Cleaning methods improvement and cleaning effect evaluation of reused ophthalmic microsurgery instruments
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摘要: 目的 探讨重复使用的眼科显微手术器械清洗方法改进后的效果,提高眼科显微手术器械清洗质量,杜绝医院感染的发生。 方法 选取2016年9-12月眼科显微手术器械600件,按照清洗方式将其随机分为常规组与改良组,每组300件。常规组采用常规清洗(多酶超声清洗);改良组采用预处理(预处理:眼科显微手术器械使用后放入盛装多酶溶液的容器内预处理)+多酶超声清洗+酸性清洁剂和医用润滑剂进行处置,观察2组眼科显微手术器械清洗后的合格率、细菌学检验、器械灵活度及损耗率。 结果 对比常规组与改良组,2组眼科显微手术器械清洗后目测合格率差异无统计学意义(P>0.05);镜检合格率改良组明显高于常规组(P<0.05);而在眼科显微手术器械灵活度上,改良组明显高于常规组(P<0.05),眼科显微手术器械损耗率方面,常规组则明显高于改良组(P<0.05);2组眼科显微手术器械清洗后的细菌检验阳性率差异有统计学意义(P<0.05)。 结论 改良组眼科显微手术器械的灵活性较常规组提高了9%,损耗率下降了2%,细菌检验阴性率提高6%,镜检法合格率上升了18.3%。改良组使用预处理、超声加多酶清洗、选用酸性清洁剂和医用润滑剂处置眼科显微手术器械,能够有效提高重复使用的眼科显微手术器械微小锈渍和斑点清除,确保重复使用的眼科显微手术器械的清洗质量,提高器械使用的灵活度,降低器械损耗率。Abstract: Objective To discuss the effect of the improved methods of reused ophthalmic microsurgery instruments and to improve the cleaning quality of the instrument for preventing infection in hospital. Methods The methodology used in this research is to distribute 600 instruments which are chosen from operation room from September to October in 2016 into two groups randomly, namely, the regular group and improved group, with 300 devices in each group. The routine cleaning method used by the regular group from sterilization and supply center (multi-enzyme ultrasonic cleaning) will be used to compare the method adopted by the improved group which comprises pretreatment (put multi-enzyme solution) ultrasound, acid cleaning agent as well as lubricant oil for medical devices cleaning. The qualified rate after cleaning, comparison of bacteriological examination and flexibility and loss rate of device will be compared between two methods. Results Although there is no significant qualified rate difference between regular group and improved group in terms of visual method (P>0.05), the qualified rate of microscopic examination in the improved group is significantly superior to the regular group (P<0.05). In addition, the improved group is better than the regular group in regard to the flexibility (P<0.05), and the loss rate of improved group is lower than that of the regular group (P<0.05). It should be noted that there is also an obvious difference between two groups in regard to positive rate of bacterial test after cleaning (P<0.05). Conclusion In the improved group, the flexibility of ophthalmic microsurgical instruments was increased by 9%, the loss rate was decreased by 2%, the bacterial test negative rate was increased by 6%, and the pass rate of microscopy was increased by 18.3%. Improved group which used pretreatment, ultrasonic and enzyme washing, acid detergent and medical lubricant can effectively improve the reuse of the ophthalmic microsurgery instrument, promote small rust stains and spots to be removed, enhance the cleaning quality the reuse of the ophthalmic microsurgery device and increase the flexibility of utilization of devices and decrease the loss rate.
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