高水平消毒后消化内镜钳道中二甲硅油残留情况及对内镜检查视野的影响

 目的 分析消化内镜高水平消毒后钳道中二甲硅油残留情况及对内镜检查视野的影响。方法 分别用无菌纯净水或低、中、高浓度(0.5%,1%,3%)二甲硅油冲洗医院10条胃肠内镜钳道。经过严格清洗及高水平消毒后使用SteriCam管道镜检查内镜钳道中的液体残留情况,并检测钳道液滴的三磷酸腺苷(adenosine triphosphate,ATP)生物发光值。结果 使用中浓度(液滴13.47±5.64, ATP值22.58±8.12)和高浓度(液滴17.30±6.61, ATP值24.00±10.60)二甲硅油冲洗钳道内液滴及ATP生物发光值,显著高于低浓度(液滴5.81±2.77, ATP值15.56±6.37)或无菌纯净水(液滴6.30±3.52, ATP值10.97±4.84),差异有统计学意义(P<0.05)。结论 尽量选择低浓度二甲硅油液体使用,当使用高浓度二甲硅油后要进行2个循环的洗消或适当延长洗消时间。

Residuals of simethicone in endoscope clamp tract after high level disinfection and its effect on endoscopy

Objective To analyze the amount of residuals of simethicone in the endoscope clamp tract after high level disinfection and its effect on endoscopy. Methods Aseptic water and simethicone at low, middle and high concentrations (0.5%, 1% and 3%) were used to rinse the endoscope clamp tract respectively. After strict cleaning and high-level disinfection, the SteriCam borescope was used to examine the residual fluid in the endoscope.The bioluminescent value of adenosine triphosphate (ATP) was measured as well. Results The amount of droplets and values of ATP bioluminescence in the endoscope clamp were significantly larger or higher when simethicone at a medium concentration (number of droplets:13.47±5.64, ATP value: 22.58±8.12) and a high concentration (number of droplets: 17.30±6.61, ATP value: 24.00±10.60)was used than when simethicone at a low concentration (number of droplets: 5.81±2.77, ATP value: 15.56±6.37) or sterile water was used(number of droplets: 6.30±3.52, ATP value: 10.97±4.84), P<0.05. The use of low-concentration simethicone did not increase the amount of residual droplets or values of ATP bioluminescence in the endoscope clamp. Conclusions Lowconcentration simethicone liquid is preferable. When high-concentration simethicone is used, two cycles of washout should be considered or the duration of washout should be extended appropriately.