气管切开患者气道细菌培养及套管消毒方法相关因素的研究

目的 探讨气管切开术后气管内套管消毒前后主要细菌及致病菌菌株分类,比较气管套管消毒方法及效果.方法 随机抽取110例气管切开术后病人,气管内套管消毒前采样进行细菌培养分析;分别采用煮沸消毒20min、30min,75%乙醇、2%戊二醛、3%过氧化氢(H2O2)分别浸泡消毒20min、30 min.四种消毒方法及消毒剂,两组消毒时间段进行消毒效果对比.结果 消毒前采样62例次做细菌培养,培养出18个菌种89例菌株,无培养出细菌6例.致病菌+条件致病菌占80%,P<0.05.经煮沸消毒、75%乙醇、2%戊二醛、3%过氧化氢浸泡消毒四种消毒方法比较,经20 min煮沸消毒和浸泡消毒后,75%乙醇浸泡消毒分别与煮沸消毒、3%H2O2、2%戊二醛浸泡消毒阳性率有统计学意义(P<0.05):经30 min消毒后,四种消毒方法均无统计学意义.结论 气管内套管消毒前细菌培养致病菌大大高于非致病菌,采用煮沸消毒20 min、3%过氧化氢、2%戊二醛浸泡消毒加min、75%乙醇浸泡消毒30 min均可达到良好消毒效果.从高效、安全、低成本角度首推3%过氧化氢.

Study on related factors in airway bacterial culture and inner tubes disinfection methods among patients after trachenstomy

Objective To investigate the classification of major bacteria and pathogen strains before and after inner tubes disinfection within the trachea after the tracheotomy, and to compare the method of disinfection and the results. Methods 110 patients after tracheotomy were randomly selected, and tracheal tubes were sampled before the disinfection and were conducted a bacterial culture analysis. These tracheal tubes were disinfected by boiling for 20 minutes and 30 minutes, respectively. Then they were soaked in 75% ethanol, 2% glularaldehyde and 3% hydrogen peroxide for 20 minutes and 30 minutes, respectively. The disinfection effects were compared among the four disinfection methods and disinfectants, and the two groups of disinfection time. Results 62 cases before the disinfection were sampled to make a bacterial culture. 89 strains in 18 species were cultivated, and no bacteria in six cases. Pathogenic bacteria and conditioned pathogen accounted for 80 percent (P<0.05). For the four disinfection methods including boiling disinfection, 75% ethanol, 2% glutaraldehyde and 3% hydrogen peroxide immersion disinfection, after 20 minutes of disinfection and immersion disinfection, 75% ethanol immersion disinfection had statistical meanings with the positive rates of boiling disinfection, 3% H2O2 and 2% glutaraldehyde soaking disinfection, respectively (P<0.05) ; After 30 minutes of disinfection, all of the four disinfection methods had no statistical meaning. Conclusions Pathogenic bacteria cultivated before the disinfection of tracheal tubes are much more than the non-pathogenic bacteria. Boiling disinfection for 20 minutes, 3% hydrogen peroxide and 2% glutaraldehyde disinfectant soaking for 20 minutes, and 75% ethanol immersion disinfection for 30 minutes can achieve good disinfection results. From the aspects of high efficiency, safety and low cost, 3% hydrogen peroxide is the best choice.