钳子管道内刮痕对软式内镜再处理质量的影响

 目的 观察软式内镜钳子管道内刮痕发生情况，探讨刮痕对内镜再处理质量的影响。方法 选取某综合性医院162条再处理后的内镜钳子管道内部情况进行调查，使用管腔检测仪观察内镜钳子管道内刮痕发生情况，并对管腔进行微生物检测，最后将刮痕严重、反复培养不合格的管腔拆卸后在扫描电镜下观察刮痕内情况。结果 162条内镜的钳子管道中有刮痕的占91.36%（148条），其中黑色刮痕占18.24%（27/148），微生物检测不合格率为18.52%（5/27）；黄色刮痕占6.76%（10/148），微生物检测不合格率为20.00%（2/10）。将1条刮痕严重、反复微生物检测不合格的内镜钳子管道拆卸后，在扫描电镜下观察到纵横交错的生物膜。结论 内镜钳子管道内刮痕发生率高，刮痕为生物膜营造了良好的生长繁殖环境，影响内镜再处理质量，建议定期使用管腔检测仪检查钳子管道内刮痕情况，并定期进行微生物监测。

Impact of scratches in the endoscopic forceps channel on the quality of endoscopic reprocessing

Objective To observe the occurrence of scratches in flexible endoscopic forceps channel, evaluate scratches on the quality of endoscopic reprocessing. Methods The lumens of 162 reprocessed endoscopic forceps channel in a general hospital were investigated, the occurrence of scratches in endoscopic forceps channel was observed with borescope, microorganisms in the lumen were detected, lumen with severe scratches and unqualified result of repeated culture was dismantled, scratch condition was observed under scanning electron microscope. Results Of 162 endoscopic forceps channels, 91.36% (n=148) had scratches, among which the black scratches accounted for 18.24%(27/148), the unqualified rate of microbial detection was 18.52%(5/27); yellow scratches accounted for 6.76%(10/148), the unqualified rate of microbial detection was 20.00%(2/10). After dismantling a severely scratched endoscopic forceps channel that was unqualified in repeated microbial detection, crisscross biofilms were observed under the scanning electron microscope. Conclusion Incidence of scratches in endoscopic forceps channel is high, which creates a good growth environment for the biofilm, affects the quality of endoscopic reprocessing. It is suggested to use the borescope to check the scratches in the forceps channel regularly, and to conduct microbial surveillance regularly.