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目的:总结我院内镜中心清洗与消毒过程中发生感染的主要危险因素,制定相应的预防措施,降低内镜感染发生率,确保患者医疗安全。方法:专人检查内镜清洗消毒全过程,统计各个环节发生感染的危险因素。随机抽取600例消毒后处于备用状态的内镜,采集内镜内腔及外表面标本,检测结果作为评估清洗消毒质量指标。结果:检测600例样本合格584例,合格率97.3%,胃镜、肠镜、十二指肠镜、气管镜和超声内镜合格率分别为98.6%,96.8%,95.6%,96.0%和97.2%;16例不合格样本中共检出病原菌28株,其中幽门杆菌13株,大肠埃希菌7株,铜绿假单胞菌4株,绿脓杆菌2株,金黄色葡萄球菌1株,肺炎克雷伯菌1株;16例检测不合格原因分析中,刷洗不彻底占37.5%,未按说明要求使用多酶及消毒液占18.75%,特殊感染患者用过的内镜未做特殊处理占12.5%,内镜干燥不充分及工作人员手卫生不达标各占6.25%。结论:内镜清洗消毒环节引发感染的危险因素众多,应加强对内镜中心所有人员的感染控制教育,定期对清洗消毒人员进行职业化培训,规范管理清洗消毒流程,建立可追溯性登记系统,从各个环节把关内镜清洗消毒的质量,是预防消化内镜中心发生感染的主要手段。
OBJECTIVE: To summarize the main risk factors of infection during the cleaning and disinfection of endoscopic center in our hospital, and to make corresponding preventive measures to reduce the incidence of endoscopic infection and ensure the medical safety of patients. Methods: special inspection endoscopy cleaning and disinfection of the whole process, statistics of various aspects of risk factors for infection. Six hundred and sixty cases of endoscopes, which were in a standby state after disinfection, were randomly selected, and the endoscopic and endoscopic specimens were collected. The test results were used as indexes to evaluate the quality of cleaning and disinfection. Results: The qualified rate of endoscopy, colonoscopy, duodenoscopy, endoscopic bronchoscopy and endoscopic ultrasound were 98.6%, 96.8%, 95.6%, 96.0% and 97.2% 28 strains of pathogens were detected in 16 cases of unqualified samples, of which 13 were H. pylori, 7 strains of Escherichia coli, 4 strains of Pseudomonas aeruginosa, 2 strains of Pseudomonas aeruginosa, 1 strain of Staphylococcus aureus, 1 strains of bacteria; 16 cases failed to analyze the reasons, brushing is not completely accounted for 37.5%, according to the instructions did not require the use of multi-enzyme and disinfectant accounted for 18.75%, special infection in patients with endoscopic treatment without special treatment accounted for 12.5% , Endoscopic drying is inadequate and staff hand hygiene standards are not up to 6.25%. Conclusion: There are many risk factors of infection caused by endoscope cleaning and disinfection, we should strengthen the infection control education for all staff in endoscopy center, regularly carry out vocational training for cleaning and disinfection personnel, standardize the cleaning and disinfection process, establish the traceability registration system, From all aspects of the quality of endoscopic cleaning and disinfection, is to prevent digestive endoscopy center of the main means of infection.