CN108926577A - 一种电位水用于伤口抗菌愈合清洁护理的方法 - Google Patents
一种电位水用于伤口抗菌愈合清洁护理的方法 Download PDFInfo
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Abstract
本发明涉及一种电位水用于伤口抗菌清洁护理的方法。电位水理化指标为：pH3.10‑5.5，有效氯50‑100mg/L，氧化还原电位ORP 1000‑1100mV。这种稳定的电位水实际上也是酸性氧化电位水(简称EOW)。以较稳定的有效氯(纯次氯酸)和高缺电子程度改进了以前酸性氧化电位水的不足之处，不但保持了其杀菌、消毒功效不变，还更加稳定，扩大了使用范围，用于高端的伤口清洁护理抗菌愈合医用敷料。
Description
技术领域
本发明涉及一种电位水用于伤口抗菌清洁护理的方法。电位水理化指标为：pH3.10-5.5，有效氯50-100mg/L，氧化还原电位ORP 1000-1100mV。这种稳定的电位水实际上也是酸性氧化电位水(简称EOW)。以较稳定的有效氯(纯次氯酸)和高缺电子程度改进了以前酸性氧化电位水的不足之处，不但保持了其杀菌、消毒功效不变，还更加稳定，扩大了使用范围，用于高端的伤口清洁护理抗菌愈合医用敷料
背景技术
几十年来，世界各国都在积极研究，用于高端的伤口清洁护理抗菌愈合敷料。专利号：ZL.018036163(生理上平衡的离子化的酸性溶液及其应用伤口愈合的方法)。由此可见，绿色环保没有污染残留和不产生抗药性，是解决这个问题的一个选择。人体本身的免疫功能白细胞就是产生次氯酸为抗体，阻止有害菌过多繁殖，起到自我修复作用，所以说纯次氯酸对人体无毒、无害。而其高电位具有止痛、止血、能刺激组织细胞生长，促进伤口愈合，还能促进电离子转化促使神经恢复正常，调整人体内微生态平衡，在治疗疑难病症中有意想不到的疗效，它也是快速杀菌、消毒，替代抗生素针对超级细菌的有力武器。
我国2011年制定了《酸性氧化电位水生成器安全与卫生标准》GB28234，规定了酸性氧化电位水生成指标：PH值2.0-3.0、有效氯Acc 60±10mg/L、氧化还原电位≥ 1100mV。经研究证明，酸性氧化电位水在PH值2.0-3.0时，其有效氯主要成份以氯气形式存在。由于氯气不稳定容易溢出水中，造成氯气味较重，有一定刺激性，对一般金属表面有一定腐蚀性，所以现状下酸性氧化电位水只能保持现制现用。
电位水PH值在3.1-5.5之间，其有效氯成份主要以纯次氯酸的形式存在，电位水相对稳定。电位水和酸性氧化电位水的杀菌消毒原理都是由其多因素独特的结构成份组成：一是氧化还原电位(ORP)、二是有效氯浓度(纯次氯酸)、三是酸性(pH值) 决定。这三项指标比例适宜，保持动态平衡，起到相互促进增效的作用。单独一项指标，在低浓度下都起不到杀菌作用。有趣的是高电位不一定是高缺电子，化学勾兑也能出现高电位，而缺电子必须是高电位。用有膜电解的方法使ORP保持1000-1100mV保证高缺电子很重要。常规有效氯消毒剂其有效氯杀菌浓度一般在1000-4000ppm之间，酸性氧化电位水其有效氯杀菌浓度在25-100ppm之间。中国疾控中心李新武专门做过对照实验，试验结果：酸性氧化电位水有效氯浓度60ppm，就能起到和有效氯浓度4000ppm次氯酸钠杀菌液同样杀菌效果，两者相差60多倍。这充分证明酸性氧化电位水单独一项不能杀菌，必须共同作用，才能达到杀菌效果。这种稳定的电位水它已经不是一种简单的杀菌消毒剂。由于最终解决了保存期短的难题，这就为开发电位水作为伤口清洁液体或制成敷料，在市场上普及使用奠定了基础。
酸性氧化电位水及其在医疗中的应用现状“(济南军区总医院)实用医药杂志2005年第22卷第11期-杨燕”。在这一文献资料中做了详细叙述。
酸性氧化电位简称EOW水的理化特性及消毒机理是。EOW具有高氧化还原电位 ORP≥1100mV、低pH值≤2.7的特性，破坏了病原微生物的生存环境pH值4～9，ORP400～ 900。在高电位、低pH值环境下，EOW中的低浓度次氯酸(20～60mg/L)起主要杀菌作用，其次H2O2、OH-和新生态氧等多种离子也有杀菌作用。次氯酸杀菌作用主要是通过氯化和氧化，除了氯直接作用于菌体蛋白外，次氯酸分解形成新生态氧可将均体蛋白氧化从而起到杀菌作用。因此，EOW具有强大的消毒杀菌作用。可在30s内杀灭各种细菌繁殖体，如金黄色葡萄球菌、MRSA菌、大肠杆菌、淋病菌、真菌、HBV、艾滋病病毒(HIV) 等，并完全破坏乙肝病毒表面抗原；30min杀灭细菌芽胞。但EOW的理化性状不稳定，极易受光和空气的影响，氧化还原电位随时间和有效氯的丧失而下降，pH易被缓冲液改变，杀菌作用易受有机物的影响。由于EOW与光、空气、有机物接触一段时间后可还原成普通水，因此其不稳定的性质也决定了其具有不污染环境，消毒后不必用洁净水冲洗等优点。EOW作为一种高效、速效、广谱、安全、方便、经济的新型消毒剂，正逐渐被人们所接受。
EOW具有以下特点是：1、杀菌谱广：可杀灭各种细菌繁殖体、病毒、真菌、芽胞；2、高效速效：数十秒即可完全灭活细菌、使病毒完全失去抗原性；3、使用方便：生产的原料只需自来水和氯化钠，由强酸化水生成机产生，取之即用，无需配制；
EOW在临床中的应用在各种创面感染治疗中的应用：对新鲜创面立即用EOW冲洗和湿敷，能起到预防感染的作用，大大降低术后创面感染率；对已感染创面或顽固性溃疡可用大量EOW进行浸泡，时间约20～30min。浸泡过程中，对感染创面进行清洗，尽可能清除坏死组织。浸泡后用EOW纱布湿敷，促进创面愈合。与单用生理盐水和消毒药洗必泰来进行清洗相比较，EOW有较好的清创效果，表面坏死组织仅浸以EOW便可被除掉，创面颜色可以见到比原来红，由此判断EOW可能具有促进血液循环的作用，并且 EOW还能减轻臭味。用EOW处理烧烫伤创面，不仅对创面无刺激，而且可减轻组织水肿，加速创面干燥、减少感染机会，缩短愈合时间，对浅度烧伤创面和深度烧伤创面平均缩短3～4d。目前国内尚无应用EOW治疗胸腹腔感染的报道，但国内已有完成腹膜透析后应用EOW冲洗腹腔以达到预防感染的动物模型的报道。
在皮肤科的应用：有学者用EOW治疗各种真菌感染，如霉菌性阴道炎、手足癣、脂溢性皮炎等，效果明显。对67例足癣患者单纯使用EOW湿敷或浸泡后，止痒迅速，无过敏和继发不良反应，症状消失时间较使用其它各类足癣药物者平均缩短了1.53d，总有效率100％。有学者用EOW对32例皮肤病患者做局部治疗，湿疹、包皮龟头炎、尖锐湿疣、固定性药疹、小腿溃疡等多采用开放式连续性湿敷，痤疮、单纯疱疮多采用开放式间歇性湿敷，急性外阴溃疡采用浸泡清洗1次/1d，(约15～30min)后再用其它外用药包敷，治疗一周，显效60％，有效30％。笔者认为在皮损糜烂或溃疡基础上继发感染时，用EOW控制感染、缩短病程效果理想。
在泌尿外科和妇产科的应用：用于下尿路感染、下尿路溃疡、前列腺术后、膀胱出血等灌注、冲洗或浸泡，收到良好效果，不仅能有效杀菌，而且具有止血作用。对各种阴道炎、宫颈糜烂、淋病、尖锐湿疣、产后会阴伤口等进行坐浴冲洗，可收到良好的治疗作用。
在口腔科的应用：治疗口腔溃疡有杀菌谱广、作用迅速的优点，它能激活伤口表层细胞，加速伤口愈合，对黏膜无刺激，无异味，对组织产生轻微麻醉作用，减轻患者痛苦，并有清除口臭的作用。临床观察有效率100％，明显优于传统漱口液复方硼砂液。在口腔科治疗过程中，使用的漱口水多是蒸馏水或过滤水，不能达到杀灭口腔中细菌的目的。采用EOW漱口水并消毒口腔科器械，是防止口腔科交叉感染最有效和最简便的方法。
综上所述，EOW在医疗领域已被广泛采用，在防止医院交叉感染、治疗某些体表感染中取得了一定效果，但是，如何发挥EOW的优点，克服其缺点，合理用于临床实践，仍需进一步研究。
生物相容性评价研究(空军总医院感染控制与管理科主任曹晋桂介绍酸性氧化电位水在医疗机构的应用)。在这一文献资料中做了详细叙述。
MRSA(耐甲氧西林金黄色葡萄球菌)常常导致医院感染的暴发流行，被称为“超级细菌”，至今，如何预防和控制MRSA仍是摆在我们面前必须解决的难点问题。从2000 年开始，酸性氧化电位水在一些医疗机构应用到MRSA病人的护理工作中，感染控制效果明显，主要体现在以下三个方面：基础医疗专项护理，病区保洁，容器消毒。
酸性氧化电位水在护理中的应用。一般认为人是MRSA的主要储菌库，如何消除定植是预防和控制MRSA病人感染、继发感染或暴发流行的一项重要护理措施，实验室检测和医护人员反映证实，使用酸性氧化电位水对MRSA病人的体表、口腔、鼻腔、外耳道、肛周等部位进行专项护理，无不良气味，病人无不良反应。
MRSA是引起包括气管切口感染、烧伤感染、脓疮病、糖尿病肢端坏疽感染等不少深部感染以及皮肤感染的主要致病菌。医护人员通常情况下会使用生理盐水、个别甚至错误地采用万古霉素对MRSA感染的病人的伤口进行冲洗和湿敷。这些方法虽然有一定的效果，但MRSA清除率不明显或加重了MRSA的耐药性。我们认为，采用酸性氧化电位水对MRSA感染的伤口进行处理，杀灭MRSA有效迅速，控制创面感染效果显著，敷料更换次数少，敷料与创面不粘连，再创伤小，同时由于酸性氧化电位水的高电位对神经轻微的麻醉作用，病人疼痛减轻，再加上酸性氧化电位水的促进组织再生作用，病人愈后瘢痕小。
酸性氧化电位水在高危科室的应用。MRSA可以感染和复制一种名为AP的阿米巴原虫，这种阿米巴原虫十分常见，在病房的水草，墙壁等没有生命的物质上都可以找到这种生物，在干燥的环境下，阿米巴原虫的胞囊可以携带MRSA借助空气流动广泛传播，而且进一步研究表明，先感染了阿米巴原虫的MRSA感染人类时，可能会变得更具毒性，对抗生素和消毒剂的抗性也会增加。所以有效地开展环境卫生仍然是控制MRSA的一个重要途径。选用酸性氧化电位水用于MRSA高危科室环境消毒保洁，可以充分利用它的高效性、安全性、无残留性、可操作性和实用性，我们采用酸性氧化电位水代替其他普通消毒剂用于病区的各类保洁工作的8年来，MRSA高危科室环境卫生学监控指标合格，未检出MRSA，未发生暴发流行事件。在MRSA暴发流行的流行病学调查中，通常很容易追踪到医护人员鼻腔和手部正常携带MRSA。由于已经证实了菌株有克隆性，MRSA的主要传播方式是接触性传播，所以在切断传播途径的感染控制措施中，医务人员自身的消毒工作是极为重要的。要切断病人和病人(或医务人员)之间的传播，就要求必须采用感染控制措施。由于一般性处理(如涂抹莫匹罗星药膏)有可能会产生耐药性，而且毒副作用也比较大，因此，在多次的MRSA感染控制中，我们使用了酸性氧化电位水作为应急性措施，使用酸性氧化电位水对医务人员实施手卫生和鼻腔消除定植，都收到了显著的效果，对预防和控制MRSA起到了重要作用。
纵上资料所述，可以肯定酸性氧化电位水对生物体安全，用于伤口抗菌清洁护理是非常可行的。
具体实施方式
将稳定的理化指标为：pH3.10-5.5，有效氯50-100mg/L，氧化还原电位ORP 1000-1100mV的电位水，可直接用于伤口抗菌清洁护理即可，或直接浸泡医用纱做成敷抗菌愈合料，用于伤口清洁护理抗菌治疗。
用膜电解的方法制备电位水，使ORP氧化还原电位保持1000-1100mV、采用碱水回流电解，调整pH值、当pH值在3.10——5.5之间时，让其有效氯成份主要以纯次氯酸的形式存在、浓度含量保持在50——100ppm之间。电位水相对稳定。使三项指标比例适宜，保持动态平衡，生产出合格的电位水，为无色澄清的透明液体，有轻微的次氯酸味；无异物、无杂质、无沉淀。
按照卫生部《消毒技术规范》2002年版，对本发明的电位水进行对微生物的杀灭效测定，结果见表1。
表1电位水杀灭微生物效果
| 微生物名称 | 作用时间(min) | 杀灭对数值 |
| 金黄色葡萄球菌ATCC8099 | 1 | ≥5.00 |
| 大肠杆菌ATCC6538 | 1 | ≥5.00 |
| 白色念珠菌ATCC10231 | 1 | ≥4.00 |
| 脊髓灰质炎病毒I型疫苗株 | 5 | ≥4.00 |
将生产的电位水根据产品用途分装为六种型号，八种规格产品使用，见下表2。
表2产品型号/规格用途划分表
结果表明：一种稳定的电位水用于伤口抗菌清洁护理的方法可行，效果可靠，有利于预防疾病，保障人类健康。
Claims (4)
1.一种电位水用于伤口抗菌清洁护理的方法是：将稳定的电位水，直接用于高端的伤口清洁护理抗菌愈合，或直接浸泡医用纱布或无纺布做成敷抗菌愈合料，用于伤口清洁护理抗菌治疗。
2.如权利要求1所述，用于伤口抗菌清洁护理的电位水，不含任何防腐剂、香精和其它化学杀菌剂。符合国家卫生用品准标的要求。
3.如权利要求1所述，用于伤口抗菌清洁护理的电位水，理化指标是：pH为3.10-5.5，有效氯50-100mg/L，氧化还原电位ORP 1000-1100mV。
4.如权利要求1所述，用电位水浸泡的材料为医用无菌纱布，或予先经消毒处理的无纺布。
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| CN114097818A (zh) * | 2020-08-25 | 2022-03-01 | 张宝生 | 一种高效消毒液及其制备方法 |
| CN114569630A (zh) * | 2020-12-02 | 2022-06-03 | 全鹏科技股份有限公司 | 消毒杀菌液、其制造方法及其用途 |
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Application publication date: 20181204 |