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目的 了解上海市支气管镜和胃镜的消毒现状 ,进一步规范消毒操作方法 ,提高消毒质量。方法 调查上海市 17所医院支气管镜和胃镜的消毒方法和消毒效果。结果 部分医院对内镜消毒前的清洗不够重视 ,5 0 %支气管镜和 5 .9%胃镜没有使用流动水清洗 ;5 0 %支气管镜和 35 .3%胃镜采用 2 %戊二醛消毒剂 ;内镜消毒时间过短和浸泡方法不当甚为普遍 ;受检的医院支气管镜浸泡均超过 10 min,但有 8所医院胃镜消毒时间短于 10 m in,部分不足 5 m in;不少医院没有将活检钳插入孔浸入消毒剂液面以下 ,致使镜钳孔消毒不彻底 ,细菌检出率高 ;作为医院感染高危物品的活检钳 ,没有 1所按照灭菌要求处置 ;部分消毒后内镜及其配件的微生物污染严重 ;10所医院的支气管镜及其配件中 ,有 3所污染 ,其中 1所系极严重污染 ;消毒后的 17所胃镜及其配件中 ,有 5所污染 ,其中 2所属重度污染 ,1所为极严重污染。结论 我市部分医院对支气管镜和胃镜消毒观念淡薄、清洗消毒不规范、消毒剂使用不当、消毒时间过短 ,导致不少消毒后的内镜及其配件仍存在病原菌污染 ,有引发医院感染的严重隐患 ,亟待重视和解决
Objective To understand the status of bronchoscopy and gastroscope disinfection in Shanghai, further standardize the disinfection operation method and improve the disinfection quality. Methods To investigate the disinfection and disinfection effects of bronchoscope and gastroscope in 17 hospitals in Shanghai. Results Some hospitals did not pay sufficient attention to the cleaning before endoscope disinfection. 50% bronchoscope and 5.9% gastroscope were not cleaned with flowing water; 2% glutaraldehyde disinfectant was used in 50% bronchoscope and 35.3% gastroscope; Endoscopic disinfection time is too short and improper soaking method is very common; hospital bronchoscopy were soaked for more than 10 min, but 8 hospitals gastroscopy disinfection time of less than 10 m in some less than 5 m in; many hospitals do not The biopsy forceps inserted into the hole immersed in disinfectant below the surface, resulting in mirror clamp hole disinfection is not complete, high detection rate of bacteria; as a high risk of hospital infection biopsy forceps, no one in accordance with the requirements of sterilization; partial disinfection endoscopy and The accessories of the micro-organisms pollution; 10 hospitals bronchoscopy and accessories, there are three pollution, one of the Department of serious pollution; disinfection of 17 gastroscopy and accessories, there are 5 pollution, of which 2 are Severe pollution, a very serious pollution. Conclusion Some hospitals in our city have weak concept of bronchoscopy and gastroscope disinfection, non-standard cleaning and disinfection, improper use of disinfectant, too short disinfection time, leading to the contamination of pathogenic bacteria in many endoscopes and their accessories after disinfection. Serious hidden dangers, urgent attention and solution