滤膜法与涂抹法在软式内镜消毒效果评估中的应用

Application of filter membrane method and smear method in the evaluation of disinfection effect of flexible endoscope

摘要:

目的 对比滤膜法与涂抹法在软式内镜消毒效果评估中的应用价值。方法 抽取2022年1月－2022年11月该院消化内镜中心清洗消毒后的242条软式内镜，所有内镜均采用滤膜法和涂抹法检测消毒效果，比较两种检测方法的合格率、病原菌检出率、菌落检出情况和使用成本。结果 242条软式内镜中，滤膜法检测总合格率低于涂抹法，病原菌总检出率和菌落检出数明显多于涂抹法，差异均有统计学意义（P < 0.05）。两种评价方法中，胃镜检出菌落数均以 ≤ 100 cfu/件为主；肠镜检出菌落数均以 ≥ 100 cfu/件为主，但两组组间比较，差异无统计学意义（P > 0.05）。滤膜法的经济成本和时间成本均高于涂抹法（P < 0.05），同时，滤膜法增加了976元的抽滤系统年折旧费。结论 相较于涂抹法，滤膜法对软式内镜消毒的评估效果更佳，但其经济成本和时间成本也更高。为建设绿色环保型医院，需适当增加内镜中心投入，推荐应用滤膜法。

Abstract:

Objective To compare the application value of filter membrane method and smear method on the evaluation of disinfection effect of flexible endoscope.Methods 242 flexible endoscopes after cleaning and disinfection from January 2022 to November 2022 were collected as the study subjects, and the disinfection effect of all endoscopes was tested by filter membrane method and smear method. The qualified rate, pathogen detection rate, colony detection and use cost of the two detection methods were compared.Results Among the 242 flexible endoscopes, the total qualified rate of filter membrane method was lower than that of smear method while the total detection rate of pathogenic bacteria and the number of bacterial colony were significantly higher than those of smear method (P < 0.05). In the two evaluation methods, the colony count detected by gastroscopy was mainly ≤ 100 cfu/n, and the colony count detected by enteroscopy was mainly ≥ 100 cfu/n (P > 0.05). The economic cost and time cost of filter membrane method were higher than those of smear method (P < 0.05), and filter membrane method increased the annual depreciation cost of the suction filtration system of 976 yuan.Conclusion Compared with smear method, filter membrane method is more effective in evaluating the disinfection of flexible endoscope, but its economic cost and time cost are also higher. However, in order to build a green environment-friendly hospital, it is necessary to increase the investment of endoscopy center, thus it is recommended to apply filter membrane method.