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目的采用不同检测方法对经复用处置的手术器械清洗质量进行比较研究,为医疗机构开展手术器械清洗质量监测提供现场快速检测技术。方法 2012年5月-2013年6月对某综合医院的消毒供应中心,采用残留蛋白检测和三磷酸腺苷(ATP)生物荧光法,对经过自动清洗机清洗后的手术器械进行随机抽检,比较两项检测技术的阳性率;采用SPSS19.0软件对数据进行统计处理;计数资料用合格率进行统计描述,组间差异用χ2检验进行统计分析。结果采用残留蛋白检测组,抽检各类手术器械共148件,阳性14件,阳性率为9.46%;ATP检测组共抽检144件器械,其中<2 000相对光单位值(RLU)/件的器械有108件,占总监测数的75.00%;2 000~4 000RLU/件,共有25件,占17.37%;≥5 000RLU/件,有11件,占7.63%;≥8 000RLU/件,仅为2件,占1.39%;ATP组如设定≥5 000RLU/件为阳性判断标准,则阳性率为7.63%;两项技术检测的阳性率差异无统计学意义。结论残留蛋白和ATP检测技术均可用于手术器械清洗质量的现场监测,医疗机构应根据自身特点选择监测技术,提高手术器械清洗质量,保障高度危险物品的消毒与灭菌质量。
Objective To compare the cleaning quality of the surgical instruments reused by different detection methods to provide on-site rapid detection technology for the quality control of surgical instruments in medical institutions. Methods From May 2012 to June 2013, a total hospital disinfectant supply center was used for the random sampling of the surgical instruments cleaned by the automatic cleaning machine by using residual protein detection and adenosine triphosphate (ATP) biofluorescence. Two tests The positive rate of technology; the use of SPSS19.0 software for statistical processing; count data with a statistical description of the pass rate, the difference between groups using χ2 test for statistical analysis. Results A total of 148 pieces of surgical instruments were selected for detection of residual proteins. The positive rate was 9.46%. The ATP test group sampled a total of 144 instruments, of which <2 000 relative light units (RLU) / piece of equipment There are 108, accounting for 75.00% of the total number of monitors; 2 000 ~ 4 000RLU / piece, a total of 25, accounting for 17.37%; ≥ 5000RLU / piece, 11, accounting for 7.63%; ≥ 8000RLU / piece, 2 cases, accounting for 1.39%. In the ATP group, the positive rate was 7.63% if the test result was ≥5 000 RLU / case. There was no significant difference in the positive rates between the two techniques. Conclusion Both residual protein and ATP detection technology can be used to monitor the quality of surgical instrument cleaning. Medical institutions should choose monitoring technology according to their own characteristics to improve the cleaning quality of surgical instruments and ensure the disinfection and sterilization quality of highly dangerous substances.