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Since the Ministry of Health issued the standard for cleaning and disinfection of endoscopes in 2004, glutaraldehyde disinfectant has been widely used in the cleaning and disinfection of endoscopes in medical institutions. However, due to the inherent toxicity of glutaraldehyde disinfectant itself and improper use, long-term or short-term health hazards to medical personnel and patients occur from time to time..., In order to avoid the harm of glutaraldehyde to human health and explore a more practical, safe and efficient disinfection method, 70 gastroscopes after use were disinfected by glutaraldehyde soaking and phthalaldehyde soaking respectively from October 2010 to November 2010, and the disinfection effects were compared. The report is as follows.

1 Objects and Methods 1.1 Research Objects 70 cases of Olympus gastroscope (model: 260,240) after gastroscopy were randomly divided into 2 groups according to random number method, 35 cases in each group, and were disinfected by glutaraldehyde immersion for 10min and phthalaldehyde immersion for 5rain respectively. 1.2 cleaning disinfectant Legu special multi-enzyme cleaning solution for endoscopes (German Depp Laboratory);2% glutaraldehyde (Shanghai medical institute medicine co., ltd.),Cidex phthalaldehyde high-level disinfectant (OPA )[Johnson & Johnson (yilhai) medical equipment co., ltd.], containing 0.153 ortho-phthalaldehyde with a pH value of 7.45. 1.3 cleaning and disinfection methods Manual cleaning and disinfection shall be carried out in strict accordance with the requirements of the Ministry of Health's Technical Operation Specification for Cleaning and Disinfection of Endoscopes}) Version 2004 (hereinafter referred to as the "Specification"), I .e. water washing, enzyme washing, cleaning and disinfection, and repeated cleaning. When each step is converted, each tube cavity of the gastroscope shall be dried with a high-pressure air gun. During disinfection, the cleaned and dried gastroscope was placed in a disinfection tank containing 2% glutaraldehyde and OPA stock solution respectively, and each hole was filled with disinfectant and soaked for 10rain and 5rain respectively. 1.4 sampling method to monitor the sampling site is the inner cavity surface of the endoscope, take 10 ml neutralizer, inject it from the entrance of the biopsy hole with sterile method, recover it to the sampling tube at the exit, and send it for inspection in time. 1.5 to the detection method, the test solution is fully shaken with a vortex device, and then 0.5ml is sucked by a sterile pipette and injected into two sterile plates with a diameter of 90mm. 17ml of melted 47% nutrient agar is added to each plate respectively, and the agar is solidified, cultured at 35cC, and counted after 48h. At the same time, it is inoculated into blood plate, Chinese blue plate and ss plate for culture to observe the growth of pathogenic bacteria. Disinfection qualified judgment standard is based on "Disinfection Technical Specification" (2002 Edition): the number of bacterial colonies <20cfu/piece, and no pathogenic bacteria growth is qualified. Results The disinfection effects of the two disinfectants on gastroscopes were compared, as shown in Table 1.

Discussion 3.1 As an invasive and minimally invasive instrument, digestive endoscopy has been widely used in clinical practice. Because of its special material, high precision and complex structure, it is very difficult to clean and disinfect after use. Digestive endoscopy disinfection is not in place, will affect the medical safety of patients. As the only disinfectant in the Disinfection Technical Specification, glutaraldehyde has been widely used in the disinfection of endoscopes. Due to the inherent toxicity of glutaraldehyde disinfectant and improper use, long-term or short-term health hazards to medical staff and patients occur from time to time..., Moreover, the time of glutaraldehyde disinfectant is longer (10-45min), which seriously affects the requirement of rapid reuse of endoscopes, reduces the disinfection compliance of medical staff, and increases the safety hazard of cross infection in hospitals. Therefore, 35 cases of endoscopic instruments after clinical examination were disinfected with 2% glutaraldehyde and compared with 35 cases of endoscopes disinfected with phthalaldehyde. The results confirmed that the two methods were safe and reliable, but the endoscopic disinfection time was shortened from the original 10min to 5rain, which greatly improved the reuse rate of endoscopic instruments, improved the working efficiency of the endoscopic room, and reduced the waiting time of patients for examination, increased patient satisfaction.