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目的将循证思维方法应用于灭菌监测工作中,探讨影响灭菌包内化学指示卡变色的各种因素,为临床合理选择化学监测卡提供参考。方法设置5kg手术敷料包,7kg手术器械包,8kg手术敷料包三类,选择132℃压力蒸汽灭菌化学指示卡(A卡)、1322IY型(B卡)、爬行式卡(C卡),将3种化学指示卡置于每包中心位置后放在灭菌器同一部位灭菌,对比三类手术敷料包中3类化学指示卡的监测结果及监测总合格率。结果 5kg手术敷料包中3类卡监测结果差异无统计学意义;7kg手术器械包和8kg手术敷料包中3类卡监测结果差异有统计学意义(P<0.05);5kg手术敷料包3类卡和7kg手术器械包3类卡监测总合格率与8kg手术敷料包3类卡监测总合格率差异有统计学意义(P<0.05)。结论四类化学卡的改良产品,监测的准确性和五类卡一致,工作中应规范选择化学指示卡,避免监测误差,严格操作程序,保证灭菌物品的质量。
Objective To apply evidence-based thinking method to sterilization monitoring and discuss various factors that affect the discoloration of chemical indicator in sterilization package, so as to provide a reference for clinical selection of chemical monitoring card. Methods A total of 5 kg surgical dressing kits, 7 kg surgical kits and 8 kg surgical dressing kits were set up. The chemical vapor pressure indicator (A card), 1322 IY (B card) and crawling card (C card) Three kinds of chemical indication cards were placed in the center of each package and placed on the same part of the sterilizer to sterilize. The results of the three kinds of chemical indicator cards in the three kinds of surgical dressing packages were compared and the total qualified rate was monitored. Results There was no significant difference in the results of 3 kinds of cards in the 5kg surgical dressing package. The results of 3 kinds of cards in 7kg surgical instrument package and 8kg surgical dressing package showed significant difference (P <0.05); 5kg surgical dressing package (P <0.05). There was a significant difference between the total qualified rate of 3kg cards of 7kg surgical instruments and the total qualified rate of 3kg cards of 8kg surgical dressing packets (P <0.05). Conclusion The improved products of the four types of chemical cards, the accuracy of monitoring and the five types of cards are consistent. In the work, the chemical indicator cards should be standardized to avoid monitoring errors and strict operating procedures to ensure the quality of sterilized articles.