SanPiN: tua thiab kom tsis muaj menyuam ntawm kev kho mob cov khoom

Nyob rau hauv Russia, tag nrho cov tsev muab kev koom tes nyob rau hauv kev kho mob cov kev ua ub yuav tsum tau yuam ua hauj lwm mus ua hauj lwm raws li stringent qauv, cov uas ib qho tseem ceeb qhov chaw yuav siv sij hawm kom zoo tua thiab kom tsis muaj menyuam ntawm kev kho mob kiag li lawm.

Yog vim li cas raws li cov txheej txheem

Niaj hnub no, muaj ntau yam, txawm deb los ntawm cov tshuaj txiv neej kos npe rau ib lub sij hawm xws li nosocomial kab mob. Qhov no muaj xws li tej yam kab mob uas tau txais mob los yog vim hais tias ntawm nws cov recourse mus rau ib tug lub tsev kho mob, los yog lub koom haum cov neeg ua haujlwm nyob rau hauv qhov kev kawm ntawm lawv tej hauj lwm. Raws li statistics, nyob rau hauv kev phais tsev kho mob rau cov theem ntawm inflammatory mob tom qab ua hauj lwm, net ntawm 12-16% nyob rau hauv lub gynecological teeb meem tom qab ua hauj lwm tshwm sim nyob rau hauv 11-14% ntawm cov poj niam. Tom qab tshuaj ntsuam lub qauv ntawm morbidity nws tau los ua khees tias 7 mus rau 14% ntawm cov me nyuam mos raug kis kab mob nyob rau hauv tsev kho mob thiab xyuas pawg ntseeg.

Ntawm cov hoob kawm, xws li ib tug qauv tau cai tsis nyob rau hauv tag nrho cov kev kho mob tsev thiab lawv loj heev yog nyob rau ntawm ntau yam xws li lub hom ntawm lub koom haum, qhov xwm ntawm cov kev pab, cov kev siv ntawm cov kis mechanisms ntawm nosocomial kab mob, nws cov qauv. Tiv thaiv no tom qab, ib tug ntawm lub ntsiab uas tsis yog-kev ntsuas kom tiv thaiv tau qhov rov tshwm sim thiab kis tau tus mob ntawm nosocomial kab mob yog lub tua thiab kom tsis muaj menyuam ntawm kev kho mob kiag li lawm.

ntxawg cov ntaub ntawv

Nyob rau hauv nws cov hauj lwm, tag nrho cov kev kho mob chaw yog coj los ntawm cov tswv yim pom zoo enshrined nyob rau hauv ntau cov kev cai. Cov yooj yim ntaub ntawv no yog SanPin (tua thiab kom tsis muaj menyuam ntawm kev kho mob cov khoom nyob rau ntawd nyob rau hauv ib tug nyias muaj nyias ib seem). Tseeb kev kho nqi lus tau pom zoo nyob rau hauv 2010. Nws kuj txiav txim lub lag luam ntawm kev kho mob chaw muaj xws li cov nram qab no cov kev cai.

1. Law tooj 52, uas tshaj hais tias ib tug epidemiological kev ruaj ntseg ntawm cov pejxeem.
2. Kev txiav txim № 408 (viral kab mob siab) ntawm 12.07.1984.
3. Kev txiav txim tooj 720 (rau tshwj kom txhob nosocomial kab mob).
4. Xaj los ntawm 03.09.1999, lub (txoj kev loj hlob ntawm tua).

OST "kom tsis muaj menyuam thiab tua ntawm kev kho mob pab kiag li lawm» № 42-21-2-85 kuj yog ib tug ntawm lub ntsiab ntaub ntawv regulating tus ua ntawm standard cov cuab yeej. Hais tias lawv yog ua los ntawm tag nrho cov tsev kho mob.

Nyob rau hauv tas li ntawd, muaj ib tug loj tus naj npawb ntawm cov lus qhia (MU), tua thiab kom tsis muaj menyuam ntawm kev kho mob pab kiag li lawm nyob rau hauv uas saib los ntawm lub foundations ntawm txawv disinfectants tso cai rau lub hom phiaj no. Niaj hnub no, vim yog lub fact tias muaj ntau officially tso cai los ntawm misinformation. txhais tau tias tsim nyog raws li kev cai yog ib qho tseem ceeb heev ib feem ntawm cov ntaub ntawv nyob rau hauv uas lub chaw ua hauj lwm ntawm kev noj qab nyob chaw nyob rau hauv kev tsim kho. Rau hnub tim, tus qauv ua lub cuab tam muaj peb sib law liag theem - tua, ji thiab kom tsis muaj menyuam ntawm kev kho mob kiag li lawm.

tua kab

Es ho yog hu ua ib tug set ntawm kev ntsuas raws li ib tug tshwm sim ntawm uas tus pathogens yog puas nyob rau hauv lub cheeb tsam tej khoom. Cov no muaj xws nto (phab ntsa, plag tsev, qhov rai, nyuaj rooj tog, nto khoom), noj qab haus huv cov khoom (linen, tableware, tsis muaj kab mob cov khoom), raws li zoo raws li lub cev, rho tawm ntawm cov neeg mob thiab thiaj li nyob. D.

Nyob rau hauv paub qhov kab mob yog nqa tawm kev tshwm sim, hu ua "focal tua." Nws lub hom phiaj yog ua kom puas lub pathogens ncaj qha qhia chaw zov me nyuam. Cov nram qab no hom ntawm focal tua:

• tam sim no - hais tias nws yog nqa tawm nyob rau hauv cov tsev kho mob kom tsis txhob kis kab mob;
• kawg - nyob tom qab ntawm qhov chaw ntawm tus kab mob yog raug rho tawm, uas yog ib tug neeg mob twb pw tsev kho mob.

Nyob rau hauv tas li ntawd, muaj ib tug tiv thaiv kab mob li cas. Cov kev ua ub no nqa tawm lossi, tsis hais los qhov twg los ntawm kab mob. Lawv muaj xws li ntxuav tes, tu ntawm lub surrounding chaw siv cov tshuaj mas siv muaj bactericidal additives.

tua kab txoj kev

Nyob ntawm seb lub hom phiaj nram qab no tua txoj kev yog siv:

• Neeg kho tshuab: Qhov no muaj xws li ncaj qha txhua yam kev txiav txim nyob rau hauv cov kev kawm - ntub tu, tapping tawm los yog knock-tawm ntaub pua chaw pw - nws tsis tua cov pathogens, tiam sis tsuas yog ib ntus txo lawv tus xov tooj;
• Lub cev: ultraviolet raug, siab los qis kub - nyob rau hauv cov ntaub ntawv no kev puas tsuaj yog cov ntaub ntawv nyob rau hauv lub precision ntawm qhov kub thiab tib lub sij hawm;
• Science News for KIDS: kev puas tsuaj ntawm pathogenic microorganisms nrog tshuaj - ntsw, so los yog yam khoom irrigation tshuaj tov (feem ntau thiab npaum txoj kev);
• txog biology - nyob rau hauv cov ntaub ntawv no rau kev siv cov antagonist ntawm lub microorganism uas yuav tsum tau ua kom puas lub (feem ntau siv rau tshwj xeeb bacteriological noj);
• Ua ke - combines ob peb txoj kev tua kab.

OST "kom tsis muaj menyuam thiab tua ntawm kev kho mob pab kiag li lawm" 42-21-2-85 neeg pab leg ntaubntawv uas kis los ntawm tus kab mob li cas cov txheej txheem yuav tsum tau tag nrho cov khoom thiab cov cuab yeej uas tus neeg mob tau muaj kev sib cuag. Nyob rau hauv tsev kho mob rau kev siv ntawm lub cev los yog tshuaj tua kab txoj kev. Thaum nws kawm tiav, cov khoom, nyob ntawm seb lawv lo lus uas peb, yog ntxiv tiav, siv los yog re-siv.

pre-sterilized cleansing

Es ho thiab kom tsis muaj menyuam ntawm kev kho mob li rau ntau yam seev yuav tsum tau sterilized muab txawm thiab pre-tu, uas yuav siv sij hawm qhov chaw tom qab tua kab mob cov khoom. Lub hom phiaj ntawm cov kauj ruam no yog zaum kawg txhua yam kev tshem tawm ntawm seem ntawm roj thiab protein kab mob raws li pharmaceuticals.

Tshiab SanPiN, tua thiab kom tsis muaj menyuam ntawm kev kho mob cov khoom uas yog xam nyob rau hauv kev nthuav dav, muab rau cov nram qab no ua sawv ntawm lub PSO.

1. Tsis pub dhau 0.5 feeb cov khoom yog ntxuav nyob rau hauv khiav dej kom tshem tawm residual tshuaj tua kab.
2. Nyob rau hauv lub ntxuav dej cawv, rau zus tau tej cov uas tsuas pom zoo neeg sawv cev siv, cov khoom no yog soaked nrog rau tag nrho immersion. Nyob rau hauv cov ntaub ntawv uas, yog hais tias lawv muaj xws li ob peb qhov chaw ntawm cov khoom yuav tsum tau rhuav, thiab kom paub tseeb tias tag nrho cov kab noj hniav twb tau sau nrog ib tug daws. Yog hais tias tu cov tshuaj kub 50º raug yog 15 feeb.
3. Tom qab lub sij hawm txhua yam khoom ntawm ib tug ruff los yog gauze rwb rau 0.5 feeb ntxuav nyob rau hauv tib lub tshuaj.
4. Khiav dej yaug cov khoom. Duration yaug nyob rau hauv lub siv neeg sawv cev ( "Astra", "Qhaus" - 10 feeb "Progress" - 5 "Biolot" - 3).
5. Yaug nyob rau hauv dej distilled rau 30 vib nas this.
6. Ziab nyob rau hauv lub kub huab cua kom qhuav ncu.

Yuav kom npaj tu cov tshuaj siv yog 5 g ntawm CMC ( "Progress", "Astra", "Qhaus", "Biolot"), perhydrol 33% - 16 g, los yog 27,5% - 17 kuj tso cai rau kev siv ntawm 6% (85 g ) thiab 3% (170 g) ntawm hydrogen peroxide, potable dej - 1 liter.

Niaj hnub nimno cov cuab yeej siv kom tuaj tua kab, tso cai rau kom muab cov txheej txheem ntawm tua thiab PCP. Nyob rau hauv cov ntaub ntawv no, tom qab raug tus kab mob ncaj qha mus rau misinformation. cov tshuaj yog muaj ershevanie cuab yeej thiab rau - tag nrho cov tom ntej theem ntawm ji.

zoo tswj

JV, tua thiab kom tsis muaj menyuam ntawm kev kho mob pab kiag li lawm uas pleev xim rau cia ruam yog kauj ruam, them zoo mloog los zoo tswj ntawm txhua theem ntawm kev. Ua li no, ua ib tug qauv tswj nyob rau hauv qhov qhaj ntawv los ntawm lub kho ntshav khoom, thiab lwm yam proteinaceous tebchaw raws li qhov zoo tshaj ntawm ntxuav detergents. Control yog raug mus rau ib feem pua ntawm cov kho seev.

Phenolphthalein mus sib los soj ntsuam raws li qhov uas kom huv si nrog xab npum cov khoom uas muaj tau muab tshem tawm, uas tau raug siv tau nyob rau presterilizing tu. Rau nws ua yeeb yam nyob rau hauv lub kua ntswg seb puas muaj ntaub ntawv rau ib tug me me muaj pes tsawg tus ntawm tas 1% phenolphthalein tshuaj, thiab ces so cov khoom uas xav kom mus kuaj. Yog hais tias muaj yog ib tug liab coloration, qhov zoo ntawm ntxuav detergents tswv tsis txaus.

Es ho thiab kom tsis muaj menyuam ntawm kev kho mob pab kiag li lawm yuav tsum tau saib xyuas nyob rau txhua txhua theem, thiab lwm cov qauv, uas tso cai rau koj mus ntsuam xyuas zoo npaum li cas cov thawj kauj ruam tau nqa tawm - nws azopiramovaya qauv. Nws soj ntsuam qhov kev muaj los yog tsis tuaj kawm ntawv ntawm residual ntshav rau lawv, thiab tshuaj yeeb. Rau nqa tawm nws yuav tsum tau azopirama kua uas yog siav yuav tsum fwm rau 2 lub hlis nyob rau hauv lub tub yees (nyob rau hauv chav tsev kub, qhov no lub sij hawm yog luv rau ib lub hlis). Ib tug clouding ntawm lub reagent nyob rau hauv lub qhaj ntawv ntawm cov txo tsis muaj feem xyuam nws zoo.

Rau cov qauv ua ntej nqa tawm tib tooj azopirama thiab 3% hydrogen peroxide twb mixed thiab thov mus ntsuam xyuas nyob rau hauv cov ntshav stain. Cov tsos ntawm violet xim qhia tau hais tias lub reagent neeg ua hauj lwm - koj yuav pib qhov kev xeem. Yuav kom qhov no reagent npaj moistened kua ntswg thiab so qhov chaw ntawm cov cuab yeej thiab cov khoom siv. Cov khoom muaj hollow raws, ib tug ob peb tee ntawm reagent yog muab tso rau hauv thiab nyob rau thaum xaus ntawm 1 feeb, soj ntsuam cov kev tshwm sim, them tshwj xeeb mloog mus rau lub pob qij txha. Nyob rau hauv cov kev tshwm sim hais tias muaj yog ib tug violet xim, maj mam tig mus rau ib tug liab-lilac xim, ascertain lub xub ntiag ntawm cov ntshav. Brownish xim qhia lub xub ntiag ntawm xeb thiab ntshav - chlorinated tshuaj.

Rau kom zoo luj xyuas ntawm qhov kev tshwm sim azopiramovoy qauv yuav tsum coj mus rau hauv tus account ob peb yam tseem ceeb:

• tus qauv yog suav tias yog zoo tsuas yog hais tias muaj uas tseg tau thaum lub sij hawm thawj feeb tom qab daim ntawv thov ntawm cov reagent;
• ua hauj lwm tov yuav siv tau tsuas yog rau cov thawj ob xuab moos tom qab ua noj ua haus;
• khoom uas yuav tsum tau nyob chav tsev kub (nyob rau hauv kub nto ntawm tus qauv yuav tsis tuav);
• hais txog ntawm cov ntsiab ntawm cov khoom nyob rau hauv uas tus qauv tau ntxuav nrog dej thiab rov raug mus purification nqa predsteriztsionnoy.

Nyob rau hauv cov ntaub ntawv ntawm zoo tau tom qab qhov kev kuaj rau tag nrho cov batch dua raug mus rau ib tug tsis zoo tshwm sim.

kom tsis muaj menyuam

Kom tsis muaj menyuam yog cov kauj ruam kawg nyob rau hauv cov kev ntawm cov khoom uas muaj nyob rau hauv kev sib cuag nrog ib tug mob nto ntawm mucosa los yog ntshav, raws li zoo li tshuaj preparations. Yog li muaj ib tug ua tiav kev puas tsuaj ntawm tag nrho cov ntaub ntawv ntawm cov kab mob, ob qho tib si vegetative thiab spore. Nqa tag nrho cov manipulations li tswj xws nthuav dav normative ntawv Tsab, raws li kev txiav txim. Kom tsis muaj menyuam thiab tua ntawm kev kho mob pab kiag li lawm manufactured nyob rau hauv raws li cov specifics ntawm cov kev kho mob tsim, thiab lawv lub hom phiaj. Khaws cia sterilized khoom, nyob ntawm seb lub pob tau los ntawm hnub rau rau lub hlis.

kom tsis muaj menyuam txoj kev

Txoj kev kom tuaj tua kab thiab kom tsis muaj menyuam ntawm kev kho mob pab kiag li lawm yog sib txawv dog dig los ntawm txhua lwm yam. Kom tsis muaj menyuam yog nqa tawm los ntawm cov nram qab no txoj kev:

• thermal - huab cua, chav, glasperlenovy;
• tshuaj - roj los yog nyob rau hauv kev daws teeb meem ntawm cov tshuaj;
• ntshav los yog ozone;
• tawg.

Nyob rau hauv kev kho mob tsev mas feem ntau yog chav, huab cua, los yog tshuaj txoj kev. Yog li ib tug tseem ceeb feem ntawm cov tsis muaj menyuam txheej txheem yog faj observance ntawm kev cai tswjhwm tej yam kev mob (lub sij hawm, kub, siab). Hom kab mob li cas thiab kom tsis muaj menyuam ntawm kev kho mob pab kiag li lawm yog xaiv nyob ntawm seb cov ntaub ntawv uas los ntawm qhov uas cov workpiece yog ua.

huab cua txoj kev

Yog li sterilized kho mob seev, pab kiag li lawm thiab qhov chaw ntawm pab kiag li lawm uas ua los ntawm cov hlau, iav thiab silicone roj hmab. Ua ntej lub kom tsis muaj menyuam lub voj voog cov khoom yuav tsum tau kom huv si qhuav.

Qhov siab tshaj plaws txawv los ntawm cov kub nyob rau hauv no txoj kev ntawm kom tsis muaj menyuam yuav tsum tsis txhob ntau tshaj 3 ° C.

chav txoj kev

Chav txoj kev yog nyob deb ntawm cov feem ntau lug siv, vim lub luv luv voj voog, tau ntawm nws siv rau sterilizing cov khoom ua los ntawm tshav kub rhiab ntaub ntawv (fabrics, sutures thiab cov ntaub qhwv, roj hmab khoom, yas, yas). Sterility nyob rau hauv no txoj kev yog tiav los ntawm kev siv zog nkag nyob rau hauv overpressure. Qhov no tshwm sim nyob rau hauv ib tug chav sterilizer los yog autoclave.

Variations nyob rau hauv siab regimes tso cai mus rau 2 kg / m² thiab ib tug kub - 1-2 °.

Glasperlenovaya kom tsis muaj menyuam

Kev them nyiaj yug kho mob tsev nyob rau hauv xyoo tsis ntev los tau zoo ho thiab qhov no yog muab sau rau hauv lub xeem SP (tua thiab kom tsis muaj menyuam ntawm kev kho mob pab kiag li lawm). Tshiab kom tsis muaj menyuam txoj kev, uas tau lug siv nyob rau hauv cov tsev kho mob - nws glasperlenovaya kom tsis muaj menyuam. Nws yog raus nyob rau hauv kub lub cuab tam nyob rau hauv nruab nrab kom 190 - 330 ° iav hlaws dai. Lub kom tsis muaj menyuam txheej txheem yuav siv sij hawm feeb, thiab tom qab lub cuab tam yog npaj txhij rau kev siv. Lub downside ntawm no txoj kev yog hais tias nws muaj peev xwm tiv thaiv tsuas yog me me cov cuab yeej, li ntawd nws yog siv feem ntau nyob rau hauv kev kho hniav qhov chaw ua hauj.

Es ho, tu, kom tsis muaj menyuam ntawm kev kho mob pab kiag li lawm yog qhov tseem ceeb nyob rau hauv lub niaj hnub kho mob. Nyob rau tag nrho cov kev ua ub no yuav muab nqa tawm raws li zoo, uas yog enshrined nyob rau hauv cov kev cai pom zoo los ntawm lub Ministry of Health, yuav yog nyob ntawm seb cov kev kho mob ntawm ob cov neeg mob thiab kev kho mob cov neeg ua haujlwm.