【摘要】 目的:探讨内镜清洗消毒机对胃镜污染乙肝病毒(HBV)的清除破坏效果,尝试确定机器消毒的效果及最佳消毒时限。方法:模拟试验将2μg/ml HBsAg涂布在胃镜的镜身、活检钳、活检孔道,对胃镜进行手工消毒及机器消毒1min、3min、5min,收集消毒前、消毒后的标本,测其HBsAg。现场试验以HBsAg阳性病人用后的污染胃镜,作为消毒前对照,经内镜清洗消毒机清毒,胃镜表面涂抹采样,用免疫层析分析技术检测其HBsAg,用聚合酶链反应(PCR)技术检测HBV-DNA。结果:模拟试验消毒前能检测出HBsAg,手工消毒后及机器消毒3min、5min后测不出HBsAg,机器消毒1min后镜身能检测出HBsAg,而活检钳、活检孔道测不出HBsAg。现场试验50例血清HBsAg阳性病人污染的胃镜消毒前,HBsAg阳性检出率为30％(15/50),HBV-DNA阳性检出率为24％(12/50),消毒后HBsAg、HBV-DNA检测均阴性。结论:内镜清洗消毒机消毒3min可有效去除胃镜上污染的HBV。同时具有省时省力、效果不易受人为因素影响的优点。更多还原

【Abstract】 Objective: To investigate the effectiveness of automatic mechanical cleaning and disinfection method and the shortest disinfectant time of automatic mechanical disinfection Methods: Through the imitative experiment on disinfection of gastroscope contaminated with hepatitis B surface antigen, 2ug/ml HBsAg was artificially spreaded on the body of gastrosope, biopsy clamp and biopsy hole. the gastroscope was disinfected by manule method and mechanical one for 1min, 3min, 5min respectively. HBsAg in the samples collected before and after disinfection were tested by immunoassay. Gastroscopes used for patients with positive serum HBsAg were disinfected by automatic disinfection machine, samples were collected before and after treatment.Immunoassay was used to test HBsAg, PCR(Polymerase hain reaction) techniques were used to test HBV - DNA.Results: HBsAg can be detected before disinfection, and can not be detedted after manual disinfection or mechanical one for 3min. or 5min. After mehanical disinfection for 1min, HBsAg can be detected in thesamples collected from the body of gastroscope but can not be detected from biopsy clamp and biopsy hole. After disinfection, 15/50 samples with positive HBsAg became negative, 12/50 samples with positive HBV DNA became negative,too.Conclusion: Automatic mehanical disinfection can effectively remove HBsAg and HBV DNA, and can promote the frequency of utilizing gastrosopy, and can also save man power and prevent atrefact affecting disinfection outcome.更多还原