Objective To compare the influences of different storage time and pretreatment methods on the cleaning effect and the cleaning effect of different evaluation methods after nonthermal cleaning and disinfecting for surgical instruments. Methods 300 surgical instruments with obvious blood that recovered from the operation room in our hospital from January 2013 to December 2016 were selected as the research object, of which 188 vessel forceps and 112 tissue forceps. 300 surgical instruments were randomly divided into two groups (group Ⅰ and group Ⅱ), of 150 cases. Group Ⅰ was given natural storage in the operation room before send the supply room, group Ⅱ timely washed and kept the moisture in the operation room. The operation time of each group was set as <3, 3~6, >6 h, and each group had 50 pieces. After disinfection, three methods (the corrected visual acuity, occult blood test method and colony counting method) were used to evaluate the positive rate of each group, and the detection results of different pretreatment, storage time and evaluation methods were compared. Results For the three evaluation methods, positive rates of group Ⅰ and group Ⅱ under the conditions of <3 h were no significant difference (P>0.05), while under the condition 3~6 h and >6 h positive rates appeared significant difference - the positive rate of group Ⅱ was significantly lower than that of group Ⅰ (P<0.05). With the same pretreatment and storage time, positive rate from corrected visual acuity test was significantly lower than that from the occult blood test and colony counting (P<0.05). The detection results from occult blood test method and colony counting method were no significant difference (P>0.05). Conclusion Timely pretreatment for surgical instruments after using can effectively reduce the difficulty of cleaning and improve the cleaning effect. The longer the storage time before cleaning, the worse the cleaning effect. Occult blood test method and colony counting method are better than visual correction method.%目的 对比非热力清洗消毒手术器械使用后不同放置时间、预处理方法 对清洗效果的影响及不同评价方式下的清洗效果.方法以2013年1月~2016年12月我院手术室回收的300件具明显血迹的手术器械为研究对象,其中血管钳188件,组织钳112件.将300件手术器械随机分为两组(Ⅰ组和Ⅱ组),每组各150件.Ⅰ组在送供应室前于手术室自然存放,Ⅱ组在手术室及时冲洗保湿存放.将每组手术器械根据清洗前放置时间设为3、3~6、>6 h组,每组各50件.清洗消毒后采用矫正视力法、隐血试纸法与菌落计数法评价每组的检测阳性率,并对不同预处理方式、不同放置时间及不同评价方法的检测结果 进行比较.结果3种评价方式下,Ⅰ组和Ⅱ组<3 h条件下组间检测阳性率均无显著性差异(P>0.05),3~6 h与>6 h条件下两组的检测阳性率开始出现显著性差异,Ⅱ组的阳性率明显低于Ⅰ组(P<0.05).同种预处理方式、同样放置时间条件下,矫正视力法对手术器械的检测阳性率明显低于隐血试纸法与菌落计数法,差异有统计学意义(P<0.05),隐血试纸法与菌落计数法间检测结果则未见显著性差异(P>0.05).结论 手术器械在使用后及时进行预处理,可有效降低清洗难度,提高清洗效果;清洗前放置时间越长,清洗效果越差;隐血试纸法与菌落计数法的评价效果要优于矫正视力法.
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