本文關(guān)鍵詞： 快速多酶清洗劑 吸唾管道 生物膜 細(xì)菌菌落數(shù) 感染風(fēng)險(xiǎn)　出處：《吉林大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:相關(guān)研究表明口腔綜合治療臺(tái)的吸唾管道內(nèi)存在微生物污染,這為生物膜的形成提供了有利條件�；颊咴谶M(jìn)行口腔治療的過程中,應(yīng)用負(fù)壓吸唾頭吸引口腔內(nèi)唾液、血液和碎屑等物質(zhì)時(shí)有發(fā)生回吸的可能,細(xì)菌可通過回吸進(jìn)入患者口腔,對(duì)患者構(gòu)成潛在風(fēng)險(xiǎn)。故本實(shí)驗(yàn)將吸唾管道作為研究對(duì)象,觀察吸唾管道中寄存于生物膜內(nèi)細(xì)菌的生長狀況。以往的研究大多僅采用水對(duì)吸唾管道進(jìn)行清潔,本研究采用快速多酶清洗劑來清除口腔吸唾管道內(nèi)的生物膜,探討不同濃度的快速多酶清洗劑對(duì)吸唾管道內(nèi)生物膜的清除效果,得出最佳濃度并驗(yàn)證最佳清除時(shí)機(jī),從而有效減少回吸污染,降低不同患者間交叉感染的風(fēng)險(xiǎn),提高醫(yī)護(hù)人員預(yù)防交叉感染的意識(shí)以及為臨床的交叉感染預(yù)防工作提供參考。方法:在2016年7月~2016年12月期間,將吉林大學(xué)口腔醫(yī)院某科室的口腔綜合治療臺(tái)(一臺(tái))的吸唾管道作為研究對(duì)象。依次對(duì)使用過1~7天的吸唾管道進(jìn)行采樣。其中,第1~5天的吸唾管道處于工作狀態(tài),第6~7天的吸唾管道處于非工作狀態(tài)。1條吸唾管道的長度為120cm,將保留的96cm管路以1.5cm為間距分為64段,將64段吸唾管道的管路片隨機(jī)分為4組,每組16段。A組(空白對(duì)照組):采用無菌蒸餾水浸泡的方式,無菌蒸餾水容量為500ml,溫度為40℃,浸泡時(shí)間5min;B_1組(實(shí)驗(yàn)組):采用濃度為1:100的快速多酶清洗劑浸泡,清洗劑容量為500ml,溫度為40℃,浸泡時(shí)間5min;B_2組(實(shí)驗(yàn)組):采用濃度為1:150的快速多酶清洗劑浸泡,清洗劑容量為500ml,溫度為40℃,浸泡時(shí)間5min;B_3組(實(shí)驗(yàn)組):采用濃度為1:200的快速多酶清洗劑浸泡,清洗劑容量為500ml,溫度為40℃,浸泡時(shí)間5min。評(píng)價(jià)指標(biāo):細(xì)菌菌落數(shù)、生物膜清除率、掃描電鏡觀察生物膜形態(tài)、顯微鏡觀察細(xì)菌形態(tài)結(jié)果:1.第1~7天A組(空白對(duì)照組)的細(xì)菌菌落數(shù)(CFU/cm2)分別為30.00±10.214、63.47±19.057、179.72±59.196、608.13±236.141、1471.41±634.854、7318.75±2287.038、9480.47±2909.568,第1~3天生物膜的細(xì)菌菌落數(shù)呈較慢增長狀態(tài),第4~5天生物膜的細(xì)菌菌落數(shù)呈較快增長狀態(tài),第6~7天生物膜的細(xì)菌菌落數(shù)呈快速增長狀態(tài)。2.第5、6、7天A組(空白對(duì)照組)的細(xì)菌菌落數(shù)(CFU/cm2)有顯著的統(tǒng)計(jì)學(xué)差異(P0.05)。3.第1~7天B_1組(1:100)、B_2組(1:150)、B_3組(1:200)三組的細(xì)菌菌落數(shù)(CFU/cm2)與A組比較均有統(tǒng)計(jì)學(xué)差異(P0.05)。4.第1~3天B_1組(1:100)、B_2組(1:150)、B_3組(1:200)三組的細(xì)菌菌落數(shù)(CFU/cm2)均無統(tǒng)計(jì)學(xué)差異(P0.05)。5.第4~5天B_1組(1:100)、B_2組(1:150)、B_3組(1:200)三組的細(xì)菌菌落數(shù)(CFU/cm2)有統(tǒng)計(jì)學(xué)差異(P0.05),其中B_1組(1:100)與B_2組(1:150)的細(xì)菌菌落數(shù)無統(tǒng)計(jì)學(xué)差異(P0.05),B_1組(1:100)與B_3組(1:200)的細(xì)菌菌落數(shù)有統(tǒng)計(jì)學(xué)差異(P0.05),B_2組(1:150)與B_3組(1:200)的細(xì)菌菌落數(shù)有統(tǒng)計(jì)學(xué)差異(P0.05)。6.第6~7天B_1組(1:100)、B_2組(1:150)、B_3組(1:200)三組的細(xì)菌菌落數(shù)(CFU/cm2)有統(tǒng)計(jì)學(xué)差異(P0.05),其中B_1組(1:100)與B_2組(1:150)的細(xì)菌菌落數(shù)有統(tǒng)計(jì)學(xué)差異(P0.05),B_1組(1:100)與B_3組(1:200)的細(xì)菌菌落數(shù)有統(tǒng)計(jì)學(xué)差異(P0.05),B_2組(1:150)與B_3組(1:200)的細(xì)菌菌落數(shù)無統(tǒng)計(jì)學(xué)差異(P0.05)。7.第1~7天B_1組(1:100)的生物膜清除率(%)分別為86.23、85.73、84.84、80.79、76.16、63.21、51.08;第1-7天B_2組(1:150)的生物膜清除率(%)分別為85.30、84.10、84.11、78.69、73.32、50.61、36.51;第1-7天B_3組(1:200)的生物膜清除率(%)分別為85.00、83.80、82.56、74.77、69.24、46.98、30.85。8.對(duì)全新吸唾管道、使用過7天的吸唾管道和經(jīng)濃度為1:100的快速多酶清洗劑浸泡清潔過的吸唾管道做掃描電鏡觀察,全新吸唾管道可觀察到光滑的管腔平面,使用過7天的吸唾管道可觀察到生物膜結(jié)構(gòu),經(jīng)濃度為1:100的快速多酶清洗劑浸泡清潔過的吸唾管道可觀察到被分解的生物膜結(jié)構(gòu)。從培養(yǎng)48小時(shí)后的營養(yǎng)瓊脂培養(yǎng)皿中選取典型菌落進(jìn)行革蘭染色后發(fā)現(xiàn),可檢測出桿菌和球菌(鏈球菌)的存在。結(jié)論:1.口腔吸唾管道內(nèi)存在生物膜污染,生物膜內(nèi)的細(xì)菌菌落數(shù)在1~7天內(nèi)會(huì)隨著時(shí)間的推移而不斷增加。2.采用快速多酶清洗劑能有效分解吸唾管道中的生物膜,可減少不同患者間交叉感染的風(fēng)險(xiǎn)。3.吸唾管道中的細(xì)菌隨著時(shí)間的推移會(huì)不斷的粘附、生長和繁殖,最終形成相對(duì)成熟的生物膜結(jié)構(gòu),并且隨著生物膜的發(fā)育,其抵抗力會(huì)逐漸增強(qiáng),導(dǎo)致清除率下降。4.吸唾管道中的生物膜在早期形成時(shí),采用濃度為1:200的快速多酶清洗劑即能取得較好的清潔效果;在形成相對(duì)成熟的生物膜結(jié)構(gòu)時(shí),即使采用濃度為1:100的快速多酶清洗劑也不能取得理想的清潔效果。因此,從清潔效果和經(jīng)濟(jì)角度考慮,建議應(yīng)每天采用1:200濃度的快速多酶清洗劑進(jìn)行清除。5.在第1~5天使用吸唾管道對(duì)患者進(jìn)行口腔治療時(shí),吸唾管道生物膜內(nèi)細(xì)菌菌落數(shù)增長的速度相對(duì)較慢;在第6~7天停止使用吸唾管道對(duì)患者進(jìn)行口腔治療時(shí),生物膜內(nèi)細(xì)菌菌落數(shù)會(huì)迅速增加。因此,如無法做到每天對(duì)吸唾管道進(jìn)行清潔,應(yīng)在每周五治療結(jié)束后對(duì)吸唾管道進(jìn)行徹底清潔以去除生物膜,使管路保持干燥狀態(tài),以防止生物膜進(jìn)入成熟期,導(dǎo)致清潔難度加大。
[Abstract]:Objective: research shows that the saliva suction conduit memory for microbial contamination in dental treatment, which provides favorable conditions for the formation of biofilm. The patients in the process of oral treatment, application of negative pressure aspirator head suction oral saliva, blood and other substances occur debris suction may, by bacteria suction into the oral cavity of a patient, the patients pose a potential risk. So this study will absorb saliva pipeline as the research object, observe the growth status of saliva pipe suction applied to the bacteria in the biofilm. Most previous studies only use water to clean the saliva suction pipeline, this research adopts the fast multi enzyme cleaning agent to remove oral absorption the biofilm spit in the pipeline and study the effect of different concentration of fast multi enzyme cleaning agent for removing effect of suction pipe biofilm saliva, the optimum concentration and verify the best time to remove, so as to effectively reduce the suction contamination, To reduce the risk of cross infection among the patients, improve medical personnel to prevent cross infection awareness and provide reference for clinical prevention of cross infection. Methods: during the period of July 2016 ~2016 year in December, the dental treatment of a department of Stomatology Hospital of Jilin University (a) the saliva suction pipeline as the research object. In order to saliva suction the pipeline used 1~7 days of sampling. Among them, the first 1~5 days of saliva suction pipe is in the working state, the first 6~7 days of saliva suction pipeline length in the non working state.1 saliva suction pipes for the 120cm 96cm pipeline will be retained in 1.5cm spacing is divided into 64 sections, the 64 section saliva suction pipeline the pipeline tablets were randomly divided into 4 groups, each group 16.A group (control group): using sterile distilled water soaked, sterile distilled water capacity is 500ml, the temperature is 40 DEG C, soaking time 5min; group B_1 (experimental group): the concentration of 1:100 fast Multi enzyme detergent soak, cleaning capacity is 500ml, the temperature is 40 DEG C, soaking time 5min; group B_2 (experimental group): the concentration of fast multi enzyme 1:150 cleaning agent for cleaning agent, capacity of 500ml, the temperature is 40 DEG C, soaking time 5min; group B_3 (experimental group): the concentration for the fast multi enzyme 1:200 immersion cleaning agent cleaning agent, capacity of 500ml, the temperature is 40 DEG C, soaking time 5min. evaluation index: the number of bacterial colonies, the clearance rate of biofilm, biofilm morphology was observed with scanning electron microscope, observation of bacterial morphology microscope: 1. days 1~7 A group (blank control group) of bacterial colonies the number (CFU/cm2) were 30 + 10.214,63.47 + 19.057179.72 + 59.196608.13 + 236.1411471.41 + 634.8547318.75 + 2287.0389480.47 + 2909.568, the number of bacterial colonies in 1~3 days showed slower growth of biofilm, bacteria day 4~5 biofilm colony showed rapid growth, the first 6~7 days 鐢熺墿鑶滅殑緇嗚弻鑿岃惤鏁板憟蹇，

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