阅读说明：本技术 一种口腔综合治疗台水路消毒方法 (Waterway disinfection method for oral comprehensive treatment table ) 是由 *** 张鑫 王欣 夏娴 张玉军 梁坤 孙业发 邵辉 刘芳汝 于 2019-08-16 设计创作，主要内容包括：本发明公开了一种口腔综合治疗台水路消毒方法,消毒水准备,根据口腔综合治疗台水路容量大小准备相应量的微酸性次氯酸水,利用消毒水充满整个口腔综合治疗台水路；然后将口腔综合治疗台水路与气锤脉冲机相连,设定脉冲频率；之后启动气锤脉冲机对综合治疗台水路进行循环清洗一段时间,完成口腔综合治疗台水路的一次性消毒处理,而后采用特定浓度的微酸性次氯酸代替口腔治疗用水持续消毒。本发明可以有效减少口腔综合治疗台水路在消毒过程中管壁生物膜的聚集,降低长期持续消毒过程中生物膜脱落而造成的二次污染风险,其消毒效果优于单纯微酸性次氯酸水浸泡。(The invention discloses a waterway disinfection method of an oral cavity comprehensive treatment table, which comprises the steps of preparing disinfectant, preparing a corresponding amount of slightly acidic hypochlorous acid water according to the waterway capacity of the oral cavity comprehensive treatment table, and filling the whole waterway of the oral cavity comprehensive treatment table with the disinfectant; then connecting the waterway of the oral cavity comprehensive treatment table with an air hammer pulse machine, and setting the pulse frequency; then the air hammer pulse machine is started to circularly clean the waterway of the comprehensive treatment table for a period of time, so that the disposable disinfection treatment of the waterway of the oral comprehensive treatment table is completed, and the subacid hypochlorous acid with specific concentration is adopted to replace the water for oral treatment for continuous disinfection. The invention can effectively reduce the aggregation of the biomembrane on the tube wall of the waterway of the oral cavity comprehensive treatment table in the disinfection process, reduce the risk of secondary pollution caused by the shedding of the biomembrane in the long-term continuous disinfection process, and has better disinfection effect than the disinfection effect of the single slightly acidic hypochlorous acid water soaking.)

1. A method for disinfecting a waterway of an oral comprehensive treatment table is characterized by comprising the following steps:

Step 1, preparing disinfectant, namely preparing corresponding amount of disinfectant according to the water path capacity of the oral cavity comprehensive treatment table, and filling the whole water path of the oral cavity comprehensive treatment table with the disinfectant;

Step 2, connecting a waterway of the oral cavity comprehensive treatment table with an air hammer pulse machine, and setting pulse frequency;

And 3, starting the air hammer pulse machine to circularly clean the waterway of the comprehensive treatment table for a period of time to finish the waterway disinfection of the oral comprehensive treatment table.

2. The waterway disinfection method for the oral complex treatment table of claim 1, wherein: the disinfectant fluid is subacid hypochlorous acid water.

3. The waterway disinfection method for the oral complex treatment table of claim 2, wherein: and 3, circularly cleaning the water channel of the comprehensive treatment table by adopting high-concentration subacidity hypochlorous acid water, and continuously circularly cleaning the water channel of the comprehensive treatment table by adopting low-concentration subacidity hypochlorous acid water in the using process of the comprehensive treatment table.

4. The waterway disinfection method for the oral complex treatment table of claim 3, wherein: the concentration range of the slightly acidic hypochlorous acid water is 5mg/L-500 mg/L.

5. The waterway disinfection method for the oral complex treatment table of claim 4, wherein: the concentration range of the high-concentration subacid hypochlorous acid is 100mg/L-500mg/L, and the concentration range of the low-concentration subacid hypochlorous acid is 5mg/L-40 mg/L.

6. The waterway disinfection method for an oral complex treatment table according to any one of claims 1 to 5, wherein: the pulse frequency is low-frequency pulse, and the frequency range is 0.01-100 Hz.

7. the waterway disinfection method for an oral complex treatment table according to any one of claims 1 to 5, wherein: the circulating cleaning time in the step 3 is 3-60 min.

Technical Field

the invention belongs to the field of disinfection, relates to a disinfection method for oral treatment equipment, and particularly relates to a waterway disinfection method for an oral comprehensive treatment table.

Background

There is increasing concern about hospital infection control during oral diagnosis and treatment. The national sanitation committee 2015 issued the technical operating specifications for disinfection and sterilization of oral instruments (WS506-2016), and the risk degrees of the oral instruments are classified in detail, but at present, the microbial content of the water for treatment in the oral cavity is not unified. Although the anti-suck-back mobile phone is widely used in stomatology, research shows that the pollution condition of a waterway (Dental Unit Water Lines, abbreviated as DUWLs) of an oral comprehensive treatment table is still more common, and the risk of cross infection of patients, medical staff and the like exists. The comprehensive treatment table for stomatology is mostly provided with a heating device, and the warm environment is suitable for the growth of bacteria. Due to the characteristics of DUWLs, bacteria are easy to adhere and fix and form a biological film for a long time. It has been found that 1000-1500 times the concentration of disinfectant required to kill bacteria in a biofilm is greater than that of planktonic bacteria.

The recent concern and related research concerning pollution status of DUWLs and their potential risk of infection has raised a high level of attention by scholars. One reason for this is that the narrow inner wall of the DUWLs is an ideal breeding place for microorganisms, and the long-term closed humid and warm environment can increase the breeding speed of microorganisms by several times or even millions of times. Microbial contamination in DUWLs occurs as planktonic microbes and biofilms. The number of floating bacteria in the tube cavity can be reduced by about 70% by using sterile water washing, but the biological film on the inner wall of the tube cavity can not be removed by using the sterile water washing. Given the specificity of oral treatment, there is a need for safe, long-lasting, and highly effective methods for removing biofilm in DUWLs. The subacidity hypochlorous acid water is safe, efficient and environment-friendly, has certain application in the aspects of oral sterilization and removal of DUWLs biomembranes, but only replaces oral treatment water with subacidity hypochlorous acid, so that the biomembrane is slowly separated in 7-60 days, the total number of bacterial colonies in the treatment water can be greatly increased, even the infection risk can be aggravated in a short period, the biomembrane can be effectively removed in a short period, and the advanced technology for avoiding the increase of the bacterial colonies due to the continuous falling of the biomembrane in the disinfection process is urgently needed to appear.

Disclosure of Invention

The invention aims to provide a method for disinfecting a waterway of an oral comprehensive treatment table, aiming at the problems in the prior art, and providing a basis for formulating a DUWLs disinfection scheme for stomatology by utilizing the disinfection effect of slightly acidic hypochlorous acid water and air hammer pulse flushing on DUWLs, so that the risk of infection is reduced, and the safety of a patient is guaranteed.

In order to solve the technical problems, the invention adopts the technical scheme that:

A method for disinfecting a waterway of an oral comprehensive treatment table is characterized by comprising the following steps:

Step 1, preparing disinfectant, namely preparing corresponding amount of disinfectant according to the water path capacity of the oral cavity comprehensive treatment table, and filling the whole water path of the oral cavity comprehensive treatment table with the disinfectant;

Step 2, connecting a waterway of the oral cavity comprehensive treatment table with an air hammer pulse machine, and setting pulse frequency;

And 3, starting the air hammer pulse machine to circularly clean the waterway of the comprehensive treatment table for a period of time to finish the waterway disinfection of the oral comprehensive treatment table.

Preferably, the disinfectant fluid is slightly acidic hypochlorous acid water.

Preferably, in step 3, the water channel of the comprehensive treatment table is circularly cleaned by using high-concentration slightly acidic hypochlorous acid water, and then the water channel of the comprehensive treatment table is continuously circularly cleaned by using low-concentration slightly acidic hypochlorous acid water in the using process of the comprehensive treatment table.

preferably, the concentration of the slightly acidic hypochlorous acid water ranges from 5mg/L to 500 mg/L.

Preferably, the concentration range of the high-concentration slightly acidic hypochlorous acid is 100mg/L-500mg/L, and the concentration range of the low-concentration slightly acidic hypochlorous acid is 5mg/L-40 mg/L.

Preferably, the pulse frequency is low-frequency pulse, and the frequency range is 0.01-100 Hz.

Preferably, the circulation cleaning time in the step 3 is 3-60 min.

The invention has the beneficial effects that:

the invention utilizes the combined action of slightly acidic hypochlorous acid water with better sterilization effect and low-frequency pulse air hammer flushing, utilizes the traditional sterilization effect of slightly acidic hypochlorous acid water, and utilizes the periodic change of the low-frequency pulse air hammer to cause the alternate expansion and compression of microbubbles in liquid, destroy cell membranes, widen the intercellular space and inhibit the growth of bacteria, can effectively reduce the aggregation of the biomembrane on the tube wall of the waterway of the oral comprehensive treatment table in the sterilization process, reduce the secondary pollution risk caused by the shedding of the biomembrane in the long-term continuous sterilization process, and has the sterilization effect superior to that of the single slightly acidic hypochlorous acid water soaking.

Drawings

FIG. 1 is a plot of log values versus time for water at the coupling end of a dental handpiece.

FIG. 2 three-way gun water log versus time.

Detailed Description

The real-time effect of the present invention will be illustrated with reference to the following examples.

1.1 study subjects:

In 3-4 months of a year, 10 stomatological department comprehensive treatment tables (Sefulai brand) with independent water storage tanks are selected for normal use in stomatology departments of hospitals with a certain comprehensive third-level A and the like, and the stomatology departments are divided into two groups, namely a subacid hypochlorous water soaking group (hereinafter referred to as soaking group) and a subacid hypochlorous water soaking and air hammer pulse washing group (hereinafter referred to as washing group), according to the standards of close service life, same treatment use and equivalent daily treatment amount, and each group is 5.

1.2 test materials

SmileZT-A1 type subacidity hypochlorous acid water generator (made in China); ② SmileMC-10 DUWLs special air hammer pulse cleaning machine (made in China); ③ a constant temperature incubator; fourthly, disposable aseptic straws (1ml and 15 ml); fifthly, nutrient agar culture medium; sixthly, 0.5 percent of sodium thiosulfate; seventhly, adding 0.1 percent peptone normal saline; 8, preparing pH test paper; ninthly, quickly measuring the available chlorine.

1.3 test methods

1.3.1 preparation before the experiment, carry out the final maintenance to the comprehensive treatment platform of research, guarantee normal operating in the testing process, start the trial run to subacidity hypochlorous acid water generator and air hammer pulse cleaning machine, the adjustment parameter to guarantee normal water supply and washing in the testing process.

1.3.2 sampling before intervention (0 d), sampling at noon on the dental workday, between clinical work. Using sterile cotton swab to dip 75% medical ethanol to respectively wipe the connecting end of the high-speed mobile phone of the oral cavity comprehensive treatment table and the water outlet of the three-purpose gun and wait for drying, starting a pedal switch of the treatment table to start and wash for 30s with water, using a sterile sampling tube (with the volume of 50ml) filled with 0.5ml of neutralizer to collect about 15ml of water sample, and sending the water sample to a laboratory for inspection within 2 h.

1.3.3 intervention of DUWLs 150mg/L of slightly acidic hypochlorous acid water was generated using a slightly acidic hypochlorous acid water generator, pumped into the DUWLs including the water storage tank, and the residual water in the DUWLs was emptied to fill the DUWLs with generated hypochlorous acid. After soaking for 12h, the soaking group is not treated, the flushing group is connected with DUWLs by using an air hammer pulse machine, the pulse frequency and the pulse duration are set, the frequency is 10Hz, the duration is 4 minutes, and the DUWLs are subjected to pulse flushing. After the completion of the treatment, both groups were replaced with slightly acidic hypochlorous acid water of low concentration (10mg/L), and then the water storage tank was supplied with slightly acidic hypochlorous acid water of 10mg/L for the subsequent treatment.

1.3.4 after intervention, continuously sampling in the same way as 1.3.2, sampling 3 times per week 4 weeks after DUWLs intervention, wherein the two sampling intervals are 48-72 h (due to special conditions such as national statutory holidays, the interval between individual sampling days is 96h, and the interval between the last sampling days is 30d and 29d is 24h), and sampling is carried out for 12 times in total.

1.3.5 detection method: reference to viable bacteria count in Disinfection Specification (2002 edition)The method performs colony counting. And (3) fully and uniformly mixing the water sample, performing 10-time serial dilution, inoculating and culturing with proper dilution, culturing in an incubator at 37 ℃ for 48h, and counting. According to GB5749-2006 sanitary Standard for Drinking Water, the total number of bacteria is less than or equal to 100cfu/ml, and the number of the colonies of the sample is judged to be qualified^[7]。

2. statistical method

The percent of pass of the water sample (%) (total number of detection samples-number of unqualified samples)/total number of detection samples × 100; the χ 2 test was performed using SPSS23.0 software, and differences were statistically significant if P < 0.05. The continuous disinfection effect comparison applies a repeated measurement model, and if P is less than 0.05, the difference is judged to have statistical significance.

3. Results

3.1 comparison of two groups of qualification rates before and after intervention

And collecting 260 parts of water samples, wherein 130 parts of water samples (10 parts before intervention and 120 parts after intervention) are respectively collected at the connecting end of the high-speed mobile phone and the water outlet of the three-purpose gun. Before intervention, the qualification rate of water samples at the connecting ends of the two groups of mobile phones is 0 percent, the qualification rate of the three-purpose gun of the soaking group is 20.00 percent (1/5), and the qualification rate of the three-purpose gun of the flushing group is 40.00 percent (2/5). After the dry method is used, the qualification rate of the water sample at the connecting end of the mobile phone of the soaking group is 71.67 percent (43/60), and the qualification rate of the water sample of the three-purpose gun is 80.00 percent (48/60); the qualification rate of the water sample at the connecting end of the mobile phone of the flushing group is 98.33 percent (59/60), and the qualification rate of the water sample of the three-purpose gun is 100 percent (60/60). The chi fang test shows that the difference between the percent of pass of the two groups before disinfection has no statistical significance (P is more than 0.05), and the difference after disinfection has statistical significance (P is less than 0.05), which is shown in table 1.

Table 1 comparison of water sample qualification rates (%) (for immersion and rinse groups) before and after intervention

3.2 comparison of the Disinfection Effect

Drawing a log value of the total number of the bacterial colonies of the water sample at the connection end of each mobile phone, finding that the bacterial colonies are kept at a qualified level 5 days before the soaking group, and starting from 9d, the total number of the bacterial colonies is increased and unqualified until the 12d and 15d reach peak values, then is decreased to the qualified level, and is increased back to the standard-exceeding level after 24 d; while the wash group continued to be at acceptable levels for 30 days of monitoring, with a small rise at 12d, 15d but still in an acceptable state (see fig. 1). The colony log values of the three-way gun water samples were also plotted each time, the soaking group showed a similar wave trend to the cell phone connection, while the rinsing group was always at a qualified level (see fig. 2). A. The results of the two groups B of application repeated measurement models indicate that the total number of bacteria at the connecting ends of the A, B two groups of stomatological handpieces and the three-purpose gun is obviously reduced, but the two groups of comparison washing groups are obviously superior to the soaking group and have statistical significance (the comparison P of the connecting ends of the stomatological handpieces is 0.019, and the comparison P of the three-purpose gun is 0.015).

The slightly acidic hypochlorous acid water is also called slightly acidic electrolyzed water, has pH of 5.0-6.5, is colorless and slightly chlorine-like, contains hypochlorous acid (HClO) as main ingredient, and has good bactericidal effect. Because of low cost, no chemical residue, no pollution to the environment and no harm to human body, the disinfectant has wide application in the fields of animal husbandry, food processing, agriculture, aquatic products and the like, and is also used for disinfecting hands, skins, mucous membranes and object surfaces, sterilizing oral cavities and removing DUWLs biological membranes in the medical field.

the periodic variation of the low-frequency pulse sound pressure can cause the alternate expansion and compression of the micro bubbles in the liquid to destroy cell membranes, widen the intercellular spaces and inhibit the growth of bacteria. The air hammer pulse cleaning is to form micro bubbles in DUWLs by using a pulse principle, overcome the laminar flow effect of water flow, form turbulent flow of water-vapor mixing in a narrow tube cavity, and vibrate and impact a tube wall biomembrane at a high speed to accelerate the falling of the tube wall biomembrane.

In order to compare the disinfection effect of the water channel of the oral comprehensive treatment table by using the slightly acidic hypochlorous acid water soaking method based on slightly acidic hypochlorous acid water, the research adopts slightly acidic hypochlorous acid water with higher concentration (the general range is 100-500mg/L, the optimal concentration range is 100-250mg/L) to soak two groups of DUWLs for pretreatment, then a pneumatic hammer pulse cleaning machine is used for cleaning one group of pipelines, and then the low-concentration (the general range is 5-40mg/L, the optimal concentration range is 5-10mg/L) slightly acidic hypochlorous acid water with high safety and clinical acceptance replaces treatment water for continuous disinfection.

The results of this study showed that before interventionDUWLs Total bacteria at 10⁵The pollution is serious, and is basically consistent with other literature reports. The qualification rates of two groups of water samples are obviously improved after intervention (P)<0.05). The water sample qualification rates of the mobile phone connecting end of the soaking group and the three-purpose gun are 71.67 percent (43/60) and 80.00 percent (48/60) respectively; the washing groups are 98.33% (59/60) and 100.00% (60/60) respectively, which shows that the two groups of interventions have good effect on the whole.

The continuous disinfection effect comparison shows that in the continuous 30-day monitoring, the number of bacterial colonies of the water sample of the mobile phone connecting end of the soaking group and the three-way gun is obviously reduced and continues for 5-9 days after intervention, rebounding is started at 9d-12d, the bacterial colonies reach the peak at 12d-15d, then the bacterial colonies are reduced to the qualified level, and the bacterial colonies rise to the standard-exceeding level after 24 d. This phenomenon may be associated with the loosening, gradual detachment of the biofilm. After the water sample is washed, the water sample number of the mobile phone connecting end and the three-purpose gun is in a continuous qualified state, and the water sample at the mobile phone connecting end is in a qualified state even though the water sample rises slightly at 12d and 15d (figures 1 and 2). The biofilm is thoroughly treated in the pulse flushing stage, and the phenomenon that the biofilm falls off again to cause the colony count to rise is basically avoided. Therefore, the air hammer pulse disinfection method based on slightly acidic hypochlorous acid water is reasonable to think that the method can effectively remove the biomembrane on the inner wall of the DUWLs, reduce the risk of secondary pollution caused by the shedding of the biomembrane in the long-term continuous disinfection process, and the disinfection effect is better than that of the single slightly acidic hypochlorous acid water soaking.

The above embodiments are merely illustrative of the present invention, and do not represent a limitation on the scope of the present invention, and particularly, the parameters in the embodiments are exemplified and do not represent practical limitations on the parameters; while the foregoing has been with reference to the disclosure of the present invention, it will be appreciated by those skilled in the art that various changes in form and detail may be made therein without departing from the spirit and scope of the invention. Therefore, the scope of the present invention should not be limited to the embodiments disclosed, but should include various alternatives and modifications without departing from the present invention, which are encompassed by the contents of the following claims.