刘素美

【摘要】 目的：探讨不同清洗流程应用于妇科器械的清洗，选择能够获取最佳质量的清洗流程，确保器械的灭菌质量保证手术患者的安全，降低院内感染的发生。方法：将已使用的妇科器械分为A、B、C组，A组妇科器械全自动清洗机清洗，B组妇科器械纯手工清洗，C组妇科器械采用超声清洗+手工刷洗+全自动清洗机清洗，利用目测法、白纱垫法、ATP荧光检测法比较三组妇科器械清洗质量。结果：三组清洗器械方法中清洗质量比较，B、C组清洗方法下的质量明显高于A组，比较差异有统计学意义（P<0.05）。B组与C组比较，差异无统计学意义（P>0.05）。结论：妇科器械因结构特殊不能完全依赖清洗机清洗，也不可以纯手工清洗，必须将手工清晰与超声清洗相配合才能保证清洗质量。

【关键词】 妇科器械； 清洗流程； 清洗效果

【Abstract】 Objective：To discuss the different cleaning processes used in the cleaning of gynecological instruments，to get the best quality of cleaning process to ensure quality sterile surgical instruments to ensure patient safety，reduce the incidence of nosocomial infections.Method：The gynecological instruments used were divided into A，B and C group，A group was given automatic washing machine cleaning，B group was given pure hand washing，C group was given ultrasonic cleaning hand scrub+automatic washing machine cleaning.The visual method， white gauze pad method and ATP fluorescence detection were used to compare three groups cleaning quality.Result：The quality of cleaning in group B and C were significantly higher than that in group A（P<0.05），the differences were statistically significant.There was no significant difference between group B and C（P>0.05）.Conclusion：Gynecological equipment due to the special structure can not rely entirely on washing machine cleaning，can not be purely manual cleaning， manual cleaning and ultrasonic cleaning must be matched to ensure the quality of cleaning.

【Key words】 Gynecological apparatus； Cleaning process； Cleaning effect

First-authors address：Maternal and Child Health Hospital of Jiangxi Province，Nanchang 330006，China

doi：10.3969/j.issn.1674-4985.2016.34.039

窥阴器、宫腔刮勺、宫腔吸引管等妇科手术器械，因其结构特殊、污染程度高，清洗难度大，尤其是这些器械大多是门诊人工流产患者使用，量大不能及时回收到消毒供应室处理，如超过3 h以上再清洗的器械其清洗的难度加大，在供应室集中处理，如果完全依赖清洗机清洗难以保证质量[1-2]。本院为三级甲等妇产科专科医院，日均门诊量4000例次，日使用窥阴器2000余只，门诊人工流产患者使用刮勺、宫腔吸管100余根，均为复用器械。以往本院供应室采取全自动清洗机定期集中清洗，清洗后检测质量不合格比例很高，在规定回收时间后所使用的器械要到次日才回收到消毒供应室，器械生锈现象非常严重，必须进行除锈处理，除锈剂的使用也会损伤器械表面的保护层，造成器械的二次损伤，对工作人员及环境的污染影响也很大，反复清洗也容易造成人力、清洗剂、水、电等资源的浪费。……