区凌冰等

【摘要】目的对比分析腔镜器械两种清洗消毒模式的清洗消毒效果。方法将2011年5月～2012年10月手术室按传统清洗与消毒模式进行腔镜手术器械管理的数据作为对照组；将2013年6月～2014年11月手术室规范化管理后实行一体化清洗消毒的腔镜器械数据作为研究组。比较两组的腔镜手术感染率及腔镜器械的清洗合格率。结果研究组腔镜器械清洗合格率显著高于对照组，而腔镜手术感染率显著低于对照组，两组对比差异有统计学意义（P<0.01）。结论手术室腔镜器械一体化清洗消毒可以显著提高清洗合格率，降低手术感染率，值得推广。

【关键词】腔镜器械；清洗消毒；一体化

中图分类号：R187 文献标识码：ADOI：10.3969/j.issn.10031383.2015.04.010

【Abstract】ObjectiveTo compare effects of two patterns of cleaning and disinfection of endoscopic instrument.MethodsData of endoscopic management conducted through traditional mode of cleaning and disinfection from May，2011 to October，2012 were selected as control group.And data of endoscopic instrument after the standardization and integration of cleaning and disinfection from June，2013 to November，2014 were selected as research group.Then，infection rate of endoscopic surgery and qualified rate of endoscopic instrument were compared between groups.Results Qualified rate of endoscopic instrument of the research group was obviously higher than that of the control group，but infection rate of endoscopic surgery was obviously lower than that of the control group，difference was statistically significant（P<0.01）.ConclusionIntegration of cleaning and disinfection of endoscopic instrument can significantly improve the qualified rate of cleaning and lower the infection rate of surgery.Thus，it is worth to be recommended.

【Key words】endoscope equipment；cleaning and disinfection；integration

当前，精细手术成为手术发展的一个方向，得到医护和患者的认可和青睐。但精细手术需要设备器械等的支撑。因腔镜器械具有精密易损、管腔多而纤细、结构复杂、价格昂贵、材质特殊的特点，对清洗、灭菌提出了更高的要求。过于繁复的清洗工作，加大了器械的损坏率，成本高，同时降低临床工作效率。为有效控制和预防交叉感染，满足临床对腹腔器械进行有效的无菌化消毒处理及手术量逐渐增多的需要，必然要求清洗工作专业化，细节管理精细化[1]。手术室从组织或管理因素、团队因素、工作任务因素、环境因素和个人因素等方面分析手术室腔镜器械管理不良事件发生原因[2]，运用PDCA循环管理方法打破科室间的壁垒[3]，提出现代手术室与消毒供应室进行专业合作及合理整合是控制医院感染的重要措施和发展趋向，而一体化管理模式则能够实现此目标。……