钳子管道残留组织胶对内镜清洗消毒质量的影响

 目的 观察内镜下组织胶注射术后钳子管道组织胶残留情况, 评价残留组织胶对内镜清洗消毒质量的影响。方法 随机选取2021年6—8月某三甲医院消化内镜中心行内镜下组织胶注射术患者使用后的胃镜41条, 清洗消毒后采用管腔检测仪目测法观察内镜钳子管道组织胶残留情况并进行微生物检测, 比较有无残留组织胶内镜组的清洗消毒合格率和菌落数分布情况。结果 41条内镜下组织胶注射术使用后的钳子管道, 清洗消毒后28条有组织胶残留, 发生率为68.29%。组织胶残留部位以距离钳子管道出口0~2 cm处为主(23条), 组织胶残留形状多呈块状(23条)。28条残留组织胶内镜首次清洗消毒合格率为46.43%(13条), 13条无组织胶残留的内镜清洗消毒合格率为100%, 两组内镜首次清洗消毒合格率比较, 差异有统计学意义(χ²=8.794, P=0.003)。残留组织胶内镜组和无组织胶残留内镜组的菌落数分布比较, 差异有统计学意义(Z=-3.767, P＜0.001)。28条残留组织胶内镜重复清洗消毒合格率为53.57%(15条), 与残留组织胶内镜首次清洗消毒合格率比较, 差异无统计学意义(χ²=0.286, P=0.593)。残留组织胶内镜重复清洗消毒后菌落数与首次清洗消毒菌落数比较, 差异无统计学意义(Z=-1.185, P=0.236)。结论 内镜下组织胶注射术后钳子管道组织胶残留发生率高, 导致钳子管道清洗消毒不合格率及细菌检出率高, 降低了内镜清洗消毒质量。

Effect of residual tissue glue in forceps channel on cleaning and disinfection quality of endoscope

Objective To observe the residual tissue glue in forceps channel after endoscopic tissue glue injection, and evaluate the effect of residual tissue glue on the cleaning and disinfection quality of endoscope.Methods 41 pieces of gastroscopes used by patients who underwent endoscopic tissue glue injection in the digestive endoscopy center of a tertiary first-class hospital from June to August 2021 were randomly selected, residual of tissue glue in endoscopic forceps channel after cleaning and disinfection was observed with lumen detector visual method, and microbial detection was performed, qualified rate of cleaning and disinfection as well as bacterial colony distribution between endoscopes with and without residual tissue glue were compared.Results Among 41 forceps channel after endoscopic tissue glue injection, 28 (68.29%) had tissue glue residue after cleaning and disinfection. The residual sites of tissue glue were mainly 0-2 cm away from the outlet of forceps channel (n=23), most residual of tissue glue presented lumpy shape (n=23). Qualified rates of the initial cleaning and disinfection of 28 pieces of endoscopes with residual tissue glue and 13 pieces of endoscopes without residual tissue glue were 46.43% (n=13) and 100% respectively, there was significant difference in the initial cleaning and disinfection qualified rate between two groups (χ²=8.794, P=0.003). There was significant difference in the distribution of bacterial colony number between endoscope groups with and without residual tissue glue (Z=-3.767, P < 0.001). The qualified rate of repeated cleaning and disinfection of 28 pieces of endoscopes with residual tissue glue was 53.57% (n=15), there was no significant difference compared with qualified rate of the initial cleaning and disinfection of endoscopes with residual tissue glue (χ²=0.286, P=0.593). There was no significant difference between the number of bacterial colony in endoscopes with residual tissue glue after repeated cleaning and disinfection as well as the initial cleaning and disinfection (Z=-1.185, P=0.236).Conclusion Residual rate of tissue glue in forceps channel after endoscopic tissue glue injection is high, which leads to the high unqualified rate of cleaning and disinfection as well as high detection rate of bacteria of forceps channel, and reduces the quality of endoscopic cleaning and disinfection.