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內窺鏡是集傳統光學、人體工程學、精密機械、現代電子等于一體的檢測儀器,可以經口腔進入胃內或經其他天然孔道進入體內。相對于超聲成像、X線檢查等影像成像,內窺鏡可直接觀察病變,且亮度大、視野清晰、盲區少,用途日益擴大。現階段,消化內窺鏡檢查已經越來越普及,內窺鏡也隨著技術的不斷發展而變得越來越精密。使用及維護人員必須熟悉其基本構造及各部件的性能,正確地維護、保養,防止故障發生,故障發生時及時處理,防止故障的擴大化。現介紹內窺鏡使用中的維護保養要點,及一些常見故障的處理方法。
Endoscope is a detection instrument that integrates traditional optics, ergonomics, precision machinery, and modern electronics. It can enter the stomach through the oral cavity or enter the body through other natural channels. Compared to imaging such as ultrasound imaging and X-ray examination, endoscopy can directly observe lesions, with high brightness, clear field of view, and fewer blind spots, making its use increasingly expanding. At present, digestive endoscopy has become increasingly popular, and endoscopes have become more and more precise with the continuous development of technology. Users and maintenance personnel must be familiar with its basic structure and the performance of each component, maintain and upkeep it correctly, prevent faults from occurring, promptly handle faults when they occur, and prevent the expansion of faults. This article introduces the maintenance points during the use of endoscopes, as well as some common troubleshooting methods.
在使用前進行準備與檢查是保證內窺鏡正常使用的重要條件。從消毒柜中取內窺鏡時,應一手拿操作部,一手拿導光插頭部和插入部,避免前端自由擺動,造成插入部或者導光插頭部與鏡柜等物發生碰撞,引起彎曲外皮的破裂、先端玻璃蓋的破裂或者導光束的斷裂等故障。送氣送水管路及吸引管路確保通暢,大小旋鈕處于自然狀態,控制旋鈕確認彎曲部角度是否合乎要求,以及卡鎖功能是否正常。送氣送水按鈕、吸引按鈕在消毒干燥后涂少許硅油再按在內窺鏡上,從而使按鈕使用時更靈活,避免按鈕按下去之后無法彈出。用乙醇紗布順著噴嘴方向擦拭鏡頭,開機看光線亮度、圖像清晰度及顏色,必要時做白平衡。
Preparation and examination before use are important conditions to ensure the normal use of the endoscope. When taking the endoscope from the disinfection cabinet, one hand should hold the operating part and the other hand should hold the light guide plug and insertion part to avoid free swinging of the front end, which may cause collision between the insertion part or light guide plug head and the mirror cabinet or other objects, resulting in bent outer skin rupture, broken glass cover at the front end, or broken light guide beam. Ensure unobstructed air and water supply pipelines as well as suction pipelines, with the size knobs in their natural state. Control the knobs to confirm whether the bending angle meets the requirements and whether the locking function is normal. After disinfection and drying, apply a little silicone oil to the air and water supply buttons and suction buttons before pressing them onto the endoscope, making them more flexible to use and avoiding the inability to pop out after pressing them down. Wipe the lens with ethanol gauze in the direction of the nozzle, turn it on to check the brightness of the light, image clarity, and color, and if necessary, perform white balance.
使用時注意事項
Precautions during use
操作中蛇管應呈弧形彎曲,不可形成直角,以免鏡身打彎過甚而致像束折斷,轉角動作不要太快,用力不要過猛,如轉角過猛易使鋼絲拉長,鏡頭轉角不能達到設計角度,易折斷,使角度失靈。止血夾等治療附件在進出時要保證夾子處于閉合狀態,避免張開角度導致在進出時破壞鉗道管;在抽出時保證與鉗道口處于垂直狀態,避免與鉗道口摩擦造成鉗道口(吸引座)的磨損。
During operation, the snake tube should be curved in an arc shape and not form a right angle to prevent the mirror body from bending too much and even causing the image beam to break. The turning action should not be too fast, and the force should not be too strong. If the turning angle is too strong, it can easily cause the steel wire to elongate, and the lens angle cannot reach the design angle, which can easily break and cause the angle to malfunction. During the entry and exit of hemostatic clips and other therapeutic accessories, it is necessary to ensure that the clips are in a closed state to avoid damaging the forceps tube due to the opening angle; Ensure that it is perpendicular to the clamp opening during extraction to avoid friction and wear on the clamp opening (suction seat).
使用后維護保養
Post use maintenance
拔出內窺鏡后,立即用紗布蘸上洗滌液或多酶洗液擦拭插入部,拔下送氣、送水按鈕并放入洗滌液中,插入清洗專用按鈕,來回送氣送水,按下吸引按鈕座,來回吸引洗滌液與空氣。防止黏液干燥后難以清除,同時點檢內窺鏡的外觀。內窺鏡在入水前一定要戴上防水帽,并認真檢查防水帽是否蓋緊。防水帽要時刻確保處于干燥狀態,避免引起電氣接口潮濕使 EL 座接點腐蝕。手工清洗時要確認清洗工具沒有臟污,沒有磨損的劃痕、裂縫、扭曲、金屬與刷毛脫落等情況,避免對內窺鏡造成破損,清潔刷應保持平直,避免與按鈕安裝座產生摩擦。當天檢查結束后應進行漏水檢測,在水中測漏時不可安裝或拆除測漏器連接接口,避免內窺鏡進水,造成損壞,測漏結束后應充分排除鏡中氣體,避免彎曲外皮損壞。檢測完畢,須用壓縮空氣將活檢孔、吸引孔、送氣送水等管腔吹干,特別是電氣接點上的水分,然后垂直懸掛在干燥、溫度適中的地方,否則殘留的水分會使空氣中的細菌在內窺鏡內外繁殖,造成污染。
After removing the endoscope, immediately wipe the insertion part with gauze dipped in detergent or multi enzyme detergent, unplug the air and water supply buttons and put them into the detergent, insert the cleaning special button, send air and water back and forth, press the suction button seat to attract the detergent and air back and forth. Prevent mucus from becoming difficult to remove after drying, and also inspect the appearance of the endoscope. Before entering the water, be sure to wear a waterproof cap on the endoscope and carefully check if the cap is tightly covered. The waterproof cap should always be kept in a dry state to avoid causing electrical interface moisture and corrosion of the EL socket contacts. When manually cleaning, it is necessary to ensure that the cleaning tool is free of dirt, scratches, cracks, twisting, metal and brush bristles falling off, etc. to avoid damage to the endoscope. The cleaning brush should be kept straight to avoid friction with the button mounting seat. After the inspection on the same day, a leak detection should be carried out. When conducting leak detection in water, the connection interface of the leak detector should not be installed or removed to avoid water ingress and damage to the endoscope. After the leak detection is completed, the gas in the endoscope should be fully discharged to avoid bending and damaging the outer skin. After the detection is completed, compressed air must be used to blow dry the biopsy holes, suction holes, air and water supply cavities, especially the moisture on the electrical contacts, and then hang vertically in a dry and moderate temperature place. Otherwise, residual moisture will cause bacteria in the air to multiply inside and outside the endoscope, causing pollution.
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