目的：调查消化内镜在江阴市各级医院清洗消毒现状，旨在规范内镜清洗消毒工作，预防消化内镜检查造成的交叉感染。方法依据卫计委制定的《内镜清洗消毒技术操作规范（2004版）》和《软式内镜清洗消毒技术规范》送审稿制定督查表，并结合江阴市实际情况制定问卷表，采取现场督查和问卷调查相结合的方法，于2015年6月对江阴市24所开展消化内镜诊疗的医院进行内镜清洗消毒情况调查，将调查结果进行分析总结。结果在24所不同级别的医院中，均明确监管部门并建立了管理制度，成立专门的内镜室感染管理小组占50%，体现质量持续改进占67%，接受内镜消毒专业培训占71%。内镜室设有单独清洗间占71%，全部配备有清洗消毒槽，末洗配备过滤水占13%，一级医院内镜清洗消毒必备设备不够完善。24所医院都使用多酶洗液，但做到一镜一换占50%，均使用一次性活检钳，但有2所一次性活检钳过期，占8%。结论江阴市二级及二级以下医院内镜清洗消毒方面存在诸多问题，需加强管理，加大投入，定期督查指导，以提高内镜清洗消毒质量。%Objective To investigate the current situation of cleaning and disinfection of digestive endoscope in hospitals of different grades in Jiangyin, to standardize its cleaning and disinfection so as to prevent cross infection in hospital. Methods The checklist was designed based on 2004 national guidelines of cleaning and disinfection for GI endoscopy and the standard for cleaning and disinfection of flexible endoscopy (draft edition), and the questionnaire based on the actual situation of Jiangyin. We made a survey of cleaning and disinfection of digestive endoscope in 24 hospitals in Jiangyin in June 2015, with on-site inspection and questionnaire survey. Results There were regulatory authorities and management system in all hospitals and the hospitals with specialized endoscopic management team accounted for 50%. Of the total, 67% of the hospitals made continuous quality improvement and specialized endoscopic disinfection training was conducted in 71% of the hospitals. Institutes with separate cleaning room in endoscopic room accounted for 71% and all equipped with cleaning and disinfection tank but 13% institutes did not provided with filtered water at the end of washing, and a number of faultiness occurred in the necessary equipments for endoscopic cleaning and disinfection in first-level hospital. There was multiple enzyme lotion in all hospitals, but only 50%of them could accomplish changing multiple enzyme lotion every time after the examination. All instutites used disposable biopsy forceps, but there were 2 institutes with expired disposable biopsy forceps, accounting for 8%. Conclusion There are many problems in endoscopic cleaning and disinfection in second-class or below hospitals in Jiangyin, so we should strengthen management, increase investment, regularize supervision and guidance, so as to improve the quality of endoscopic cleaning and disinfection.
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