医疗器械超声清洗效果的影响因素

目的 研究影响医疗器械超声清洗效果的因素，为合理改进医院消毒供应中心超声清洗医疗器械的方法和流程提供参考依据。方法 采用超声波能量检测瓶和超声波声强测试仪对超声波效能进行检测，采用管腔型清洗效果检测卡对超声波清洗效果进行检测。结果 能量瓶平均变色时间、超声波声强、检测卡平均清洗合格时间比较，脱气组和未脱气组差异有统计学意义（P<0.05）；器械规则摆放组和堆叠摆放组差异有统计学意义（P<0.05）；单层摆放组和双层摆放组差异有统计学意义（P<0.05），层数相同条件下单筐组和双筐组在相同测试位点差异无统计学意义（P>0.05）。4种品牌清洗剂中A品牌的清洗效果最好、清洗速度最快，但能量瓶平均变色时间和声强测试差异无统计学意义（P>0.05）。清洗剂加注量在1：100、清洗温度在45℃时清洗效果最好。超声时间2 h内清洗剂的酶活力均在1 600 U左右，差异无统计学意义（P>0.05）。结论 脱气、器械摆放、器械装载方式以及不同清洗剂、清洗温度均能导致超声清洗效能的改变，合理选择清洗条件才能够使医疗器械超声清洗达到满意效果。

Influencing factors for ultrasonic cleaning efficiency of medical devices

Objective To study factors influencing the efficiency of ultrasonic cleaning of medical devices, and provide reference for rational improvement in methods and processes of ultrasonic cleaning of medical devices in hospital central sterile supply department. Methods Ultrasonic energy detection bottle and ultrasonic intensity detector were used to detect the ultrasonic efficiency, lumen type cleaning effect detection cards were used to detect the ultrasonic cleaning efficiency. Results There were significant differences between degassing group and non-degassing group in the average discoloration time of the energy bottle, the ultrasonic intensity and average cleaning qualified time of detection cards (P<0.05); differences between device regular placement group and stacking placement group was statistically significant (P<0.05); there was significant difference between single-layer placement group and double-layer placement group (P<0.05), there was no significant difference in the same detection site between single basket group and double basket group under the condition of the same number of layer (P>0.05). Among 4 kinds of detergent, brand A had the best cleaning efficiency and the fastest cleaning speed, but there was no significant differences in the average discoloration time of energy bottle and ultrasonic intensity detection (P>0.05). The best cleaning efficiency was achieved when the amount of detergent was 1:100 and the cleaning temperature was at 45℃. Enzyme activity of detergent was about 1 600 U within 2 hour of ultrasonic time, difference was not statistically significant (P>0.05). Conclusion Degassing, device placement, device loading mode, different detergent and cleaning temperature can all lead to the change of ultrasonic cleaning efficiency, only by selecting rational cleaning conditions can achieve satisfactory results of ultrasonic cleaning of medical devices.