不同清洗方法对可重复使用腹腔镜器械清洗质量的观察

摘要

Objective To evaluate the cleaning quality of different cleaning methods for laparoscopic instruments, ensure the cleaning quality of instruments.Methods The used laparoscopic instruments were classified into two categories: non-lumen instruments and lumen instruments. Three cleaning methods, traditional manual cleaning (A), manual cleaning + ultrasonic cleaning (B), manual cleaning + automatic cleaning disinfector (C), were adopted respectively for treating instruments. Cleaning quality of instruments were detected with ATP bioluminescence assay.Results The qualified rates of laparoscopic non-lumen instruments cleaned by methods A, B, and C were 78.75％, 95.71％, and 96.00％ respectively, difference was significant (χ2=16.453, P＜0.001);qualified rate of methods B and C for cleaning non-lumen instruments was higher than that of method A (P＜0.016), there was no significant difference between methods B and C (P＞0.016). Qualified rates of laparoscopic lumen instruments cleaned by methods A, B, and C were 76.47％, 98.75％, and 91.55％ respectively, difference was significant (χ2=21.087, P＜0.001); qualified rates of methods B and C for cleaning lumen instruments were both higher than that of method A (P＜0.016), there was no significant difference between methods B and C (P＞0.016). Conclusion Effect of manual cleaning + ultrasonic cleaning and manual cleaning + automatic cleaning disinfector on used laparoscopic instruments are both better than that of traditional manual cleaning method, can effectively guarantee the cleaning quality of instruments and help to ensure the operation safety of patients.%目的 评价不同清洗方法对腹腔镜器械的清洗质量,确保器械的清洗质量.方法 将使用后的腹腔镜器械分为非管腔器械和管腔器械两类,分别采用传统手工清洗方法(A)、手工清洗+超声波清洗(B)、手工清洗+全自动清洗消毒器(C)三种清洗方法进行处理,运用三磷酸腺苷(ATP)生物荧光检测法检测器械的清洗质量.结果 A、B、C三种方法清洗腹腔镜非管腔器械合格率分别为78.75％、95.71％、96.00％,总体比较,差异有统计学意义(χ2=16.453,P＜0.001);方法B和方法C清洗非管腔器械合格率高于方法A(P＜0.016),方法B和方法C相比,差异无统计学意义(P＞0.016).A、B、C三种方法清洗腹腔镜管腔器械合格率分别为76.47％、98.75％、91.55％,总体比较,差异有统计学意义(χ2=21.087,P＜0.001);方法B和方法C清洗管腔器械合格率高于方法A(P＜0.016),方法B和方法C相比,差异无统计学意义(P＞0.016).结论 手工清洗+超声波清洗、手工清洗+全自动清洗消毒器对使用后的腹腔镜器械清洗效果均优于传统手工清洗方法,前两种方法能有效保证器械的清洗质量,有利于保障患者的手术安全.