透明PVC气管内套管应用乙醇浸泡消毒的临床研究及效果评价

Clinical study and effectiveness evaluation on ethanol immersion disinfection of transparent PVC endotracheal tube

摘要:

目的探讨乙醇对透明PVC气管内套管的消毒效果，以及乙醇最佳更换时间。方法第一阶段：选择2011年4—7月使用透明PVC气管内套管的患者58例，对不同时间段(乙醇新开启时及开启后12、24、48、72 h)浸泡消毒透明PVC气管内套管的乙醇浓度及含菌量进行检测(乙醇连续使用72 h)。第二阶段：选择2011年7—11月使用透明PVC气管内套管的患者46例，随机分为实验组（新流程：浸泡罐和乙醇每48 h更换1次）和对照组（原流程：浸泡罐和乙醇每24 h更换1次），比较两组1个月内的更换频次、人力、费用及感染发生率。结果乙醇新开启时的浓度与开启后12、24、48 h的浓度比较，差异均无统计学意义（均P＞0.05）；开启后72 h，乙醇浓度显著低于新开启时［（71.82±0.77）% vs (72.98±0.83）%］（t=17.60，P＜0.05）。不同时间段乙醇消毒效果均符合标准。实验组费用显著低于对照组［（56.70±9.30）元 vs (178.20±4.70）元］，人力亦显著低于对照组［（37.20±5.80）人次/月vs (120.30±6.70）人次/月］ (均P＜0.05)；感染发生率，实验组(13.04%)与对照组（17.39%)比较，差异无统计学意义（t=0.17，P＞0.05)。结论乙醇浸泡消毒透明PVC气管内套管是一种保证效果、成本低、操作简便、安全的消毒方法。在临床，乙醇罐密闭情况良好且开启频次低的情况下，可持续使用48 h后更换。

Abstract:

To evaluate the disinfectant efficacy of  ethanol on transparent PVC endotracheal tube , as well as  the best replacement time. MethodsPhase I: 58 patients with transparent PVC endotracheal tube  between April and  July 2011 were  selected , the concentration and bacterial count of ethanol used for immersion disinfection of transparent PVC endotracheal tube were detected at different time point (upon opening of the new ethanol and 12, 24, 48 and 72 h after opening ), ethanol was used continuously for 72 h . Phase II: 46 patients with transparent PVC endotracheal tube between July and  November 2011 were  selected and divided into experimental group (new process: immersion tank and ethanol were changed every 48 h) and control group (former process: immersion tank and ethanol were changed every 24 h), the frequency of change, manpower, cost and incidence of infection within one month between two groups were compared .ResultsThe difference between ethanol upon opening and 12, 24 as well 48 h after opening  were not statistically significant (all P>0.05);72 h after opening, ethanol concentration was significantly lower than the newly opened (［71.82±0.77］%vs ［72.98±0.83］%,t=17.60,P<0.05). Disinfection efficacy of ethanol at different time points all met the required standards. Cost of experimental group was significantly lower than the control group (CNY［56.70±9.30］ vs CNY［178.20±4.70］),  and manpower was also significantly lower than the control group (［37.20±5.80］ persontime/month vs ［120.30±6.70］ persontime/month,all P<0.05); Incidence of infection was not statistically significant between two groups(13.04% vs 17.39%,t=0.17,P>0.05). ConclusionEthanol immersion disinfection is a effective, low cost, easy operation and safe disinfection method, ethanol can be used continuously for 48 hours before changed  if ethanol tank is sealed well and with low opening frequency.