一次性内镜床旁预处理盒在胃肠镜清洗过程中的应用效果评价: 一项单中心观察性研究

 目的 研究在内镜床旁预处理环节使用一次性内镜床旁预处理盒对内镜的清洗效果, 以及清洗阶段清洗槽内清洗液用量, 为提高内镜清洗质量, 降低临床成本探索可行措施。方法 选取112条使用后的胃肠镜随机分为A、B两组, 在预处理阶段, A组使用传统预处理桶, B组使用一次性内镜床旁预处理盒, 在清洗阶段每组再分为2小组, 即A1、A2、B1、B2共4组, A1、B1组清洗槽内清洗液多用一更换, A2、B2组清洗槽内清洗液一用一更换。采用三磷酸腺苷(ATP)生物荧光法和NICE CHECK残留蛋白检测法检测床旁预处理前后和清洗后内镜管腔内面相对光单位值(RLU) 和蛋白残留量, 比较各组的清洗效果。结果 预处理前ATP检测值和蛋白质残留量均值A组与B组比较, 差异均无统计学意义(均P＞0.05);预处理后B组ATP检测值低于A组(P＜0.05), 蛋白残留量B组与A组比较差异无统计学意义(P＞0.05)。清洗后, B1、B2组ATP检测值均比A1、A2组低(均P＜0.05), 而A1组与A2组、B1组与B2组ATP检测值比较, 差异均无统计学意义(均P＞0.05);四组蛋白残留量比较, 差异均无统计学意义(均P＞0.05)。结论 使用一次性内镜床旁预处理盒进行预处理, 并在手工清洗阶段采取清洗槽内清洗液多用一更换模式, 是综合临床成本及清洗效果的最优选择。

Evaluation of the application effect of disposable endoscope bedside pre-treatment kit in the cleaning process of gastrointestinal endoscope: A single-center observational study

Objective To study the effect of application of disposable endoscope bedside pre-treatment kit on endoscope cleaning in pre-treatment link and the amount of cleaning solution in the cleaning tank during cleaning process, so as to explore feasible measures to improve the quality of endoscope cleaning and reduce the clinical cost. Methods 112 pieces of used gastrointestinal endoscopes were randomly divided into two groups (groups A and B), during pre-treatment process, group A used traditional pre-treatment barrel and group B used disposable endoscope bedside pre-treatment kit. During the cleaning process, each group was subdivided into two groups (groups A1, A2, B1 and B2). The cleaning solution in the cleaning tanks of group A1 and group B1 were replaced after several times of use, while group A2 and group B2 were replaced every time. The relative light unit value (RLU) and protein residue in the inner surface of endoscopic lumen before and after bedside pre-treatment as well as after cleaning were detected with adenosine triphosphate (ATP) bioluminescence method and nice check residual protein detection me-thod, cleaning effect of each group was compared. Results There was no significant difference in ATP detection value and mean protein residue between group A and group B before pre-treatment (both P > 0.05); the detection value of ATP in group B was lower than that in group A after pre-treatment (P < 0.05), and there was no significant difference in protein residue between group B and group A (P > 0.05). ATP detection values of group B1 and group B2 were both lower than those of group A1 and group A2 after cleaning (both P < 0.05), but there was no significant difference between group A1 and group A2 as well as group B1 and group B2 (both P > 0.05); there was no significant difference in protein residues among four groups (all P > 0.05). Conclusion Using a disposable endoscope bed-side pre-treatment kit for pre-treatment and adopting the mode of one time replacement for multiple use of cleaning solution in the cleaning tank during the manual cleaning process is the best choice for comprehensive clinical cost and cleaning effect.