隨著醫(yī)療技術(shù)的不斷發(fā)展,醫(yī)用內(nèi)窺鏡已經(jīng)廣泛應(yīng)用于醫(yī)療領(lǐng)域。它已成為臨床診斷和治療中不可缺少的重要醫(yī)療工具。加強(qiáng)內(nèi)鏡感染管理和內(nèi)鏡消毒已成為醫(yī)院感染管理的重要環(huán)節(jié)。
With the continuous development of medical technology, medical endoscope has been widely used in the medical field. It has become an indispensable and important medical tool in clinical diagnosis and treatment. Strengthening the management of endoscopic infection and endoscopic disinfection has become an important part of hospital infection management.
內(nèi)窺鏡的組成和分類
Composition and classification of endoscope
醫(yī)用內(nèi)窺鏡由三部分組成:內(nèi)窺鏡系統(tǒng)、圖像顯示系統(tǒng)、照明系統(tǒng),內(nèi)窺鏡根據(jù)成像結(jié)構(gòu)可分為硬管內(nèi)窺鏡、光纖內(nèi)窺鏡、電子內(nèi)窺鏡;根據(jù)其功能,可分為消化道內(nèi)窺鏡、呼吸系統(tǒng)內(nèi)窺鏡、泌尿系統(tǒng)內(nèi)窺鏡等。
Medical endoscope consists of three parts: endoscope system, image display system and lighting system. According to the imaging structure, endoscope can be divided into hard tube endoscope, optical fiber endoscope and electronic endoscope; according to its function, it can be divided into digestive tract endoscope, respiratory system endoscope and urinary system endoscope.
1纖維內(nèi)窺鏡
1 fiber endoscope
2電子內(nèi)窺鏡
2 electronic endoscope
3醫(yī)院內(nèi)窺鏡系統(tǒng)
3 hospital endoscopy system
內(nèi)窺鏡感染的原因
Causes of endoscopic infection
1.內(nèi)窺鏡通道和附件難以消毒;2.自動(dòng)清潔劑造成的污染;3.消毒劑使用不當(dāng);4.內(nèi)部通道不干燥;5.原因不明。
1. Endoscope passage and accessories are difficult to disinfect; 2. Pollution caused by automatic cleaner; 3. Improper use of disinfectant; 4. Internal passage is not dry; 5. Unknown reason.
內(nèi)鏡感染的原因分析
Analysis of the causes of endoscopic infection
《中國(guó)消毒學(xué)雜志》報(bào)道因內(nèi)窺鏡檢查引起的377位感染病例,其中上消化道鏡占47.75%,下消化道引起的占26.79%,支氣管鏡引起的占25.46%。
The Chinese Journal of disinfection reported 377 cases of infection caused by endoscopy, of which 47.75% were caused by upper digestive tract, 26.79% by lower digestive tract and 25.46% by bronchoscope.
內(nèi)窺鏡傳感解決方案
Endoscope sensing solution
1醫(yī)院內(nèi)鏡的清洗和消毒分為兩部分:外部硬件系統(tǒng)和各種內(nèi)鏡。外部硬件系統(tǒng)包括圖像處理器、監(jiān)視器、冷光源等。它可以用不含酒精的衛(wèi)生抹布擦拭。
The cleaning and disinfection of endoscopes in hospital are divided into two parts: external hardware system and various endoscopes. The external hardware system includes image processor, monitor, cold light source, etc. It can be wiped with a non-alcoholic sanitary cloth.
(2)硬質(zhì)鏡片的消毒步驟:1)將硬質(zhì)鏡片放置在容器上,在清洗和浸泡過(guò)程中,將硬質(zhì)鏡片與其他手術(shù)器械分開(kāi)放置;2.用微潔多酶清洗劑清洗,用軟、清潔小刷、海綿或紗布;3.清潔后,用干凈的紗布擦拭外表面的水分。4.對(duì)干燥的五金件進(jìn)行高溫蒸汽消毒,并在操作前將其與其他儀器分開(kāi)。
(2) Disinfection steps of hard lens: 1) place the hard lens on the container, separate the hard lens from other surgical instruments during cleaning and soaking; 2. Clean with micro cleaning multi enzyme cleaning agent, and use soft, clean small brush, sponge or gauze; 3. After cleaning, wipe the water on the outer surface with clean gauze. 4. Sterilize the dry hardware with high temperature steam and separate it from other instruments before operation.
3.軟鏡定時(shí)消毒法:軟鏡定時(shí)消毒采用二氧化氯消毒(一次清洗,泡騰片)(1)整個(gè)軟鏡管道注入空氣,排出清水,防止水稀釋消毒液;(2)將軟鏡放入消毒劑中充分浸泡,用一次性注射器將消毒劑注入所有管道,直至無(wú)氣泡出現(xiàn);(3)將軟鏡、的附件和清潔工具浸泡在消毒劑中,直至達(dá)到規(guī)范要求的浸泡時(shí)間;(4)浸泡后,向注射器內(nèi)注入空氣,去除多余的消毒劑,去除多余的消毒劑,取出內(nèi)窺鏡。
3. Soft mirror timing disinfection method: the soft mirror timing disinfection adopts chlorine dioxide disinfection (one-time cleaning, effervescent tablets) (1) the whole soft mirror pipe is injected with air, and the clear water is discharged to prevent the water from diluting the disinfectant; (2) the soft mirror is fully immersed in the disinfectant, and the disinfectant is injected into all pipes with a disposable syringe until there is no bubble; (3) the soft mirror, accessories and cleaning tools are immersed in the disinfection After soaking, inject air into the syringe to remove the excess disinfectant, remove the excess disinfectant and take out the endoscope.