医疗机构消化内镜清洗消毒历史和现状调查

目的了解国内医疗机构消化内镜清洗消毒历史及现状。方法采用问卷调查方法,对中国部分省市医疗机构消化内镜清洗消毒历史、现状进行调查与分析。结果全国11个省市共278所医疗机构参与调查,其中1986、2005、2015年信息填写完整的医疗机构分别为78、175、278所。清洗人员由医生、护士和工人组成,其中护士和工人两者结合的医疗机构由1986年的2.56%上升至2015年的23.74%。1986年100%的医疗机构使用存储水进行消化内镜的清洗;2005、2015年均使用流动自来水清洗,且2005年有30.29%使用过滤水或纯化水清洗,2015年50.72%的医疗机构使用过滤水,17.63%使用纯化水进行消化内镜的清洗。1986年均未使用清洗酶,2015年已有98.92%的医疗机构使用酶液清洗消化内镜;1986年消化内镜孔道冲洗以简单冲洗为主(94.87%),2015年以强化冲洗(34.53%)和自动化冲洗(53.24%)为主。2005年及之前消化内镜清洗消毒90%不记录或采用人工记录,2015年采用信息化追溯系统的机构占36.33%。结论国内医疗机构消化内镜清洗人员配备、清洗用水质量、高效消毒剂的选用、监测及记录操作程序等方面较1986、2005年均有很大程度地提高,清洗消毒逐渐规范,消化内镜消毒灭菌方法趋于多元化。

History and current situation of digestive endoscope cleaning and disinfection in domestic medical institutions

ObjectiveTo understand the history and current situation of digestive endoscope cleaning and disinfection in domestic medical institutions. MethodsQuestionnaire survey was used to investigate and analyze the history and current situation of digestive endoscope cleaning and disinfection in medical institutions in some provinces and cities in China. ResultsA total of 278 medical institutions in 11 provinces and cities of China participated in the investigation, 78, 175, and 278 institutions filled out complete information in 1986, 2005, and 2015 respectively. The personnels participated in cleaning consisted of doctors, nurses and workers, the combination of nurses and workers increased from 2.56% in 1986 to 23.74% in 2015. In 1986, 100% of medical institutions used storage water for digestive endoscope cleaning; in 2005 and 2015, all used running water for cleaning, besides, 30.29% of medical institutions used filtered water or purified water for cleaning, in 2015, 50.72% of medical institutions used filtered water, 17.63% used purified water for cleaning. In 1986, no cleaning enzyme were used, in 2015, 98.92% of medical institutions used enzyme for cleaning; in 1986, irrigation of digestive endoscopy channel was performed with simple rinsing（94.87%）, in 2015, enhanced irrigation (34.53%) and automatic irrigation (53.24%) were the main rinsing modes. In 2005 and before, >90% of digestive endoscope cleaning and disinfection were not recorded or manually recorded, in 2015, 36.33% of institutions used information traceability system. ConclusionThe staffing of digestive endoscope cleaning in domestic medical institutions, quality of cleaning water, selection of high efficiency disinfectant, monitoring and recording of digestive endoscope cleaning and disinfection in domestic medical institutions were greatly improved compared with 1986 and 2005, cleaning and disinfection gradually standardized, disinfection and sterilization methods of digestive endoscope tend to be diversified.