两种清洗消毒方法对消化内镜清洗消毒效果的比较

目的比较使用全自动清洗消毒机和传统手工清洗消毒方法对消化内镜清洗消毒效果的影响。方法收集某院消化内镜中心的109条消化内镜,根据编号分为试验组和对照组,试验组采用全自动清洗消毒机进行清洗消毒,对照组采用传统手工清洗消毒方法,对两组内镜不同部位进行采样。采用目测法结合ATP生物荧光检测法检测内镜的清洗质量,采用倾注培养法检测内镜的染菌量。比较两组内镜的清洗、消毒合格率。结果试验组共55条内镜,对照组共54条内镜。试验组内镜清洗总合格率为94.55%,对照组内镜清洗总合格率为83.33%,两组比较差异无统计学意义(P0.05)。其中试验组内镜阀门的清洗合格率高于对照组(96.36%vs85.19%),差异有统计学意义(P0.05),而内镜表面、内镜管腔清洗合格率比较,差异均无统计学意义(均P0.05)。试验组内镜消毒总合格率为96.36%,对照组内镜消毒总合格率为85.19%,两组比较差异有统计学意义(P0.05)。试验组内镜管腔消毒合格率高于对照组(96.36%vs 85.19%),差异有统计学意义(P0.05),而两组内镜表面、阀门两个部位的消毒合格率比较,差异均无统计学意义(均P0.05)。结论全自动清洗消毒机对于消化内镜的清洗消毒效果要优于传统的手工清洗消毒。如采用传统的手工清洗消毒内镜,则需要严格执行软式内镜的清洗消毒规范,最大限度地降低内镜诊治发生交叉感染的风险。

Comparison of efficacy of two cleaning and disinfection methods for cleaning and disinfection of digestive endoscopes

Objective To compare the effect of automatic cleaning and disinfection machine as well as traditional manual cleaning and disinfection method on the cleaning and disinfection of digestive endoscopes. Methods 109 digestive endoscopes in a digestive endoscopy center of a hospital were collected and divided into trial group and control group according to their numbers, trial group was cleaned and disinfected by automatic cleaning and disinfection machine, control group was cleaned and disinfected by traditional manual cleaning and disinfection method. Samples were taken from different parts of endoscopes in two groups. Cleaning quality of endoscopes was detected by visual method and ATP biofluorescence detection method, and bacterial contamination of endoscopes was detected by poured-plate culture method. Qualified rate of cleaning and disinfection of endoscopes between two groups was compared. Results There were 55 endoscopes in trial group and 54 in control group. The total qualified rates of endoscope cleaning in trial group and control group were 94.55% and 83.33% respectively, there was no significant difference between two groups (P>0.05). Qualified rate of endoscopic valve cleaning in trial group was higher than control group (96.36% vs 85.19%, P<0.05), but there was no significant difference in qualified rates of endoscopic surface cleaning and endoscopic lumen cleaning between two groups(both P>0.05). The total qualified rates of endoscope disinfection in trial group and control group were 96.36% and 85.19% respectively, there was significant difference between two groups (P<0.05). Qualified rate of endoscopic lumen disinfection in trial group was higher than control group (96.36% vs 85.19%, P<0.05), but there was no significant difference in the qualified rates of endoscopic surface and valve between two groups (both P>0.05). Conclusion Effect of automatic cleaning and disinfection machine on cleaning and disinfection of digestive endoscopes is superior to traditional manual clea-ning and disinfection. If traditional manual cleaning and disinfection of endoscopes is adopted, cleaning and disinfection criteria of soft endoscopes should be strictly enforced to minimize the risk of cross-infection during endoscopy diagnosis and treatment.