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目的:以大型消化内镜中心控制消化内镜消毒成本的需求为牵引,评价二氧化氯气体应用于消化内镜消毒的可行性。创新点:首次研究了二氧化氯气体对细长管腔内部的消毒效果及其影响因素,并以此为基础研究了采用主动灌流方法的二氧化氯气体消毒消化内镜的原型机。方法:设计了一种聚四氟乙烯(PTFE)细长管腔实验装置(长2 m,内径1 mm),在其进气端、中部和出气端分别设置PTFE菌片容器。将含有PTFE菌片和细长管腔和置于平皿内的PTFE菌片装载于一种消毒实验原型机中,通过主动灌流使二氧化氯气体流过细长管腔,平皿内的PTFE菌片直接曝露于二氧化氯气体中,分别评价二氧化氯气体对PTFE细长管腔内壁和外壁的消毒效果。以萎缩芽孢杆菌为指示微生物,评价二氧化氯剂量(浓度与时间的乘积)、相对湿度、流过细长管腔的流量及有机干扰物对消毒效果的影响。同时使用实验原型机对8条消化内镜进行了实效验证实验。结论:实验结果表明,除了相对湿度、二氧化氯剂量和有机干扰物都显著影响二氧化氯气体的消毒效果外(图3、5和6),随着经过细长管腔流量的增大,二氧化氯气体对细长管腔内部的芽孢杀灭对数值有减小的趋势(图4)。按照本文设计的流程,应用实验原型机对8条消化内镜消毒后,未检出存活的微生物。应用二氧化氯气体消毒消化内镜时,其每条内镜的消毒剂成本小于3元人民币。
OBJECTIVE: To explore the feasibility of using digestive endoscopy to control the cost of digestive endoscopy and evaluate the feasibility of using chlorine dioxide in digestive endoscopy. Innovation: The first study of chlorine dioxide gas slender internal cavity of the disinfection and its influencing factors, and as a basis for the study of active perfusion method of chlorine dioxide gas disinfection digestive endoscopy prototype. Methods: A PTFE elongated slender tube experimental device (length 2 m, inner diameter 1 mm) was designed. The PTFE gas trays were placed on the inlet, the middle and the outlet respectively. The PTFE sheet and the elongated lumen and the PTFE sheet placed in the petri dish were loaded into a sterilizing experimental prototype and chlorine dioxide gas was flowed through the elongated lumen by active perfusion. The PTFE sheet in the petri dish was directly Exposure to chlorine dioxide gas, respectively, evaluation of chlorine dioxide gas slender PTFE tube wall and outer wall disinfection. The Bacillus subtilis was used as indicator microorganism to evaluate the effect of chlorine dioxide dose (product of concentration and time), relative humidity, flow rate through slender lumen and organic interference on disinfection effect. At the same time, the experimental prototype was used to verify the effectiveness of eight digestive endoscopes. CONCLUSIONS: The experimental results show that in addition to relative humidity, chlorine dioxide doses and organic interferences significantly affect the disinfection effect of chlorine dioxide gas (Figures 3, 5 and 6). As the slender lumen flow increases, Chlorine dioxide gas to slender lumen inside the spores kill the numerical downward trend (Figure 4). Accordance with the design of this article, the application of experimental prototype on the eight digestive endoscopy after disinfection, did not detect the survival of microorganisms. Application of chlorine dioxide gas disinfection and digestion endoscopy, each of its endoscope disinfectant costs less than 3 yuan.