一次性无纺布不同包装方式对器械包无菌屏障系统的影响

目的 观察一次性无纺布包装器械包破损情况，分析包装破损的原因，通过改进包装方法提高包装完好性。方法 选取2017年10月—2018年12月某院5 000个相同规格的手术器械包作为研究对象，按照不同的包装形式分为A—E组（A组：普通篮筐+一次性无纺布；B组：普通篮筐+一次性吸水衬纸+一次性无纺布；C组：平底篮筐+一次性无纺布；D组：平底篮筐+一次性吸水衬纸+一次性无纺布；E组：提篮+平底篮筐+一次性吸水衬纸+一次性无纺布），每组数量1 000个，观察记录自包装完成至使用前的七个环节（①包装操作完成；②装载至灭菌架；③灭菌后卸载至存储架；④装入运输车；⑤卸载至手术室存储架；⑥使用前放置在操作台；⑦使用前打开）器械包的破损情况。结果 A—E组包装破损率分别为21.7%、13.5%、8.8%、5.2%、0.1%，A组破损率最高，E组破损率最低，各组比较，差异均有统计学意义（均P<0.001）。①—⑦转运环节中包装破损率分别为0、0.24%（12件）、1.04%（52件）、1.44%（72件）、3.44%（167件）、0.30%（15件）、0.46%（23件），除环节①包装破损数量为0以外，各个环节均发生了包装破损，环节⑤破损率最高，器械包进入使用科室直至使用前，破损情况均在持续发生。结论 与使用普通篮筐比较，使用平底篮筐进行器械包装破损率更低，增加一次性吸水纸的保护可以进一步改善包装破损情况，器械包转运提篮的使用可以有效减少包装在转运、搬运过程中的损伤。

Evaluation on the cleaning methods for instruments with axle

Objective To observe the damage of disposable non-woven fabric used for packing device, analyze the causes of damage of packing, and improve the integrity of package by improving the packing method. Methods From October 2017 to December 2018, 5 000 surgical device packages of the same specification in a hospital were selected as the research objects, and divided into groups A-E according to different packing methods (group A:common basket+disposable non-woven fabric; group B:common basket+disposable absorbent liner+disposable non-woven fabric; group C:flat bottom basket+disposable non-woven fabric; group D:flat bottom basket+disposable absorbent liner+disposable non-woven fabric; group E:basket+flat bottom basket+disposable absorbent liner+disposable non-woven fabric), each group has 1 000 pieces. Damage of device packing at 7 steps from the completion of packing to pre-use was observed and recorded (① completing packing; ② loading to sterilization rack; ③ unloading to storage rack after sterilization; ④ loading into transport vehicle; ⑤ unloading to storage rack in operating room; ⑥ placing on manipulating platform before use; ⑦ openning before use). Results Damage rates of packing in group A-E were 21.7%, 13.5%, 8.8%, 5.2%, and 0.1% respectively, the highest was in group A and the lowest in group E, differences were all statistically significant (all P<0.001). In transfer step ①-⑦, damage rates of packing were 0, 0.24% (n=12), 1.04% (n=52), 1.44% (n=72), 3.44% (n=167), 0.30% (n=15) and 0.46% (n=23) respectively, except that the number of packing damage of step ① was 0, packing damage ccurred in other steps, and step ⑤ had the highest damage rate, damage of device package occurred continuously until it was pre-used in departments. Conclusion Compared with common basket, damage rate of device packing with flat bottom basket is lower, the use of disposable absorbent paper can further protect the packing from damaging, transport basket can effectively reduce the damage of packing in the process of transportation.