麻醉科通气设备的医院感染管理与监测

目的 采用不同方式对麻醉通气设备进行合理统一的管理与监测,并将结果进行比较分析,以明确麻醉科通气设备的最佳医院感染管理方式.方法 将麻醉机及通气设备根椐所在手术间的不同随机分为A、B两组,每组各50件,A组麻醉机定期清洗、消毒加一次性通气设备应用,B组麻醉机及通气设备进行普通消毒；对每组麻醉机及通气管道在每次使用前、后及清洗、消毒前、后分别进行细菌培养采样.结果 两组各采样部位均培养出条件致病细菌,A组麻醉机定期的清洗、消毒前虽有细菌被检出,但与B组比较,差异有统计学意义(P＜0.05),麻醉机清洗、消毒后A组细菌阳性率为8.00％,低于B组的52.00％ (P＜0.01)；B组应用75％的乙醇的密闭容器浸泡麻醉咽喉镜,使用前喉镜片细菌的检出率达100.00％；且术后有4例患者发生医院感染.结论 麻醉机及通气设备定期清洗、消毒处理可以使麻醉机的机械性能得到改善和提高,延长机器使用寿命；配合与一次性麻醉呼吸回路可以有效地避免围手术期患者呼吸道的感染,降低医院感染的发生,值得临床应用推广.

Management of ventilation equipment-related nosocomial infections in anesthesia department and its surveillance

OBJECTIVE To conduct a reasonable and unified management and monitoring of the anesthesia aeration equipment by adopting different methods so as to make clear of the best approach of the management of nosocomial infections due to aeration equipments.METHODS The anesthesia apparatus and the aeration equipments were divided into Group A and B in accordance with the operating rooms,with 50 pieces in each,the group A was treated with regular cleaning and disinfection plus disposable aeration equipment,while the group B was treated with the routine disinfection;the bacteria were sampled and cultured from anesthesia apparatus and aeration pipeline before and after the application,cleaning and disinfection.RESULTS The opportunistic pathogens were cultured from the sampling sites.Although there were bacteria detected before the regular cleaning and disinfection in group A,the difference was statistically significant as compared with group B(P<0.05);after the cleaning and disinfection of the anesthesia apparatus,the positive rate of the bacteria in group A was 8.00%,lower than 52.00% in group B(P<0.01).The group B used 75% of the alcohol blocking container to soak the anesthesia throat lens,the detection rate of bacteria from the throat lens reached up to 100.00%;nosocomial infections occurred in 4 patients after the operation.CONCLUSION Regular cleaning and disinfection of anesthesia apparatus and the aeration equipments can improve the mechanical property and extend the service life of the machine;along with disposable anesthesia aeration circuit,it can effectively avoid the respiratory tract infection and reduce the nosocomial infections,which is worthy of clinical promotion.