【摘要】 目的 观察腔镜手术器械多酶洗涤剂残留的影响因素。方法 选择2022年6月至2023年6月许昌市中心医院腔镜手术使用后的78件器械，均使用多酶洗涤剂清洗。观察洗涤剂残留情况，统计残留率。采用单因素与Logistic多因素回归分析腔镜手术器械多酶洗涤剂残留的影响因素。结果 78件腔镜手术器械中，多酶洗涤剂残留器械有12件，残留率为15.38%。残留组清洗流程不熟悉、预处理不规范、重度污染程度、漂洗与终末漂洗时长<20 min、器械干燥温度≥140℃的腔镜手术器械多于未残留组，差异有统计学意义(P<0.05)。Logistic多因素回归分析结果显示，清洗流程不熟悉(OR=1.958)、预处理不规范(OR=3.085)、重度污染程度(OR=4.031)、漂洗与终末漂洗时长<20min(OR=3.957)、器械干燥温度≥140℃(OR=2.967)是腔镜手术器械多酶洗涤剂残留的独立影响因素(P<0.05)。结论 腔镜手术器械采用多酶洗涤剂清洗后可能会发生洗涤剂残留，其影响因素包含清洗流程熟悉程度、预处理规范性、污染程度、漂洗与终末漂洗时长及器械干燥温度。临床应针对各项影响因素采取专业干预措施，加强对各清洗环节的质量监督，从而降低洗涤剂残留发生风险。更多还原

【Abstract】 Objective To observe factors influencing residual multi-enzyme detergent on endoscopic surgical instruments. Methods Seventy-eight instruments used in endoscopic surgeries at Xuchang Central Hospital from June 2022 to June 2023 were all cleaned with a multi-enzyme detergent. Detergent residue was assessed and the residue rate was calculated. Univariate analysis and multivariate logistic regression were used to identify factors associated with residual multi-enzyme detergent on endoscopic surgical instruments. Results Among 78 endoscopic surgical instruments, 12 had residual multi-enzyme detergent, with a residue rate of 15.38%. Compared with the non-residue group, the residue group included more instruments with lack of familiarity with the cleaning workflow, non-standard pre-cleaning, severe contamination level, rinse and final rinse times < 20 min, and instrument drying temperature ≥ 140 °C; the differences were statistically significant(P < 0.05). Multivariate logistic regression showed that lack of familiarity with the cleaning workflow(OR =1.958), non-standard pre-cleaning(OR =3.085), severe contamination level(OR =4.031), rinse and final rinse times < 20 min(OR =3.957), and instrument drying temperature ≥ 140 °C(OR =2.967) were independent factors associated with residual multi-enzyme detergent on endoscopic surgical instruments(P <0.05). Conclusion Residual detergent may occur after cleaning endoscopic surgical instruments with a multi-enzyme detergent. Influencing factors include familiarity with the cleaning workflow, standardization of pre-cleaning, contamination level, durations of the rinse and final rinse, and instrument drying temperature. Targeted professional interventions should be implemented for these factors, and quality oversight of each cleaning step should be strengthened to reduce the risk of detergent residue.更多还原