电子内窥镜的维护与保养

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                    <p><img data-type="gif" src="http://mmbiz.qpic.cn/mmbiz_gif/dx3KibwtDhvezhWjA9OE2EwumicC4kMAsKk2Pz01VsicM98wnG2rBnzvRXWGQfIaBFWuvAEFj8pu4K9TnhxowfPGw/0?wx_fmt=gif" data-ratio="0.1703125" data-w="640"  /></p><p>1、电子内窥镜消毒</p><p>电子内窥镜消毒的过程：① 把整支电子内窥镜放入消毒液中。② 用注射器把消毒液注入所有管道，直至没有气泡冒出。③ 将内镜的附件和清洗工具留在消毒液中，直到指定合适时间。④ 结束后，先用注射器在管道内注入空气，排出多余消毒液，再取出内镜（注意病例后的内镜必须经过洗涤液彻底清洗过后，才可以在消毒液中进行浸泡）。</p><p>电子内窥镜消毒时使用的消毒液是乙醛复合物，如戊二醛，戊二醛是一种组织固定剂，能使蛋白质变性而凝固。因此未经洗涤液擦拭的内镜，粘附着的组织和分泌物会因接触乙醛复合物而凝固成结晶，集结在内镜表面和管腔内。这些结晶的形成将会导致内镜消毒不完全，构成交叉感染；内镜的内外硬化和粗糙，加速老化，同时增加内镜破损的机会；钳子、管道和送气、送水管道容易堵塞；镜面模糊不清；内镜本身变形和变色。同时值得注意的是凝固后的结晶是不能清除的，这样会严重影响内镜的使用寿命与病人的安全。</p><p>2、电子内窥镜治疗附件维护和保养&nbsp;</p><p>2.1 &nbsp;浸泡(Immersion)</p><p>内窥镜治疗附件用后应立即把器具浸泡于洗涤液中，并把洗涤液注入所有管道。这样做的目的是为了避免脏物干涸在内镜治疗器具上。</p><p>2.2 &nbsp;超声清洗(Ultrasonic Cleaning)</p><p>内窥镜治疗附件用后把器具放置于超声清洗机中，把洗涤液注入所有管道。启动超声清洗机进行30min的清洗（超声频率为38~47kHz）。由于金属外鞘与轴心之间和钳子活动关节里的污垢不能刷洗，而超声波在洗涤液中产生负压，使细小的气泡形成。超声波在洗涤液中产生正压，使细小的气泡破裂，从而释放能量把细微隙缝里的污垢彻底去掉。达到清洁内镜治疗器具的目的。</p><p>2.3 &nbsp;漂洗(Rinsing)</p><p>用清水冲洗器具，并把清水注入所有管道中，这样做的目的是把洗涤液冲洗掉。</p><p>2.4 &nbsp;润滑(Lubrication)</p><p>把内镜治疗器具浸泡于润滑剂中数秒，并把润滑剂注入器具所有管道中，润滑后把空气注入器具管道中以去除多余的润滑剂。完成后把器具擦干。这样做的目的是保持内镜治疗器具操作时的顺滑。</p><p>2.5 &nbsp;高温高压灭菌(Autoclave)</p><p>把清洗润滑后的内镜治疗器具卷好（直径不少于20cm）并放进高温高压灭菌专用袋中，然后把袋子封好，将封好的内镜治疗器具放置于高温高压灭菌锅中，根据灭菌条件为器具进行灭菌。锅温在132~134℃，时间5min。需要注意的是，可高温高压灭菌的内镜治疗器具外观应标有“AUTOCLAVE”或“AUTOCLAVABLE”字样，另外内镜治疗器具外观部份涂有绿色，也表示可高温高压灭菌。注意内镜本身不能进行高温高压灭菌。</p><p><img data-s="300,640" data-type="jpeg" src="http://mmbiz.qpic.cn/mmbiz_jpg/dx3KibwtDhvemMTZoJJTgIuSJ1E0OUj76SmKNJicKUgKibCUn8U5hMy8Hp7AI4kbaQROgHYS6dgI02yp44TnGEthA/0?wx_fmt=jpeg" data-ratio="0.66375" data-w="800"  /></p><p style="max-width: 100%; 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