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目的对西安市医院的消毒/灭菌效果和环境卫生学监测结果进行分析,为医院感染管理工作提供参考。方法按照《消毒技术规范》要求,2006～2009年,对西安市市属医院手术室空气、无菌物品、医疗环境物体表面、医护人员手、消毒液、2%戊二醛、紫外线灯进行监测。结果总体来说三级医院监测样品合格率优于二级医院和一级医院,分别为88.18%,84.08%和79.02%,差异有统计学意义(χ2=17.08,P﹤0.05)。手术室空气、无菌物品、物体表面、医护人员手、消毒液、2%戊二醛、紫外线灯合格率差异有统计学意义(χ2=381.49,P﹤0.01),分别为75.19%、97.96%、88.93%、75.77%、98.80%、87.70%,71.07%。无菌物品和使用中的消毒液合格率较高,三级医院监测的无菌物品全部合格,与一、二级医院合格率相比,差异有统计学意义(χ2=7.49,P﹤0.05)。医务人员手和紫外线灯管监测合格率较低,尤其是一级医院合格率分别为62.96%和61.90%,与二、三级医院间差异明显。其他监测样品的合格率,不同年度、不同等级医院间无统计学差异。结论消毒/灭菌效果和环境卫生学监测对加强基层医院感染管理有一定的作用,应有针对地开展目标监测和干预。
Objective To analyze the results of hospital disinfection / sterilization and environmental hygiene monitoring in Xi’an, and provide reference for the management of hospital infection. Methods According to the requirements of Disinfection Technical Code, from 2006 to 2009, the operating room air, sterile articles, surface of medical environment, hand of medical staff, disinfectant, 2% glutaraldehyde and UV lamp were monitored in the operating room of Xi’an Municipal Hospital . Results Overall, the passing rate of tertiary hospital monitoring samples was 88.18%, 84.08% and 79.02% respectively, which was significantly different from that of secondary hospitals and primary hospitals (χ2 = 17.08, P <0.05). There was significant difference in pass rate of air, sterile goods, object surface, medical staff hand, disinfectant, 2% glutaraldehyde and UV lamp (χ2 = 381.49, P <0.01) , 88.93%, 75.77%, 98.80%, 87.70%, 71.07%. Sterile articles and the use of disinfectant pass rate higher, three hospitals to monitor all the qualified sterile goods, and first and second grade hospital pass rate, the difference was statistically significant (χ2 = 7.49, P <0.05) . The passing rate of medical staff and UV lamp was lower, especially the qualified rate of primary hospitals was 62.96% and 61.90% respectively, which was significantly different from those of secondary and tertiary hospitals. Other monitoring samples pass rate, different years, different levels of no statistically significant difference between hospitals. Conclusion The results of disinfection / sterilization and environmental hygiene monitoring have a certain effect on strengthening infection management in primary hospitals. Targeted monitoring and intervention should be carried out.