消化内镜医院感染相关危险因素分析及控制措施

Analysis of risk factors and countermeasures of hospital infection under digestive endoscopy

摘要:

目的 探讨该院消化内镜医院感染相关影响因素，并分析其原因和采取相应控制措施。 方法 对2011年1月～2013年10月消化内镜1 860个样本监测结果分析，合格1786个，为对照组；不合格74个，为观察组，分析感染相关影响因素。 结果 观察组清洗时间为（18.36±1.04）min，低于对照组（24.74±1.29）min，差异具有显著性（P <0.05）；观察组戊二醛（<1.8%）、多酶洗液浓度不合格和操作不规范分别为21.62%（16/74）、20.27%（15/74）和18.92%（14/74），均高于对照组3.25%（58/1 786）、2.97%（53/1 786）和3.47%（62/1 786），差异具有显著性（P <0.05）；观察组干燥保存为71.62%（53/74），低于对照组96.92%（1 731/1 786），差异具有显著性（P <0.05）。观察组平均检查患者数量（28.93±2.70）人次/天，高于对照组（24±3.42）人次/天，差异具有显著性（P <0.05）。Logistic分析显示，消毒效果与清洗时间、戊二醛（<1.8%）、多酶清洗液浓度、干燥保存、检查患者数量和操作不规范等相关，差异具有显著性（P <0.05）。 结论 消化内镜的医院感染因素与清洗时间、戊二醛（<1.8%）、多酶清洗液浓度、干燥保存、检查患者数量和操作不规范有关。应加大内镜工作人员培训，提高内镜消毒的管理，严格操作规程，确保医疗安全。

Abstract:

【Objective】 To explore the related influencing risk factors of hospital infection under digestive endoscopy and analyze the cause and take control measures. 【Methods】 1 860 sample monitoring results were analyzed from January in 2011 to October in 2013 in digestive endoscopy, qualified 1 786 cases were used as the control group, unqualified 74 cases as the observation group. The infection related factors were analyzed. 【Results】 The cleaning time of the observation group was (18.36±1.04) min, lower than that of the control group (24.74±1.29) min, the difference was significant statistically (P <0.05); Glutaraldehyde (<1.8%), the multi enzyme cleaner concentration of observation group and non-standard operation were 21.62% (16/74), 20.27% (15/74) and 18.92% (14/74), were higher than the control group 3.25% (58/ 1 786), 2.97% (53/1 786) and 3.47% (62/1 786), the difference was significant statistically(P <0.05); Dry preservation of observation group was 71.62% (53/74), lower than that of the control group 96.92%(1 731/1 786), the difference was significant statistically(P <0.05). The average number of patients received check-up in observation group was (28.93±2.70) per day, higher than that of the control group (28.93±2.70) per day, the difference was statistically significant(P <0.05). Logistic analysis shows that disinfection related with cleaning time, glutaraldehyde(<1.8%), multi enzyme cleaning solution concentration, drying, examination of the patient and the number of non-standard operation, the difference was statistically significant(P <0.05). 【Conclusion】 The hospital infection factors were related with cleaning time, glutaraldehyde(<1.8%), multi enzyme cleaning solution concentration, drying, quantity and operating examination in patients and irregular operation. We should increase the endoscopic staff training, improve the endoscope disinfection management, takestrict operation rules to ensure medical safety.