Gao Tao, Liu Rongyao, Cui Shuhua, Liu Ling, Wu Aimin (Endoscopy Center, Affiliated Hospital of Binzhou Medical College, Binzhou 256603, China) The machine is divided into three groups: test group 1, test group 2 and control group, and control group using suction method. Dry, test group 1 is dried by compressed air drying method, test 2 groups with 75% ethanol injection flow in each channel, and then dried by compressed air drying; bacterial culture of dried endoscopic sampling, counting each The number of colonies in the group was evaluated to evaluate the effect of the three drying methods on the quality of the disinfection. Results The number of colonies in the experimental group 1 and 2 was (4.33Â±10.55) CFU/piece and (4.00Â±10.36) CFU/piece, which were significantly less than the control group (38.33Â±86.18) CFU/piece. Statistical significance (P<0.05), and the difference between the experimental group 1 and the two groups was not statistically significant, but the experimental group 1 was simple and labor-saving. Conclusion Digestive endoscope disinfection followed by compressed air drying can improve the quality of endoscopic disinfection, and it is easy to operate and is recommended.
Digestive endoscopy is one of the most widely used and highly reusable endoscopes. The specifications of the endoscope cleaning and disinfection technology operation specifications should be strictly observed, and the quality of the endoscope cleaning and disinfection time and drying process should be controlled. The author combines domestic and foreign normative requirements, uses three different methods to dry the disinfected endoscope, and then carries out bacterial sampling and cultivation, and finds a safe and effective endoscopic drying method, which is reported below.
1Materials and methods 1.1 Materials 1.1.1 Disinfectant Wanjin medical equipment disinfectant (produced by Beijing Wanjin Zhaoyuan Disinfection Technology Co., Ltd.), the original solution is 1800022000mg/L, the gastrointestinal mirror is highly disinfected, and the dilution ratio is 1:10 soak for 10min. , Wanfu Jinan medical equipment disinfectant special chlorine test paper to determine the effective chlorine content.
1.1.3 Old Ken brand internal cleaning equipment five slots, high pressure water gun, high pressure air gun, manual cleaning.
1.2 Method 1.2.1 Three groups of treatment methods 9 gastroscopes were randomly divided into 3 groups, 3 in each group, the first group was the control group, using the method of disinfecting the endoscope to remove the moisture of each channel to dry; The two groups were the test group 1, which used the method of disinfecting the endoscope to dry the water of each channel by compressed air. The third group was the test group 2, and the endoscope was disinfected and then injected with 75% ethanol. It is then dried by means of blow drying with compressed air.
1.2.2 Gastroscope The whole bed is cleaned by a full-immersion manual cleaning method - side leakage knife wash enzyme wash - secondary wash - disinfection - final wash dry.
1.2.3 Gastrointestinal Drying Method After the three gastroscopes were cleaned and disinfected, the pipe injector was connected to the vacuum suction device, and the negative pressure was adjusted to 30 kPa for 3 minutes. After the negative pressure suction of the gastroscope, the high pressure air gun was used to connect the injection. After blowing negative pressure suction, the test group 2 was injected with 4 ml of 75% ethanol and injected with water, and then watered for 5 minutes, then dried with a high-pressure air gun for 1 min. 1.2.4 Biological monitoring standard total bacteria <20 CFU/piece , can not detect pathogenic bacteria.
1.2.5 Full-line injection sampling (1) On-site sampling: Place the decontaminated endoscope on a sterile towel, disinfect the endoscopic biopsy mouth with 75% ethanol, and extract 20 ml of neutral solution with a syringe. Inject the biopsy tube, collect the neutral solution with a test tube at the insertion end, and send it for detection at <2h. The three groups of endoscopes were monitored once a week and continuously for 20 times.
1.2.6 Culture method and result judgment The test solution was shaken thoroughly with a vortexer. 0.5 ml of each of the two sterile culture dishes was inoculated, and the number of colonies was counted after 48 hours of incubation in a 35% incubator. The results were judged: number of colonies/mirror = average number of colonies of 2 plates X20. 1.2.7 Statistical analysis Statistical analysis was performed using SPSS 16. 0 statistical software. Measurement data were expressed as mean standard deviation dd. One-way ANOVA was used for comparison between groups. P<0.05 was considered statistically significant.
2 Results The endoscopy of the 3 groups was monitored once a week for 20 times. The results showed that 38 of the control group were positive, the positive rate was 51.3%; 10 of the test group were positive, the positive rate was 16.7%; the test 2 group was positive. The number of pieces is 9 and the positive rate is 15.0% (the total number of bacteria is >20 CFU/piece is positive). See Table 1. 3 for discussion of the complex structure of the endoscope, the lumen is slender and the pipes are connected, and the vacuum suction is used to dry the endoscope, which is not easy. Microbial growth according to Table 1 3 groups of disinfection treatment methods, endoscopic disinfection colony array, another investigation number of positive pieces, number of colonies (CFU / piece), control group, 1 group of tests, 2 groups of notes: a. Test 1 group, 2 groups and control group Comparing P<0.05, the test group 1 and the test group 2 were compared P>0.05. Depending on the humid environment, drying could cause degeneration of bacterial protein and increase of salt concentration, which hindered the growth of bacteria or caused death. Therefore, choosing the right drying method is very important for the endoscope.
After the end of the mirror washing, the outer surface of the endoscope is dried with gauze, and the moisture of each channel is sucked clean before being used for the diagnosis and treatment of the next patient. Article 26 stipulates that: the daily diagnosis and treatment work is finished, and the disinfected endoscope tubes are washed, dried and stored with 75% ethanol. The guidelines for soft endoscopic cleaning and disinfection issued by the American Society of Digestive Endoscopy indicate that after endoscopic advanced disinfection, the endoscope and lumen are rinsed with sterile, filtered water to remove the disinfectant/sterilant. The rinse water is discarded after each use, and then flushed with 700900 ml/L ethanol or isopropanol, and then dried. The final drying step can greatly reduce the possibility of re-contamination of aquatic microorganisms.
At home and abroad, investigations have been reported on the spread and outbreak of nosocomial infection caused by incomplete disinfection or sterilization of endoscopes. The endoscope is in a damp state for a long time, and the lens accumulates fog, and the image is blurred. The wetted electronic parts (CCD) not only cause damage to the parts themselves and the connected electronic components, but also cause the power to be connected, increase the degree of damage to the endoscope, and shorten the use. life.
The results of this study show that the compressed air drying method is 1 min longer than the suction method and 5 min less than the compressed air drying method, and the number of positive parts and bacterial colonies is significantly smaller than that of the control group; compressed air drying method and ethanol injection flow compression Compared with the air drying method, the results are not statistically significant, but the compressed air drying method saves cost, and the operation is simple and easy, saving time and effort. Therefore, it is recommended to use compressed air drying method for endoscope drying.
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