腹腔鏡器械的清洗

Cleaning of laparoscopic instruments

腹腔鏡器械的清洗是消毒滅菌的重要環(huán)節(jié)。儀器中90%以上的病原體可以通過清洗去除。目前，腹腔鏡器械的清洗方法有手動(dòng)和超聲波自動(dòng)清洗機(jī)兩種。最常見的方法是手動(dòng)清潔。

The cleaning of laparoscopic instruments is an important part of disinfection and sterilization. More than 90% of the pathogens in the instrument can be removed by cleaning. At present, there are two cleaning methods of laparoscopic instruments: manual and ultrasonic automatic cleaning machine. The most common method is manual cleaning.

手術(shù)后立即將腹腔鏡器械在1：300中性多酶清洗劑中浸泡10分鐘，因?yàn)槊改芸焖俜纸獾鞍踪|(zhì)和有機(jī)物，使殘留的血液、有機(jī)物、粘液等不會(huì)凝固，吸附在器械上，因此易于清潔。

Immediately after the operation, immerse the laparoscopic instrument in 1:300 neutral multi enzyme detergent for 10 minutes, because the enzyme can quickly decompose protein and organic matter, so that the residual blood, organic matter and mucus will not solidify and adsorb on the instrument, so it is easy to clean.

并拆下所有可拆卸部件，分開放置，拉出每個(gè)套管芯，充分浸泡。然后用流水仔細(xì)清洗每個(gè)部分。有內(nèi)腔的器械應(yīng)用軟毛刷反復(fù)清洗，刷頭在兩端，以徹底清除所有組織碎片和其他有機(jī)物。

Remove all removable parts, place them separately, pull out each casing core and soak it fully. Then wash each part carefully with running water. Instruments with lumen shall be cleaned repeatedly with soft bristle brush with brush head at both ends to completely remove all tissue fragments and other organic matter.

清洗后，放入儀器專用潤(rùn)滑液中潤(rùn)滑2分鐘左右，取出，打開各接頭和各鉗口。對(duì)于有管腔的器械，用高壓氣槍將壓縮氣體吹入管腔，直至無水排出，并使其充分干燥。將其水平放置或掛在陰涼干燥的專用儲(chǔ)物柜中，以備后用。

After cleaning, put it into the special lubricating fluid of the instrument for lubrication for about 2 minutes, take it out and open all joints and jaws. For instruments with lumen, use a high-pressure air gun to blow compressed gas into the lumen until there is no water to be discharged, and make it fully dry. Place it horizontally or hang it in a cool and dry special storage cabinet for future use.

清洗時(shí)，要防止腹腔鏡器械的各種附件丟失。由于腹腔鏡器械的緊湊性和復(fù)雜性，許多器械都配備了小配件。因此，在拆卸清洗時(shí)，應(yīng)在洗滌槽內(nèi)鋪設(shè)過濾器，以防被沖入下水道而丟失。另外，在清洗消毒過程中，冷光源與攝像機(jī)鏡頭的連接也不能打折扣。圓的角度應(yīng)為鈍角，以免損壞光纖。

When cleaning, prevent the loss of various accessories of laparoscopic instruments. Due to the compactness and complexity of laparoscopic instruments, many instruments are equipped with small accessories. Therefore, during disassembly and cleaning, the filter shall be laid in the washing tank to prevent it from being washed into the sewer and lost. In addition, in the process of cleaning and disinfection, the connection between the cold light source and the camera lens cannot be discounted. The angle of the circle should be obtuse to avoid damaging the optical fiber.

腹腔鏡器械的消毒

Disinfection of laparoscopic instruments

目前常用的方法是安全可靠的過氧化氫等離子體低溫滅菌。與傳統(tǒng)的滅菌方式相比，具有滅菌效果準(zhǔn)確、快速、安全、環(huán)保等優(yōu)點(diǎn)，也有效減少了對(duì)腹腔的傷害。

At present, the commonly used method is safe and reliable hydrogen peroxide plasma low-temperature sterilization. Compared with the traditional sterilization method, it has the advantages of accurate, rapid, safe and environmental protection, and effectively reduces the injury to the abdominal cavity.

通常，低溫滅菌器由專人負(fù)責(zé)管理，腹腔鏡器械放置在專用器械箱內(nèi)，并用無紡布包裝。正常選擇的殺菌模式為增強(qiáng)模式，可殺菌69分鐘。

Generally, the low-temperature sterilizer is managed by a specially assigned person, and the laparoscopic instruments are placed in the special instrument box and packaged with non-woven fabrics. The normally selected sterilization mode is enhanced mode, which can sterilize for 69 minutes.

同時(shí)，我們對(duì)內(nèi)窺鏡設(shè)備維修制度進(jìn)行嚴(yán)格檢測(cè)，化學(xué)指示帶和卡片的監(jiān)控，每個(gè)鍋都有生物監(jiān)控，非常嚴(yán)格，確實(shí)可以達(dá)到理想的殺菌效果。

At the same time, we strictly detect the maintenance system of endoscope equipment, monitor the chemical indicator tape and card, and each pot has biological monitoring, which is very strict, which can really achieve the ideal sterilization effect.

監(jiān)測(cè)已滅菌器械的消毒效果非常重要。由于腹腔鏡器械的直徑長(zhǎng)而窄，以及連接處的緊密性，在浸泡和消毒過程中，個(gè)別區(qū)域會(huì)出現(xiàn)液體滲透不足的情況。醫(yī)院傳染病科應(yīng)定期檢測(cè)腹腔鏡器械消毒效果，發(fā)現(xiàn)問題及時(shí)處理。確保腹腔鏡器械的有效消毒和滅菌。

It is very important to monitor the disinfection effect of sterilized instruments. Due to the long and narrow diameter of laparoscopic instruments and the tightness of joints, insufficient liquid penetration will occur in some areas during soaking and disinfection. The infectious diseases department of the hospital should regularly test the disinfection effect of laparoscopic instruments and deal with problems in time. Ensure the effective disinfection and sterilization of laparoscopic instruments.

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