终末消毒,干燥保存[3]。由于氧气湿化瓶及其管道是塑料制品,不能采用高     

A comparison of the rate of bacterial contamination for prefilled disposable and reusable oxygen humidifiers

BACKGROUND: Prefilled disposable oxygen humidifiers are considered to prevent nosocomial pneumonia in hospital wards. However, their usefulness in intensive care units (ICUs) has not yet been established. In this study, we evaluated and compared contamination in prefilled disposable oxygen humidifiers and that in reusable oxygen humidifiers. METHODS: Six oxygen outlets in the ICU were used. Prefilled disposable oxygen humidifiers and reusable oxygen humidifiers were attached to each wall-mounted oxygen outlet using a 2-way connector. Nonsterile nasal cannulae and tubes were connected to the humidifiers through which 5 L/min of oxygen was delivered continuously. Water samples (5 mL) from each humidifier were collected on the first day and every 7 days thereafter for a period of 56 days. Each water sample was incubated aerobically at 35 degrees C for 48 hours and observed daily for bacterial growth. RESULTS: Bacterial growth was observed only once in one sample from each humidifier type. Gram-positive cocci, 40 colony-forming units in the disposable oxygen humidifier and 10 colony-forming units in the reusable oxygen humidifier, were detected. Dust was observed from the 35th day onward only in the reusable oxygen humidifier. CONCLUSION: In the ICU, bacterial contamination does not occur in oxygen humidifiers even after 56 days of continuous use. However, dust does accumulate in the reusable oxygen humidifier after 35 days of continuous use.     

可重复使用的消毒诊疗物品保存方法研究

目的探讨可重复使用消毒物品的保存期限,为临床应用提供依据。方法湿化瓶、面罩、呼吸机螺纹管、吸痰器连接管经清洗消毒后随机将：A组用预先经低温等离子灭菌后的食品包装袋按诊疗需求进行包装,B组放在铺好的治疗盘内;同时又将经A组包装后的诊疗物品随机分为A1组放在临床治疗室内,A2组放在供应室无菌室内,检测四组不同保存方法的污染率。结果 A组7d内未出现污染,B组1d出现污染,4d污染率达50.00%（P〈0.05）;A1组8d开始污染,A2组12d开始污染（P〈0.05）。结论可重复使用的消毒物品在干燥无菌保存条件下,治疗室内保存时限为7d,供应室保存时限为10d。     

Multipatient use of prefilled disposable oxygen humidifiers for up to 30 days: patient safety and cost analysis

BACKGROUND: Prefilled disposable oxygen humidification units have been shown to decrease the likelihood of contamination when compared to reusable oxygen humidification units. However, prefilled disposable humidifiers are expensive when used for single patients, especially in areas of high turnover, and it is not known whether these units need to be routinely changed before they are empty. The number of patients safely using a prefilled disposable humidifier has not been documented in previously reported work. Are patients at risk of nosocomial infections due to cross-contamination when prefilled disposable oxygen humidifiers are applied to multi-patient use? What are the cost benefits of multiple patient use of prefilled disposable oxygen humidifiers? When local practice or physician preference dictates the use of humidification for low-flow oxygen, these questions need to be answered. METHODS & MATERIALS: Data were collected over two time periods to address changes due to seasonal variations and include area of use, number of patients, and quantitative cultures for aerobic microorganisms (including Legionella). Each disposable humidifier was monitored for a period of 1 month or until only 1 inch of water remained. Costs of using reusable humidifiers and prefilled humidifiers and therapist/nurse time to initiate therapy with both units were compared. During this period, 60 reusable humidifiers were also cultured for aerobic microorganisms and Legionella. RESULTS: We report results on 1,311 of the 1,315 disposable prefilled oxygen humidifiers used. We saw no significant growth in any of the prefilled disposable humidifiers for periods of up to 30 days, with > 100 humidifiers having been used by > 20 patients. CONCLUSIONS: Our results show that prefilled disposable oxygen humidifiers can be used without cross-contamination, on multiple patients, for a period of 1 month. The use of prefilled humidifiers in this way represents a substantial cost saving when compared to reusable humidifiers.     

Factors affecting the development of precipitating antibodies in workers exposed to contaminated humidifiers

A total of 601 sera from groups of workers exposed to heavily and moderately contaminated humidifiers respectively were examined by the double diffusion test for precipitating antibodies to humidifier extracts. Clinical information was obtained using a standardized questionnaire. Skin-prick tests to control, to three common inhalant antigens and to an extract from the humidifier were performed in 103 subjects exposed to a heavily contaminated humidifier. In this environment a strong inverse relationship between current smoking and precipitins was detected (P less than 0.001). Pack years smoked had no bearing on precipitin level. In the larger study there was a clear dose response effect of smoking on precipitins. The effect of smoking appeared to reverse within 3 years. Duration of exposure also had a major effect on the development of precipitins with a clear 'dose response' again being seen in the larger study. These relationships did not apply in the groups exposed to moderately contaminated humidifiers. Levels of airborne antigen were measured using a competitive ELISA inhibition assay and were found to be much lower in sites with moderately contaminated humidifiers than at sites with heavily contaminated humidifiers. Our results suggest that the airborne antigen level is crucial in determining the pattern and strength of precipitin response in smokers and non-smokers exposed to contaminated humidifiers.     

输氧装置消毒方法的研究

目的 采用不同消毒方法对输氧装置的不同部位进行细菌学调查,强化对输氧装置的消毒管理.方法 对我院4个病区输氧装置中湿化瓶、中心供氧孔、输氧连接管口3个部位各300份样本于消毒前采样分析污染程度,并采用500 mg/L含氯消毒剂、0.5%过氧乙酸溶液和0.2%碘附消毒,比较最佳的消毒模式.结果 消毒前所有样本细菌培养阳性率为100%,湿化瓶菌落均数超过3万cfu/ml,中心供氧孔菌落均数超过28万cfu/ml,输氧管菌落均数超过1万cfu/ml,消毒后各组灭菌率均达标,500 mg/L含氯消毒剂灭菌率达100%.含氯消毒剂、过氧乙酸溶液和0.5%碘伏消毒效果比较,差异有统计学意义（P＜0.05）.结论 输氧连接管口和湿化瓶的污染相当严重,3种消毒方法均能达到高水平消毒,但含氯消毒剂消毒效果最佳.     

重复使用的氧气湿化装置与一次性氧气湿化装置用后的比较研究

目的 重复使用的氧气湿化装置与一次性氧气湿化装置进行使用后细菌学分析.方法 随机抽取老年科6个病区用后的可重复使用的氧气湿化装置与一次性氧气湿化瓶,将吸氧患者随机分为3组,A组用冷开水作为氧气湿化液,B组用蒸馏水作为氧气湿化液,C组用AQUAPAK一次性氧气湿化装置.A组和B组在每周一和周四更换湿化瓶前采样,C组在每瓶一次性氧气湿化装置使用结束后采样,按<医院消毒卫生标准>消毒液的采样方法 采样后送检验科检验.结果 A组61个样本中带菌率为81.97%,B组71个样本中带菌率为47.89%,C组52个样本中带菌率为0.3种湿化瓶使用后的污染率比较差异显著.A,B组间进行比较,A组细菌平均严重等级高于B组,A组革兰阴性菌种类的等级及革兰阳性菌的带菌率均高于B组.结论 无论是用冷开水还是蒸馏水作为氧气湿化液,湿化液均有不同程度的污染,在目前各医疗机构尚无统一湿化液选择标准以及消毒规范的背景下,对长期吸氧的患者,建议选择一次性氧气湿化装置,以期减少患者院内感染的发生率.

Abstract：

Objective To carry out bacteriological analysis between re-used and disposable oxygen humidification devices. Methods Reused oxygen equipment and disposable oxygen moisture bottles from 6 randomly selected elderly wards were collected, patients who used oxygen will be randomized into 3 groups, group A used cold water as the oxygen humidification liquid, group B used distilled water as humidification liquid, group C used AQUAPAK disposable oxygen humidification devices, sample taking in group A and group B happened on every Monday and Thursday before the replacement of sample moisture bottles, sample was taken in group C after the use of disposable oxygen humidification devices, according to "hospital disinfection health standards" (GB5982-1995)sampling method of disinfection liquid sample was taken and sent to test in the disinfectant laboratory. Results Of 61 samples in group A bacteria cartier rate was 81.97%, bacteria carrier rate of 71 samples in group B was 47.89%, of 52 samples in group C the carrier rate was 0. The comparing of bacterial contamination rate of three kinds of oxygen moisture bottles after using was statistically significant. Take group A, B for comparison, the average severity level of bacteria in group A is higher than group B. In group A, the level of the Gram-negative bacteria as well as Gram-positive bacteria colonization was higher than group B. Conclusions Whether use of cold water or distilled water, oxygen humidification liquids have different degrees of pollution. Currently there is no general criteria and norms in the context of sterilization of oxygen humidification, for patients on long-term oxygen using, to choose disposable oxygen humidification device to reduce the incidence of hospital infections is recommended.     

Amoebae and humidifier fever

One hundred and nineteen sera from workers at four different work sites exposed to different contaminated humidifiers were examined by the immunofluorescent antibody (IFA) technique for antibodies to the amoebae Acanthamoeba polyphaga and Naegleria gruberi. Twenty-five of the sera were from workers with humidifier fever (HF) and six from workers with work related asthma (WRA) shown to be due to the contaminated humidifiers. A positive IFA test was found to correlate precipitin reaction to humidifier antigen, but did not correlate with smoking habit, work related symptoms (detected by standard questionnaire) or with HF or WRA. Amoebae were identified in all humidifiers studied.     

氧气湿化瓶集中化消毒供应的探讨

目的 加强医院氧气湿化瓶的消毒管理。方法 对氧气湿化瓶的清洗、消毒进行集中化处理,由供应科专业人员对氧气湿化瓶进行清洗、消毒、包装。结果 加强医院氧气湿化瓶的消毒管理,细菌培养合格率由集中化处理前的45.6％上升为100％,大大提高了氧气湿化瓶的清洗、消毒质量。结论 通过对氧气湿化瓶进行中心化清洗、消毒,规范化管理,保...     

不同消毒方法对氧气湿化瓶消毒效果比较

目的研究不同消毒方法对氧气湿化瓶的消毒效果,选择最佳消毒方案。方法采用棉拭涂抹采样和细菌定量检测方法 ,对臭氧高强紫外线消毒法和消毒液浸泡法消毒氧气湿化瓶的效果进行了比较观察。结果经清洗干燥后的氧气湿化瓶在臭氧高强紫外线消毒柜消毒50 min,检测130件氧气湿化瓶,消毒效果平均合格率为96.92%。将清洗后的氧气湿化瓶置于含有效氯250 mg/L含氯消毒剂溶液中浸泡30 min,检测130件氧气湿化瓶,消毒效果平均合格率为70%。结论紫外线消毒柜对氧气湿化瓶消毒效果明显优于消毒液浸泡法,且前者易于保存。