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朗索消毒

科研先行 - 醫用消毒感控行業Research first, to lay a sense of control medical sterilization industry leadership

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醫用消毒劑

常見軟式內鏡的清洗消毒問題解讀

發表時間:2019-08-22 14:58【

  2016NIAN12YUE27RIYUANWEIJIWEIFABULE《RUANSHINEIJINGQINGXIXIAODUJISHUGUIFAN》(WS507—2016),DANZAISHIJIGONGZUOZHONGNEIJINGDEQINGXIXIAODURENGCUNZAIXIEXUWENTI。SHANGGESHIJIQISHINIANDAI,MEIGUOYIYOUBAODAONEIJINGZHENLIAOGANRANSHIJIANDEFASHENG。JINGUANGUONEIHUANMEIYOULEISISHIJIANDEBAODAO,DANGUOWAIDEJINGYANRENGZHIDEJIEJIAN。


  這些事件的發生都與內鏡的清洗消毒不徹底息息相關,同時也說明軟式內鏡結構復雜,難以清洗,容易造成再處理失敗,交叉感染風險明顯升高。造成內鏡感染的重要原因是生物膜的形成。


  SHENGWUMOZUICHUSHIYOUZIYOUYOUDONGDEXIJUN,FUZHUZAIWUPINBIAOMIANXINGCHENG,XIJUNZHIJIANTONGGUOXINHAOLIANXIXINGCHENGXIANGZHUHEMOGUYANGJIEGOU;CIJIEGOUNENGZUIDAXIANDUJIECHUXUNHUANYINGYANGHEJIANGDIFEIWUDUIJI。SHENGWUMOJUYOUYINGXIANGMIEJUNJIHUOXIAODUJIDECHUANTOUGONGNENG,ZAOCHENGMIEJUNHUOXIAODUSHIBAI。

面對這些問題怎么辦?

1.重視內鏡的床旁預處理工作

  NEIJINGCONGHUANZHETINEIQUCHUHOU,ZAIYUGUANGYUANHESHIPINCHULIQICHAILIZHIQIAN,YINGLIJIYONGHANYOUQINGXIYEDESHIJINHUOSHISHABUCAQUWAIBIAOMIANWUWU,CASHIYONGPINYINGYICIXINGSHIYONG;RANHOUFANFUSONGQIYUSONGSHUIZHISHAO10s;

  JIANGNEIJINGDEXIANDUANZHIRUZHUANGYOUQINGXIYEDERONGQIZHONG,QIDONGXIYINGONGNENG,CHOUXIQINGXIYEZHIZHIQILIURUXIYINGUAN。

  GAIHAONEIJINGFANGSHUIGAI。

  FANGRUYUNSONGRONGQI,SONGZHIQINGXIXIAODUSHI。

  BAOZHENGWURANWUZAIDIYISHIJIANDEDAOCHULI,WEIHOUXUDEQINGXIGONGZUODAHAOJICHU。


2.嚴格執行內鏡的清洗、漂洗、消毒及終末漂洗流程,任何一條內鏡都不得“偷工減量”

  MEIQINGXI1TIAONEIJINGHOUQINGXIYEYINGGENGHUAN。

春节 幸运飞艇  ZHISHAOMEIRIKAISHIZHENLIAOGONGZUOQIANDUIMEITIAONEIJINGCELOU。

春节 幸运飞艇  JIANGQINGXISHUAQINGXIGANJING,QINGXISHUAYINGYIYONGYIXIAODU,GAOSHUIPINGXIAODUHOUBEIYONG。

  QINGXISHIXUXUANZEDAXIAOHESHIDEMAOSHUA,SHUAXICAOZUOSHIZHUYIMAOSHUADEJIAODU。TONGSHIXUJIANGNEIJINGZHILIAOFUJIANDAKAI、XIEZAIDAOZUIXIAOHUA。

  JIANYIXUANZECHAOSHENGQINGXINEIJINGFUJIAN。YOUSHIYANZHENGMING,CHAOSHENGQINGXIKEGENGHAODIQUCHUXIWEIFENGXILIDEWUHUI,ERQIEDUIFUJIANDESUNHAIJIAOXIAO。


3.掌握內鏡消毒劑的正確應用

各國軟式內鏡消毒規范

現在使用的內窺鏡消毒劑

  目前我國適用于內鏡,合法有效的常用產品有:戊二醛、鄰苯二甲醛春节 幸运飞艇、過氧乙酸、復方含氯消毒劑、二氧化氯、酸性氧化電位水。


BIAO1CHANGYONGXIAODUJIDEJIESHAO

常用內鏡消毒劑的介紹

4.用水的要求

春节 幸运飞艇  YINGYOUZILAISHUI、CHUNHUASHUI、WUJUNSHUI。

  ZILAISHUISHUIZHIYINGFUHEGB5749GUIDING(≤100CFU/mL)。CHUNHUASHUIYINGFUHEGB5749DEGUIDING,BINGYINGBAOZHENGXIJUNZONGSHU≤10CFU/100mL(≤0.1CFU/mLvs≤100CFU/mL↑1000BEI);SHENGCHANCHUNHUASHUISUOSHIYONGDELVMOKONGJINGYING≤0.2µm,BINGDINGQIGENGHUAN。WUJUNSHUIWEIJINGGUOMIEJUNGONGYICHULIDESHUI。BIYAOSHIDUICHUNHUASHUIHUOWUJUNSHUIJINXINGWEISHENGWUJIANCE。


5.對于內鏡自動清洗消毒機的要求

春节 幸运飞艇  NEIJINGZIDONGQINGXIXIAODUJIXIANGGUANQIUYINGFUHE《NEIJINGZIDONGQINGXIXIAODUJIWEISHENGYAOQIU》GB30689-2014GUIDING:

春节 幸运飞艇  YINGJUBEIQINGXI、XIAODU、PIAOXI、ZISHENXIAODUGONGNENG。

春节 幸运飞艇  YIJUBEICELOU、SHUIGUOLV、GANZAO、SHUJUDAYINDENGGONGNENG。


6.重視使用中消毒劑的濃度檢測,保證有效的濃度

  SUANXINGYANGHUADIANWEISHUIYINGZAIMEICISHIYONGQIAN,YINGZAISHIYONGXIANCHANGSUANXINGYANGHUADIANWEISHUICHUSHUIKOUCHU,FENBIECEDINGpHHEYOUXIAOLVNONG。

春节 幸运飞艇  YINGZUNXUNCHANPINSHIYONGSHUOMINGSHUJINXINGNONGDUJIANCE。

  CHANPINSHUOMINGSHUWEIXIEMINGNONGDUJIANCEPINLVDE

  YICIXINGSHIYONGDEXIAODUJIHUOMIEJUNJIYINGMEIPICIJINXINGNONGDUJIANCE;

春节 幸运飞艇  ZHONGFUSHIYONGDEXIAODUJIHUOMIEJUNJIPEIZHIHOUYINGCEDINGYICINONGDU,MEICISHIYONGQIANJINXINGJIANCE;

  XIAODUNEIJINGSHULIANGDADAOGUIDINGSHULIANGDEYIBANHOU,YINGZAIMEITIAONEIJINGXIAODUQIANJINXINGCEDING。


7.內鏡清洗質量監測

  YINGCAIYONGMUCEFANGFADUIMEIJIANNEIJINGJIQIFUJIANJINXINGJIANCHA。NEIJINGJIQIFUJIANDEBIAOMIANYINGQINGJIE、WUWUZI。QINGXIZHILIANGBUHEGEDE,YINGZHONGXINCHULI。

春节 幸运飞艇  KECAIYONGDANBAICANLIUCEDING、ATPSHENGWUYINGGUANGCEDINGDENGFANGFA,DINGQIJIANCENEIJINGDEQINGXIXIAOGUO。


8.消毒質量監測

春节 幸运飞艇  XIAODUNEIJINGYINGMEIJIDUJINXINGSHENGWUXUEJIANCE。JIANCECAIYONGLUNHUANCHOUJIANDEFANGSHI,MEICIAN25%DEBILICHOUJIAN。NEIJINGSHULIANGSHAOYUDENGYU5TIAODE,YINGMEICIQUANBUJIANCE;DUOYU5TIAODE,MEICIJIANCESHULIANGYINGBUDIYU5TIAO。

春节 幸运飞艇  JIANCEFANGFAYINGZUNXUNGB15982DEGUIDING,XIAODUHEGEBIAOZHUN:JUNLUOZONGSHU≤20CFU/JIAN。

春节 幸运飞艇  DANGHUAIYIYIYUANGANRANYUNEIJINGZHENLIAOCAOZUOXIANGGUANSHI,YINGJINXINGZHIBINGXINGWEISHENGWUJIANCE,FANGFAYINGZUNXUNGB15982DEGUIDING。


9.內鏡消毒后的采樣方法

春节 幸运飞艇  QUQINGXIXIAODUHOUNEIJING,CAIYONGWUJUNZHUSHEQICHOUQU50mlHANXIANGYINGZHONGHEJIDEXITUOYE,CONGHUOJIANKOUZHURUCHONGXINEIJINGGUANLU,BINGQUANBUSHOUJISONGYAN。CAIYONGBOMOGUOLVFANONGSUOSHI,YINGCAIYONGKONGJING0.45μmDEMOPIAN。


10.國外內鏡自動清洗消毒設備的發展

  GUOWAIMUQIANTICHANGSHIYONGRELINEIJINGQINGXIXIAODUJI,QINGXIXIAODUHOUSHIYONGGANZAOJUGANZAO。SHIYONGMIFENGDEBAOZHUANGDAIBAOCUN。SHIYONGDANBAIZHIJIANCEFANGFADUIQINGXIHOUNEIJINGZHILIANGJINXINGJIANCE。


春节 幸运飞艇  NEIJINGDEQINGXIXIAODUSHIYIYUANGANRANFANGKONGDEZHONGYAOHUANJIE。NEIJINGDEQINGXIXIAODUXUYAOZUOJINGZUOXI,“XIJIEJUEDINGCHENGBAI”YONGZAIZHELISHIZAIHESHIBUGUOLE。NEIJINGDEQINGXIXIAODUZHENGZAIYOUHUAXUEFAXIAODUXIANGZHURELIFAXIAODUFAZHAN,ZHENGZAIYOURENGONGCAOZUOXIANGJIQIQUANCHENGCAOZUOJINJUN,QIDAIZHUWOGUOZAORIYANFACHUGENGHAODEXINXINGNEIJINGXIAODUSHEBEISHESHI。

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