CAJ | 학술논문

目的：通过对比了解多酶加超声对硬式内镜的清洗效果，为内镜器械消毒清洗寻求最佳的清洗方法，提高内镜清洗质量，保证灭菌效果。方法随机抽取2013年2月经杰力试纸检测为阳性的污染硬式内镜器械180件，根据不同清洗方法进行分组，以规范清洗作为对照组，多酶超声清洗根据清洗时间不同分为观察1组（超声时间8 min）与观察2组（超声时间4 min），每组各60件；通过3M Pro‐tect M 清洗测试棒与杰力试纸进行检测比较，并对3组阳性检出硬式内镜进行微生物学检测。结果3M清洗测试棒检测结果：对照组阳性率为46．67％、观察1组为11．67％、观察2组为13．33％；杰力试纸检测结果：对照组阳性率为45．00％、观察1组为15．00％、观察2组为16．67％，观察组阳性检出率均低于对照组（ P＜0．05），且两个观察组组间比较差异无统计学意义；硬式内镜阳性病原菌检测显示，对照组革兰阳性菌、革兰阴性菌、真菌分别为10、14、10株；观察1组分别为4、4、3株；观察2组分别为5、5、2株，观察组病原菌的检出株数明显小于对照组（P＜0．05）。结论观察组清洗效果均明显优于对照组，两观察组间清洗效果无明显差异，均可有效去除血液、有机物污染，显著提高手术器械的清洗质量，保证灭菌质量，规避清洗不彻底造成的灭菌失败，均可用于手术室硬式内镜器械清洗方法改进。
목적：통과대비료해다매가초성대경식내경적청세효과，위내경기계소독청세심구최가적청세방법，제고내경청세질량，보증멸균효과。방법수궤추취2013년2월경걸력시지검측위양성적오염경식내경기계180건，근거불동청세방법진행분조，이규범청세작위대조조，다매초성청세근거청세시간불동분위관찰1조（초성시간8 min）여관찰2조（초성시간4 min），매조각60건；통과3M Pro‐tect M 청세측시봉여걸력시지진행검측비교，병대3조양성검출경식내경진행미생물학검측。결과3M청세측시봉검측결과：대조조양성솔위46．67％、관찰1조위11．67％、관찰2조위13．33％；걸력시지검측결과：대조조양성솔위45．00％、관찰1조위15．00％、관찰2조위16．67％，관찰조양성검출솔균저우대조조（ P＜0．05），차량개관찰조조간비교차이무통계학의의；경식내경양성병원균검측현시，대조조혁란양성균、혁란음성균、진균분별위10、14、10주；관찰1조분별위4、4、3주；관찰2조분별위5、5、2주，관찰조병원균적검출주수명현소우대조조（P＜0．05）。결론관찰조청세효과균명현우우대조조，량관찰조간청세효과무명현차이，균가유효거제혈액、유궤물오염，현저제고수술기계적청세질량，보증멸균질량，규피청세불철저조성적멸균실패，균가용우수술실경식내경기계청세방법개진。
OBJECTIVE To understand the effect of cleaning of the rigid endoscopic equipments with multi‐enzyme plus ultrasound so as seek the optimal cleaning method ,improve the cleaning quality ,and ensure the sterilization effect .METHODS In Feb ,2013 ,a total of 180 contaminated rigid endoscopic equipments that were tested positive with Jieli dipstick were randomly extracted and grouped according to the different cleaning methods ,the control group was treated with standard cleaning ,while the contaminated rigid endoscopic equipments that were treated with the multi‐enzyme cleaning were divided into the observation group 1 (8 min of ultrasound) and the observa‐tion group 2 (4 min of ultrasound) according to the cleaning time ,with 60 pieces in each group;the cleaning effects were detected and compared by using 3M Pro‐tect M cleaning test bar and Jieli dipstick ,and the microbio‐logical test was performed for the rigid endoscopic equipments that were tested positive in the three groups . RESULTS The results of the detection with 3M cleaning test bar indicated that the positive rate was 46 .67% in the control group ,11 .67% in the observation group 1 ,13 .33% in the observation group 2;the results of detection with Jieli dipstick showed that the positive rate was 45 .00% in the control group ,15 .00% in the observation group 1 ,16 .67% in the observation group 2;the positive rates of the observation group were significantly lower than those of the control group (P<0 .05) ,while there was no significant difference between the two observation groups .The detection of pathogens tested positive for the rigid endoscopic equipments indicated that there were 10 strains of gram‐positive bacteria in the control group ,4 strains in the observation group 1 ,and 5 strains in the ob‐servation group 2 ,there were 14 strains of gram‐negative bacteria in the control group ,4 strains in the observation group 1 ,and 5 strains in the observation group 2 ,and that there were 10 strains of fungi in the control group ,3 strains in the observation group 1 ,and 2 strains in the observation group 2 ;the pathogens isolated from the obser‐vation group were significantly less than those isolated from the control group (P< 0 .05) .CONCLUSION The cleaning effect of the observation group is significantly better than that of the control group ,while there is no sig‐nificant difference in the cleaning effect between the two observation groups ,and both methods can effectively re‐move the blood and organic pollution ,remarkably improve the cleaning quality of surgical instruments ,ensure the sterilization quality ,and avoid the failure of sterilization due to the incomplete cleanin ,and both can be applied for the improvement of cleaning methods for the rigid endoscopic equipments .