4种低温灭菌法在内镜灭菌中的效果探讨

目的 探讨高效、安全、快速、经济实用的内镜灭菌方式,以满足临床的需求.方法 对过氧化氢等离子低温灭菌法、过氧乙酸医用灭菌器灭菌法、2.0％戊二醛溶液浸泡灭菌法、戊二醛气体熏蒸灭菌法进行内镜器械消毒,并对4种方式进行比较.结果 4种灭菌方法均达到无菌要求,过氧化氢等离子低温灭菌法,灭菌时间为55 min,保存期3～6个月；过氧乙酸医用灭菌器,灭菌时间30 min,保存期4 h；戊二醛气体.熏蒸柜,灭菌时间155 min,戊二醛溶液浸泡,灭菌时间10 h,两者保存期均为4h.结论 过氧化氢等离子低温灭菌,过氧乙酸医用无菌器,两种方式均对内镜损伤小、周期短,对人及环境无害,是内镜灭菌的首选方式；过氧化氢等离子低温灭菌适用于平诊手术或多台连台手术,过氧乙酸医用灭菌器适用于单台或急诊手术,两者联合应用可提高器械的循环周转率,满足临床的需求.

Investigation on effect of four kinds of low-temperature sterilization method in endoscopic sterilization

OBJECTIVE To find an efficient,safe,fast,economical method to meet the clinical endoscopic sterilization needs.METHODS Endoscopic equipment were disinfected in four different ways including low-temperature hydrogen peroxide plasma sterilization,peracetic acid sterilization of medical sterilizer,2% glutaraldehyde immersion sterilization,and glutaraldehyde gas fumigation.The efficacies of different sterilization methods were compared.RESULTS All the four sterilization methods met sterility requirements.Low-temperature hydrogen peroxide plasma sterilization method needed 55 minutes of sterilization time,and the equipments could be preserveed for 3-6 months,sterilization time for peracetic acid sterilization was 0.5h,and medical devices could be preserved for 4h;sterilization time for glutaraldehyde gas fumigation cabinets was 155 minutes,10h for glutaraldehyde immersion,equipments disinfected by these two methods could be preserved for 4h.CONCLUSION With less damage to medical devices,shorter sterilization cycle,harmless to human and environment,low-temperature hydrogen peroxide plasma sterilization and peracetic acid sterilization are the preferred methods of endoscopic sterilization.Low-temperature hydrogen peroxide plasma sterilization is suitable for selective operation and multiple surgeries.Peracetic acid medical sterilizer is suitable for a single or emergency operation.Combined use of the two methods can increase the turnover cycle of equipments,meet clinical needs.