延迟清洗时间对胃镜清洗消毒质量的影响
作者:
作者单位:

1.南昌大学第一附属医院消化内镜中心;2.南昌大学护理学院

作者简介:

通讯作者:

马久红  E-mail: ndyfy00740@ncu.edu.cn

中图分类号:

+2  R187]]>

基金项目:

江西省应用研究培育计划项目(20212BAG70014);南昌大学"四新"研究与改革实践项目(NCUJGLX-2022-160-2)


Effect of delayed cleaning on cleaning and disinfection quality of gastroscopes
Author:
Affiliation:

1.Digestive Endoscopy Center, The First Affiliated Hospital of Nanchang University, Nanchang 330006, China;2.School of Nursing, Nanchang University, Nanchang 330006, China

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    摘要:

    目的 评价不同溶液预处理后延迟清洗时间对胃镜清洗消毒质量的影响。 方法 根据析因设计表, 将预处理清洗液(A因素): 多酶清洗液(A1)、清水(A2); 延迟清洗时间(B因素): 预处理后0 min(B1)、预处理后30 min(B2)、预处理后1 h(B3)、预处理后3 h(B4)两因素全面交叉为8组(A1B1、A1B2、A1B3、A1B4、A2B1、A2B2、A2B3、A2B4)。按照使用胃镜先后顺序, 使用随机数字表法将2023年5—9月某三甲医院消化内镜中心使用后的96条胃镜分配至各组, 每组12条胃镜, 于预处理后、清洗前、清洗后和消毒后四个时间点取样, 除A1B1、A2B1组缺少放置时间后清洗前采样外(两组胃镜各采样3次), 其余每组所有胃镜均采样4次, 共计360份标本。在预处理后各延迟清洗时间段采用管腔检测仪观察活检腔道内部情况, 并对胃镜后续再处理流程进行采样, 比较预处理后、清洗前后、消毒后胃镜微生物情况。 结果 多酶清洗液和清水预处理后, 微生物学检测结果差异无统计学意义(P>0.05)。延迟清洗时间内活检腔道一直处于潮湿状态。A、B两因素在延迟清洗前后、消毒后的微生物学检测结果比较, 差异均无统计学意义(均P>0.05), A、B两因素间也不存在交互效应。两种清洗液预处理后胃镜菌落数分布及消毒合格率比较, 差异也均无统计学意义(均P>0.05)。 结论 预处理后延迟30 min、1 h、3 h清洗对胃镜清洗消毒质量均没有影响, 在临床工作不可周转的情况下, 应立即清洗, 但当清洗消毒工作量大, 无法及时清洗时, 可有一定的清洗缓冲时间, 以不超过3 h为宜。

    Abstract:

    Objective To evaluate the effect of delayed cleaning on the cleaning and disinfection quality of gastroscopes after pre-treatment with different solutions. Methods According to the factorial design table, combination of the pre-treatment cleaning solutions (factor A) (including multi-enzyme cleaning solution [A1], clean water [A2]) and delayed cleaning durations (factor B) (including 0 minutes after pre-treatment [B1], 30 minutes after pre-treatment [B2], 1 hour after pre-treatment [B3], and 3 hours after pre-treatment [B4])yielded eight groups (A1B1, A1B2, A1B3, A1B4, A2B1, A2B2, A2B3, A2B4). According to the usage order of gastroscopes, 96 gastroscopes used in the digestive endoscopy center of a tertiary first-class hospital from May to September, 2023 were randomly assigned to each group by random number table method, with 12 gastroscopes in each group. Specimens were taken at four time points: after pre-treatment, before cleaning, after cleaning, and after disinfection. Due to instant clea-ning, no specimen before cleaning were taken from A1B1 and A2B1 groups, thus only 3 specimens were taken from these two groups each. Four specimens were taken from gastroscopes in the rest groups, resulting in 360 specimens in total. The internal condition of the biopsy cavity was observed through a cavity detector during each delayed cleaning period after pre-treatment, and specimens were taken at the subsequent reprocessing processes of the gastroscopes. The microbial conditions of the gastroscopes after pre-treatment, before cleaning, after cleaning, and after disinfection were compared. Results After pre-treatment with multi-enzyme cleaning solution and clean water, there was no statistically significant difference in microbiological detection result (P>0.05). The biopsy cavity remained moist during the delayed cleaning period. There was no statistically significant difference in the microbial detection results of factors A and B before and after delayed cleaning as well as after disinfection (all P>0.05). There was no interaction effect between factor A and B. The distribution of bacterial colonies and disinfection qualified rate of gastroscopes after pre-treatment with two cleaning solutions were also not statistically different (both P>0.05). Conclusion Delayed cleaning for 30 minutes, 1 hour, and 3 hours after pre-treatment does not affect the cleaning and disinfection quality of gastroscopes. When clinical demand is urgent, immediate cleaning should be carried out. However, a certain buffering time (no longer than 3 hours) before cleaning is acceptable, when cleaning and disinfection workload is heavy and timely cleaning cannot be carried out.

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引用本文

陈刘吉,甄静,张洋洋,等.延迟清洗时间对胃镜清洗消毒质量的影响[J]. 中国感染控制杂志,2024,23(6):725-730. DOI:10.12138/j. issn.1671-9638.20245214.
Liu-ji CHEN, Jing ZHEN, Yang-yang ZHANG, et al. Effect of delayed cleaning on cleaning and disinfection quality of gastroscopes[J]. Chin J Infect Control, 2024,23(6):725-730. DOI:10.12138/j. issn.1671-9638.20245214.

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  • 收稿日期:2023-11-08
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  • 在线发布日期: 2024-07-18
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