影响清洗效果的因素

　　Factors affecting cleaning effectiveness

　　消毒供应中心是负责医疗器械清洗消毒处理的部门，随着手术量日益的增长，很多医疗机构消毒供应中心使用全自动清洗消毒机处理医疗器械清洗已经成为主要清洗手段。机械清洗分为全自动、半自动、超声清洗机、长龙式等多种形式，有的清洗机带加热系统和干燥系统。

　　The disinfection supply center is the department responsible for cleaning and disinfecting medical equipment. With the increasing number of surgeries, many medical institutions' disinfection supply centers use fully automatic cleaning and disinfection machines to clean medical equipment, which has become the main cleaning method. Mechanical cleaning is divided into various forms such as fully automatic, semi-automatic, ultrasonic cleaning machines, and long queue cleaning machines. Some cleaning machines are equipped with heating and drying systems.

　　目前国内部分医院采用机械清洗，全自动喷淋式清洗消毒机清洗手术器械前使用多酶液浸泡器械的方法，可使同一部器械表面、轴节、咬合面的清洗质量明显提高。超声波自动清洗机的洗净作用是极高频率水的挤压产生水泡形成真空区而产生拉力，将附在器械上的污垢松动吸离，它比人工清洗好的理由是它可以清除刷子无法触及的污物。

　　At present, some hospitals in China use mechanical cleaning and fully automatic spray cleaning and disinfection machines to soak surgical instruments in multi enzyme solution before cleaning, which can significantly improve the cleaning quality of the same instrument surface, joint, and occlusal surface. The cleaning function of an ultrasonic automatic cleaning machine is to create a vacuum zone by squeezing water at extremely high frequencies, which generates tension and loosens dirt attached to the instrument. The reason why it is better than manual cleaning is that it can remove dirt that cannot be touched by brushes.

　　相比于手工清洗，全自动清洗消毒机的机械清洗过程是一个多因素参与的复杂过程。不同厂家不同规格型号的全自动清洗消毒机清洗过程不同，清洗效果主要影响因素包括喷淋机械力，器械清洗剂，清洗温度，清洗时间以及清洗用水的水质等。每个因素的改变不仅会影响整体清洗效果，也可能会影响到其它因素的作用效果。

　　Compared to manual cleaning, the mechanical cleaning process of fully automatic cleaning and disinfection machines is a complex process involving multiple factors. The cleaning process of fully automatic cleaning and disinfection machines of different manufacturers and specifications varies, and the main factors affecting the cleaning effect include spray mechanical force, instrument cleaning agents, cleaning temperature, cleaning time, and the quality of cleaning water. The changes in each factor not only affect the overall cleaning effect, but may also affect the effectiveness of other factors.

　　一、喷淋机械效果

　　1、 Spray mechanical effect

　　全自动清洗消毒机的喷淋清洗的出水口水压、水量是形成喷淋机械力的主要因素。喷淋出水口的出水的水压越大，水量越大，形成的机械清洗力越强，更容易把医疗器械表面的污染物质冲洗干净。过大的机械力会对器械，尤其是一些精细部位造成损伤，降低器械的使用寿命，合理设置清洗机的水压和水量保证既不损伤医疗器械又能达到良好的清洗效果尤为重要。此外，喷淋悬臂的正常运作与否，医疗器械的装载是否合理等都会影响喷淋的作用效果。

　　The water pressure and volume at the outlet of the fully automatic cleaning and disinfection machine's spray cleaning are the main factors that form the mechanical force of the spray. The higher the water pressure and volume of the water from the sprinkler outlet, the stronger the mechanical cleaning force formed, making it easier to wash away the pollutants on the surface of medical devices. Excessive mechanical force can cause damage to medical equipment, especially some delicate parts, reducing the service life of the equipment. It is particularly important to set the water pressure and volume of the cleaning machine reasonably to ensure that it does not damage medical equipment and can achieve good cleaning results. In addition, the normal operation of the spray cantilever and the reasonable loading of medical equipment will affect the effectiveness of the spray.

　　二、多酶清洗剂

　　2、 Multi enzyme cleaning agent

　　研究表明，发现单纯的机械清洗对残存有有机物的器械达不到理想的清洗效果，而使用多酶液浸泡手工刷洗再清洗机清洗的效果更好。用于医疗器械清洗的含酶清洗剂本身的性质，使用时的稀释浓度，稀释用水的水质都会直接影响清洗效果。如果清洗剂与医疗器械材质不兼容，不仅会造成污染物残留，还会对医疗器械造成损伤；如果清洗剂稀释使用浓度过低，容易造成污染物质残留，经过后续干燥过程，污物在医疗器械表面干涸，更难去除，而如果使用清洗剂的浓度过高，则会成为成本上的浪费。另外，稀释用水的水质过硬或者含有有机物质，很容易造成清洗剂失活。同时，清洗时的水温温度，清洗剂接触时间也会影响清洗剂的作用，常规清洗剂的时间不低于120秒钟。

　　Research has shown that mechanical cleaning alone does not achieve ideal cleaning results for instruments with residual organic matter, while using a multi enzyme solution soaked in manual scrubbing followed by cleaning with a cleaning machine yields better results. The properties of enzyme based cleaning agents used for medical device cleaning, the dilution concentration during use, and the water quality of the dilution water all directly affect the cleaning effect. If the cleaning agent is incompatible with the material of the medical device, it will not only cause residual pollutants, but also damage the medical device; If the dilution concentration of the cleaning agent is too low, it is easy to cause residual pollutants. After the subsequent drying process, the dirt will dry up on the surface of the medical device, making it more difficult to remove. If the concentration of the cleaning agent is too high, it will become a waste of cost. In addition, the water used for dilution is of high quality or contains organic substances, which can easily cause the cleaning agent to become inactive. At the same time, the water temperature during cleaning and the contact time of the cleaning agent can also affect the effectiveness of the cleaning agent. The time for conventional cleaning agents is not less than 120 seconds.

　　三、清洗温度

　　3、 Cleaning temperature

　　常规清洗剂清洗时水温的温度越高，越容易发挥清洗剂效果，清洗效果也越好。但是医疗器械清洗温度的设定应该考虑到污物在高温下凝结变性问题，酶清洗剂在过高的温度下容易失去活性，一般含酶清洗剂要求水温25℃～55℃之间。

　　The higher the water temperature during regular cleaning with cleaning agents, the easier it is to achieve the cleaning effect and the better the cleaning effect. However, the setting of the cleaning temperature for medical devices should take into account the problem of dirt condensation and denaturation at high temperatures. Enzyme cleaning agents are prone to lose their activity at excessively high temperatures, and generally require a water temperature between 25 ℃ and 55 ℃ for enzyme containing cleaning agents.

　　需要特别注意的是清洗剂中表面活性剂发挥作用也需要适宜的温度。

　　It should be noted that the surfactant in the cleaning agent also requires a suitable temperature to function effectively.

　　四、清洗时间

　　4、 Cleaning time

　　清洗时间越长，越有利于清洗彻底。但是过长的清洗时间不仅造成成本上的浪费，也会影响整个医疗器械再处理的进度。清洗时间设定过短则不利于清洗剂在医疗器械表面停留。

　　The longer the cleaning time, the more conducive it is to thorough cleaning. However, excessive cleaning time not only results in cost waste, but also affects the progress of the entire medical device reprocessing. Setting the cleaning time too short is not conducive to the cleaning agent staying on the surface of medical devices.

　　影响医疗器械清洗效果的因素繁多复杂且互相影响，临床操作要严格按照产品厂家说明书操作和执行，每批次监测清洗消毒器的物理参数及运转情况，记录并归档，对清洗消毒器的效果可每年采用清洗效果指示物进行监测，每年检测清洗消毒器的主要性能参数，如时间、温度、A0值等。清洗消毒器新安装、更新、大修更换清洗剂、改变消毒参数或装载方法等时，应遵循生产厂家的使用说明或指导手册进行检测，清洗消毒质量检测合格后，清洗消毒器方可使用。

　　There are numerous and complex factors that affect the cleaning effect of medical devices, and they interact with each other. Clinical operations must strictly follow the product manufacturer's instructions, monitor the physical parameters and operation of each batch of cleaning and disinfection equipment, record and archive them, and monitor the effectiveness of cleaning and disinfection equipment annually using cleaning effect indicators. The main performance parameters of the cleaning and disinfection equipment, such as time, temperature, A0 value, etc., should be tested annually. When installing, updating, repairing, replacing cleaning agents, changing disinfection parameters or loading methods, etc., the cleaning and disinfection equipment should be tested according to the manufacturer's instructions or guidance manual. After passing the quality inspection of cleaning and disinfection, the cleaning and disinfection equipment can be used.

　　本文由   喷淋清洗机  友情奉献.更多有关的知识请点击  http://www.jnthcsb.com/   真诚的态度.为您提供为全面的服务.更多有关的知识我们将会陆续向大家奉献.敬请期待.

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