Cleaning of laparoscopic instruments

　　腹腔鏡器械的清洗是消毒和滅菌中的一個重要環(huán)節(jié)，經(jīng)過清洗能去除器械90%以上的病原體。現(xiàn)在腹腔鏡器械的清洗有人工和運用超聲自動清洗機兩種辦法。普遍選用的是人工清洗法。手術(shù)完畢后，立即將腹腔鏡器械放在1∶ 300中性多酶清潔劑浸泡10 min，因酶可敏捷分化蛋白質(zhì)和有機物，使殘留血液、有機物、粘液等不至于凝結(jié)而吸附在器械上，從而易于清洗。并將一切能拆卸的部件悉數(shù)取下，分開放置，各套管芯拔出，充沛浸泡。然后用流動水認(rèn)真清洗每一部件，帶有管腔的器械運用柔軟的毛刷反復(fù)洗刷，以兩頭見刷頭為準(zhǔn)，清除一切的組織碎片，一起去除其他有機物。清洗潔凈后放在器械專用光滑液里光滑約2 min后取出，并將各關(guān)節(jié)各鉗葉翻開，有管腔的器械用高壓氣槍向管腔吹入壓縮氣體直至無水分排出，使其充沛枯燥，橫放或懸掛在陰涼枯燥的專用儲存柜內(nèi)備用。

　　The cleaning of laparoscopic instruments is an important part of disinfection and sterilization, which can remove more than 90% of pathogens. Now there are two ways to clean laparoscopic instruments: manual and automatic ultrasonic cleaning machine. The commonly used method is manual cleaning. After the operation, immediately immerse the laparoscopic instrument in 1:300 neutral multi enzyme detergent for 10 minutes, because the enzyme can rapidly differentiate protein and organic matter, so that the residual blood, organic matter, mucus, etc. will not coagulate and will be absorbed on the instrument, so that it is easy to clean. All the parts that can be disassembled shall be taken down and placed separately. Each casing core shall be pulled out and fully soaked. Then carefully clean each part with flowing water. For instruments with lumen, use soft brush to wash repeatedly, and the brush head is the criterion. Remove all tissue fragments and other organic matters together. After cleaning, put it in the special smooth liquid of the instrument for about 2 minutes, take it out, turn over the tongs and leaves of each joint, blow compressed gas into the lumen with a high-pressure air gun until there is no water to discharge, make it full and dry, put it horizontally or hang it in a cool and dry special storage cabinet for standby.
              

　　鏡頭和光纜的處理

　　Lens and cable handling

　　手術(shù)完畢后運用蘸有中性多酶清潔劑的濕紗布對鏡頭及各種導(dǎo)線表面血跡、污漬進行擦洗，運用吸水較強的軟布擦干，對光纜進行放置時，應(yīng)無視點自旋放置于腹腔鏡專用盒內(nèi)，禁止成角折疊或過度彎曲，鏡面用脫脂棉球或拭鏡紙順時針方向進行擦洗，避免用粗糙布巾擦洗，避免損害鏡面，影響術(shù)中運用。

　　After the operation, use wet gauze dipped with neutral multi enzyme cleaner to clean the blood and stains on the lens and various wires, and use soft cloth with strong water absorption to dry them. When placing the optical cable, place it in the special box of laparoscope without view point spin. It is forbidden to fold or bend it excessively. The mirror surface shall be wiped clockwise with absorbent cotton ball or wiping paper to avoid roughness Wipe with cloth to avoid damaging the mirror surface and affecting the operation.

　　腹腔鏡器械清洗時注意事項

　　Precautions for laparoscopic instrument cleaning

　　清洗時要避免腹腔鏡器械各附件的缺失，因為腹腔鏡器械緊密雜亂，許多器械都配有小的附件，因而在拆卸清洗時，沖洗槽內(nèi)要鋪有過濾網(wǎng)，以防沖入下水道丟掉。另外冷光源和攝像鏡頭連接在清洗及消毒過程中，不行打折，盤旋的視點應(yīng)成鈍角，避免損害光導(dǎo)纖維。

　　During cleaning, it is necessary to avoid the loss of the accessories of the laparoscopic instruments. Because the laparoscopic instruments are closely and disorderly, many instruments are equipped with small accessories. Therefore, when disassembling and cleaning, the washing tank should be paved with a filter screen to prevent them from being washed into the sewer. In addition, the cold light source and camera lens are connected in the process of cleaning and disinfection, without discount. The rotating point of view should be obtuse to avoid damage to the optical fiber.

　　腹腔鏡器械的消毒及滅菌

　　Disinfection and sterilization of laparoscopic instruments

　　當(dāng)時普遍運用的辦法才是安全牢靠的過氧化氫等離子低溫消毒，與傳統(tǒng)的滅菌辦法相比較具有滅菌作用切當(dāng)、快速、安全、環(huán)保等長處，也有效地減少腹腔的損害，一般由專人負(fù)責(zé)辦理低溫滅菌器，將腹腔鏡器械放置在專用器械盒內(nèi)，用無紡布包裝，包裝外注明腔鏡器械的稱號、滅菌時間及有效期。正常選擇的滅菌形式是加強形式，達滅菌69 min。一起我們在嚴(yán)格地檢測系統(tǒng)，化學(xué)指示膠帶和卡片的監(jiān)測，每一鍋都有生物監(jiān)測，十分緊密，確實可達到抱負(fù)的滅菌作用。

　　At that time, the commonly used method was the safe and reliable hydrogen peroxide plasma low-temperature disinfection. Compared with the traditional sterilization method, it had the advantages of sterilization, such as proper, fast, safe and environmental protection, and also effectively reduced the damage to the abdominal cavity. Generally, a special person was responsible for handling the low-temperature sterilizer, placing the laparoscopic instruments in a special instrument box, packing them with non-woven fabric, and indicating the cavity on the outside of the package The title, sterilization time and validity of the mirror instrument. The normal choice of sterilization form is to strengthen the form of sterilization for 69 minutes. Together we are in strict detection system, chemical indicator tape and card monitoring, each pot has biological monitoring, very close, can achieve the desired sterilization effect.

　　腹腔鏡感染手術(shù)的器械消毒

　　Disinfection of instruments in laparoscopic infection operation

　　依據(jù)現(xiàn)在大都醫(yī)院的現(xiàn)有條件，有無抱負(fù)的滅菌辦法，因而我們關(guān)于有特異性感染(結(jié)核、乙肝陽性)以及其他流行癥的患者組織在之后做。用后遵從消毒、清洗、清洗消毒的準(zhǔn)則。

　　According to the current conditions of most hospitals, there is an ideal sterilization method, so we will do it later for patients with specific infection (tuberculosis, hepatitis B positive) and other epidemics. Follow the guidelines of disinfection, cleaning and disinfection after use.

　　腹腔鏡器械的保養(yǎng)

　　Maintenance of laparoscopic instruments

　　腹腔鏡器械精細(xì)，精細(xì)。清洗時分開放置，用軟毛刷沖洗后，吹風(fēng)機吹干，器械軸節(jié)部浸入光滑劑中，整齊排列、放入盒中。管腔器械用氣槍吹干后在上油。尖細(xì)器械尖端套硅膠管維護，松緊適合。生銹的器械選用專用除銹劑進行除銹處理，然后進行慣例清洗，清洗后再作煮沸、光滑、枯燥處理。這樣對器械起到保養(yǎng)、延伸其運用壽命的作用。

　　Laparoscopic instruments are fine and delicate. During cleaning, it shall be placed separately. After washing with soft brush, the blower shall be dried. The instrument shaft part shall be immersed in the smooth agent, arranged in order and put into the box. The lumen apparatus is oiled after being dried with an air gun. The tip of the fine instrument is covered with silicone tube for maintenance, which is suitable for tightness. Special rust remover shall be used for rust removal of rusty instruments, and then conventional cleaning shall be carried out. After cleaning, boiling, smooth and boring treatment shall be carried out. In this way, it can maintain the equipment and extend its service life.

　　腔鏡器械有必要定點寄存

　　It is necessary to store the endoscopy equipment at designated place

　　腔鏡器械比較精細(xì)，不能與一般器械一起進行放置，要有專用儲存柜，腔鏡必定放置在原裝盒內(nèi)，氣腹針與一些可拆的部分小零件要放在小盒內(nèi)，避免折斷和丟掉；導(dǎo)線清潔后寄存時不行打折避免折損。

　　The cavity mirror equipment is relatively fine, so it cannot be placed together with the general equipment. There should be a special storage cabinet. The cavity mirror must be placed in the original box. The pneumoperitoneum needle and some detachable small parts should be placed in the small box to avoid breaking and losing. The wire should not be folded or damaged after cleaning.

　　統(tǒng)一辦理

　　Unified handling

　　跟著腹腔鏡運用范圍的不斷擴大，為進步腹腔鏡臨床運用效率，應(yīng)組織責(zé)任心強、具有杰出職業(yè)道德、有必定的消毒和醫(yī)院感染知識的人員統(tǒng)一辦理，并樹立記載腹腔鏡器械運用掛號專冊，保證腹腔鏡安全運用。

　　With the continuous expansion of the application scope of laparoscopy, in order to improve the clinical application efficiency of laparoscopy, it is necessary to organize personnel with strong sense of responsibility, outstanding professional ethics, certain knowledge of disinfection and hospital infection to handle it in a unified way, and establish a special register for recording the application of laparoscopic instruments to ensure the safe use of laparoscopy.

　　加強消毒作用的檢測

　　Strengthen the test of disinfection effect

　　對消毒后的器械進行消毒作用監(jiān)測十分重要。因腹腔鏡器械的管徑長、窄及關(guān)節(jié)的密閉性，在浸泡消毒時會存在單個區(qū)域液體滲透不全的現(xiàn)象。醫(yī)院感染科應(yīng)定期對腹腔鏡器械的消毒作用進行檢測，發(fā)現(xiàn)問題及時處理。以保證腹腔鏡器械達到有效消毒滅菌。

　　It is very important to monitor the disinfection effect of sterilized instruments. Because of the long and narrow diameter of the laparoscopic instruments and the airtight of the joints, there will be the phenomenon of incomplete liquid penetration in a single area during immersion disinfection. The Department of nosocomial infection should test the disinfection effect of laparoscopic instruments on a regular basis and deal with the problems in time. In order to ensure the effective sterilization of laparoscopic instruments.