目的：观察放大镜目测法联合三磷酸腺苷（Adenosine Triphosphate，ATP）生物荧光法在腹腔镜手术 器械清洗效果检测中的作用。方法：选择清洗后拟行低温等离子灭菌的腹腔镜手术器械 72 套，每套 12 件，随机分 为三组，每组 288 件。A 组采用放大镜目测法，B 组采用裸视目测法联合 ATP 生物荧光法，C 组采用放大镜目测法 联合 ATP 生物荧光法，检测并记录各组器械的清洗不合格情况，记录 B 组和 C 组每套器械的检测费用。结果：检 测出清洗不合格的器械分别为 A 组 11 件（3.8％）、B 组 23 件（8.0％）、C 组 25 件（8.7％），B 组和 C 组检测出 的器械清洗不合格率明显高于 A 组（P<0.05）；C 组每套器械的平均检测费用为（802.08±35.63）元，明显低于 B 组的（825.42±41.18）元（P<0.05）。结论：放大镜目测法联合三磷酸腺苷生物荧光法检测结果客观可靠，灵敏度高， 检测费用低，适用于腹腔镜手术器械清洗效果的日常监测、重点加测或定期抽查。

Objective: To observe the role of visual inspection with magnifying lens combined with adenosine triphosphate (ATP) bioluminescence assay in the detection of the cleaning effect of laparoscopic surgical instruments. Methods: 72 sets of laparoscopic surgical instruments (12 pieces in each set)were selected to be sterilized by low-temperature plasma after cleaning and randomly divided into three groups, with 288 pieces in each group. visual inspection with magnifying lens was used in Group A, visual inspection combined with ATP bioluminescence assay were used in Group B, and visual inspection with magnifying lens combined with ATP bioluminescence assay was used in Group C to detect and record the cleaning failure of instruments in each group, and the detection cost of each set of instruments in Group B and Group C were also recorded. Results: 11 (3.8%), 23 (8.0%) and 25 (8.7%) pieces of instruments in Group A, Group B and Group C respectively were detected as failing to clean, the failure rate of instrument cleaning detected in Group B and Group C was significantly higher than that in the Group A (P<0.05). The average testing cost per set of devices in Group C was (802.08 ±35.63)CNY, which was significantly lower than that in the Group B (825.42±41.18) CNY(P<0.05). Conclusion: The combination of visual inspection with magnifying lens and ATP bioluminescence assay is an objective and reliable method with high sensitivity and low cost, which is suitable for routine monitoring, additional testing or periodic spot checking the cleaning effect of laparoscopic surgical instruments.

收稿日期：2022-08-29  录用日期：2022-09-22 

Received Date: 2022-08-29  Accepted Date: 2022-09-22 

基金项目：广西壮族自治区卫生健康委员会自筹经费项目：AQP8 在 OHSS 患者卵泡颗粒细胞中的表达及其对卵母细胞生长发育 的影响（Z20190633） 

Foundation Item: Self-funded Project of the Health Commission of Guangxi（Z20190633） 

通讯作者：王继川，Email：87539874@qq.com 

Corresponding Author: WANG Jichuan, Email: 87539874@qq.com 

引用格式：王继川，刘新，周树平，等 . 放大镜目测法联合三磷酸腺苷生物荧光法在腹腔镜手术器械清洗效果检测中的应用分析 [J]. 机器人外科学杂志（中英文），2023，4（3）：246-251. 

Citation: WANG J C, LIU X, ZHOU S P, et al. Analysis of the visual inspection with magnifying lens combined with adenosine triphosphate bioluminescence assay in the cleaning effect detection of laparoscopic surgical instruments[J]. Chinese Journal of Robotic Surgery, 2023, 4(3): 246-251.

[1] Otter J A, Yezli S, Salkeld J A, et al. Evidence that contaminated surfaces contribute to the transmission of hospital pathogens and an overview of strategies to address contaminated surfaces inhospital settings[J].Am J Infect Control, 2013, 41(5): S6-S11. 

[2] 中华人民共和国国家卫生和计划生育委员会 .WS 310.2-2016 医院消毒供应中心第 2 部分 : 清洗消毒 及灭菌技术操作规范 [S]. 北京 : 中华人民共和国国 家卫生和计划生育委员会 , 2016. 

[3] 穆俊 , 李宇生 , 周平乐 . 消毒供应中心医疗器械的 清洗效果和质量监测方法 [J]. 中西医结合护理 ( 中 英文 ), 2016, 2(11): 164-168. 

[4] 黄碧珍 , 张秀骂 , 李艺霞 . 医院消毒供应中心管腔 器械手工清洗方法的实践分析 [J].医学理论与实践 , 2018, 31(23): 3621-3623. 

[5] 中华人民共和国国家卫生和计划生育委员会 .WS 310.3-2016 医院消毒供应中心第 3 部分 : 清洗消毒 及灭菌效果监测标准 [S]. 北京 : 中华人民共和国国 家卫生和计划生育委员会 , 2016. 

[6] Lipscomb I P, Sihota A K, Keevil C W. Comparison between visual analysis and microscope assessment of surgical instrument cleanliness from sterile service departments[J].J Hosp Infect, 2008, 68(1) : 52-58. 

[7] 许缤 , 陈红岩 , 孙嫣 , 等 . 胸外科手术后医院获得性 肺炎危险因素分析 [J]. 中华医院感染学杂志 , 2012, 22(1): 64-66. 

[8] 耿军辉 , 詹朦 , 姚卓娅 , 等 .ATP 生物荧光法检测手 术器械清洗质量效果评价 [J]. 河南预防医学杂志 , 2021, 32(10): 789-791. 

[9] 杨小燕 , 田泽芳 , 时桂娟 , 等 . 两种手术器械清洗 质量评价方法的 Meta 分析 [J]. 中华医院感染学杂 志 , 2021, 33(22): 3496-3499. 

[10] 李远 . 不同检测方法在集中式管理硬式内镜清洗消 毒质量评估中的价值比较 [J]. 中国医疗设备 , 2017, 32(8): 177-179. 

[11] Brown E, Eder A R, Thompson K M. Do surface and cleaning chemistries interfere with ATP measurement systems for monitoring patient room hygiene[J].J Hosp Infect, 2010, 74 (2) : 193-195. 

[12] Bakke M, Suzuki S. Development of a novel hygiene monitoring system based on the detection of total adenylate (ATP + ADP + AMP)[J].J Food Prot, 2018, 81(5): 729-737. 

[13] Bakke M, Suzuki S, Kirihara E, et al. Evaluation of the total adenylate (ATP + ADP + AMP) test or cleaning verification in healthcare settings[J].J Prev Med Hyg, 2019, 60(2): E140-E146.