三种灭菌方法对腹腔镜器械的灭菌效果、成本与安全性

Effect, cost and safety of three sterilization methods for laparoscopic device

摘要:

目的 探讨压力蒸汽灭菌、低温等离子灭菌、环氧乙烷灭菌方法对腹腔镜器械的灭菌效果、成本与安全性。 方法 选取某三级甲等综合性医院消毒供应中心2020年11—12月灭菌的腹腔镜器械90件。按照随机数字表法，将清洗、干燥、包装后的腹腔镜分别选择上述3种灭菌方法进行灭菌，每组各30套。监测灭菌效果，分析3种灭菌方法的时间、经济成本，并比较其灭菌安全性。 结果 3组器械灭菌效果的物理、化学、生物学监测合格率均为100.00%，光学视管成像质量均为100.00%。压力蒸汽灭菌、过氧化氢低温等离子灭菌、环氧乙烷灭菌平均每组腹腔镜灭菌时间分别为3、21.7、320 min；每套腹腔镜灭菌设备与维护成本分别为：1.32、23.74、100.46元/套；每套腹腔镜灭菌所需耗材成本分别为15.60、116.67、106.67元/套；所需人力成本分别为1.55、11.17、164.96元/套。3种灭菌方法平均每套腹腔镜灭菌所需总成本分别为18.47、151.58、372.09元/套。压力蒸汽灭菌法无消毒剂残留，医护人员无不良反应；过氧化氢低温等离子和环氧乙烷灭菌法有消毒剂残留，对医护人员眼睛、呼吸道、皮肤有刺激。 结论 压力蒸汽灭菌法较其他两种方法在时间和成本、安全性方面都有明显优势，适合于耐热、耐湿的腹腔镜器械灭菌。

Abstract:

Objective To explore the effect, cost and safety of pressure steam sterilization, low temperature plasma sterilization and ethylene oxide sterilization on laparoscopic device. Methods A total of 90 sets of laparoscopic device in a tertiary first-class hospital from November to December 2020 were selected. According to random number table method, laparoscopes after cleaning, drying and packaging were respectively sterilized by the above three sterilization methods, with 30 sets in each group. Sterilization effect was monitored, time and economic cost of three sterilization methods were analyzed, sterilization safety was compared. Results Qualified rates of physical, chemical and biological monitoring of sterilization effect of three groups of laparoscopes were all 100.00%, quality of optical imaging were all 100.00%. The average sterilization time of pressure steam sterilization, hydrogen peroxide low temperature plasma sterilization and ethylene oxide sterilization were 3, 21.7 and 320 minutes respectively; cost of sterilization and maintenance of each set of laparoscope were 1.32, 23.74 and 100.46 Yuan/set respectively; cost of consumables required for sterilization of each set of laparoscope were 15.60, 116.67 and 106.67 Yuan respectively; the required human cost were 1.55, 11.17 and 164.96 Yuan/set respectively. The average overall cost for sterilization of each set of laparoscope by three sterilization methods were 18.47, 151.58 and 372.09 Yuan/set respectively. There was no disinfectant residue in pressure steam sterilization method, and there was no adverse reaction among health care workers; there was disinfectant residues in hydrogen peroxide low temperature plasma and ethylene oxide sterilization, which had irritation to the eyes, respiratory tract and skin of health care workers. Conclusion Compared with the other two methods, pressure steam sterilization has obvious advantages in time, cost and safety, it is suitable for heat-resistant and moisture-resistant laparoscopic device sterilization.