Effect of o-phthalaldehyde on gastroscope disinfection in patients with hepatitis B virus infection
Digestive endoscopy is clinically used for the diagnosis and treatment of digestive system diseases.One of the common ways of treatment,Minimally invasive in gastrointestinal or pancreaticobiliary tract diseaseimportant position in the treatment.With the continuous improvement of the level of clinical diagnosis and treatmentThe rapid development of high and increasingly refined endoscopic technology,digestive endoscopyGradually increased in clinical applications,However, digestive endoscopy inevitablyContact with patient body fluids,Blood and other prone to pollution,cause hospital infectionThe occurrence,Especially carry all kinds of infectious diseases to accept digestionPatients with endoscopic diagnosis and treatment,Disinfection of endoscopes and their appendages becomes digestive internalKey and difficult work after mirror examination［1-2］.Strict endoscopyKey ways of cross-infection.Hepatitis B virus（hepatitis Bvirus,HBV）It has become one of the most popular infectious diseases.One,around the world.20 Hundreds of millions of people infected,And that number is not.Break up.HBVas a hepatotropic virus,hepatitis B patients liverDirty is damaged to varying degrees,Serious threats and impacts on human healthKang.Due to the digestive endoscopy in the process of diagnosis and treatment will contact with the patient's body fluids and evenslime,HBVas a form of extraintestinal hepatitis,digestive endoscopyTreatment may be one of its routes of transmission.［3 ］.Structural complex of digestive endoscopyMiscellaneous,lumen stenosis,HBVInfected patients after digestive endoscopyThe disinfection work has become the key to control the spread of pathogens..ObjectiveBefore,There is no uniformity in the selection of disinfectant and disinfection methods for digestive endoscopes.Standard［4-5 ］.Therefore,Urgent need to find a good disinfection effect,And fast and simpleSingle endoscopic disinfectant.For this,This study explores the effect of o-phthalaldehyde onHBVEffect of gastroscope disinfection in infected patients,The results are reported as follows.
1 Data and methods
1 1.Clinical dataSelect Hospital2014 Year5 Month－ 2017Year5monthly admission218 ExampleHBVInfected patients undergoing gastroscopyobject of study.Collecting endoscopy218 Article gastroscope cleaning and disinfection are in eliminationDrug supply center completed,According to the different methods of gastroscope cleaning after examination,Divided into o-phthalaldehyde group and enhanced glutaraldehyde group,Each group109 Article.All the subjects included in this study signed the informed consent form.,and get medicalApproved by the Ethics Committee.
1 .2 Inclusion and Exclusion Criteriainclusion criteria：serumHBVsurface antigen（HBsAg）Positive;Receive gastroscopy.Exclude bidQuasi：AIDS Merger,Hepatitis C and severe pneumonia;Near
1 Weekly use of drugs related to the treatment of this disease;Unwilling to cooperate with this researchInvestigate.
1 .3 research method
1 .3 1.Cleaning and disinfection before each use of the gastroscope by bacteriaCulture is negative before use.strictly in accordance《Cleaning and disinfection of endoscopesTechnical Operation Specification》［6］Requirements,According“Cleaning-enzyme washing-Disinfection-Rinse-
Drying”Process cleaning and disinfection,o-phthalaldehyde group adopted0 5.5％Neighborphthalaldehyde solution（Shandong Dr. Xiao Disinfection Technology Co., Ltd.）Disinfection5 min,In the enhanced glutaraldehyde group,2％Fortified glutaraldehyde solution
（Hebei Ruikang Pharmaceutical Technology Co., Ltd.）soaking disinfection10min.
1 .3 .2 Specimen Collection［6 ］Before cleaning,Post-disinfection and post-disinfection miningSetStomachSpecimens on the surface of the mirror and the cavity of the gastroscope.Gastroscope surface specimen collection：AdoptSterile cotton swab wet physiological saline repeatedly rub the front end of the lens body,will be cotton
The swab is placed in a tube filled with saline or neutralizer.,Mix wellAfter taking the eluent for detection.Gastroscope cavity specimen collection：Will5 mlNormal saline or neutralizer injected into the biopsy tunnel,Collect the rinse solution and put it in
Sterile test tubes for testing.Sterile physiological salt for sampling before and after cleaningWater,Use neutralizer after disinfection.
1 .3 .3 HBV-DNADetection using fluorescence quantificationPCRproceedHBV-DNAQuantitative detection Real-time fluorescence quantificationPCRInstrument（Cobasz480） ，Genotyping Assay Kit（Shanghai Zhijiang Biological Company）HBV,Strictly follow the operation steps.clearance rate＝ （Before cleaningHBV-DNALoad-After cleaningHBV-DNALoad）／Before cleaningHBV-DNALoadQuantity×100％.
1 .4 systemmeterPointsAnalysisSPSS18 .0 Statistical software for data scoringAnalysis.Normal measurement data“Mean±SD”TableShown,TwoGroupAloneStand,normal,The comparison between the groups of the variance data is used.tInspectionInspection;SampleBen
Rateofthanmore adoptedQ2 Inspection.P＜ 0 0.5for the difference is statistically significant.
2 Results
2 1.HBV-DNAaverage contento-phthalaldehyde group male76 Example,Female33 Example;average age（52 6. ± 12 2.）year old.Enhance the twoAldehyde group male78 Example,Female31 Example;average age（51 .9 ± 11 8.）year old.218 Strip endoscope compared with before cleaning,Gastroscope surface and gastroscope lumen clearAfter washing and after disinfectionHBV-DNAAverage content decreased（P＜0 .05） 。
2 .2 Gastroscope cleaning and removalHBV-DNAThe effectPhthaleneThe clearance rates of gastroscope surface and gastroscope lumen in aldehyde group were99 5.0％and99 9.9％ ，Gastroscope surface and gastroscope lumen clearance rate in the enhanced glutaraldehyde groupPointsDon't.
For99 6.4％and99 9.9％,TwoGroupStomachMirrorTableFaceandendoscopyCavityQingdivision ratethanMorePoorDifferentAllNonesystemmeterLearningItalyRighteousness.
2 .3 Gastroscope disinfection removalHBV-DNAThe effectPhthaleneGastroscope surface clearance rate of aldehyde group93 .23％ ，higher than in the intensified glutaraldehyde group87 0.1％ （P＜ 0 .05 ） ，Two groups of gastroscope cavity clearance rate were100 0.0％ 。
3 Discussion
Endoscopic applications have brought significant advances in the diagnosis of gastrointestinal diseasesSimultaneously,It also provides an alternative way for its clinical treatment.,evenThere is a tendency to replace surgical options.As an invasive treatmentMeans,Use of gastroscopy increases transmission of pathogenic microorganisms through endoscopesthe possibility.Although China has established effective monitoring after endoscopyMechanism,But the pathogen has a long incubation period.,Endoscopic examination leadsComprehensive coverage of cross-infection is still very limited.［7 ］.There is obvious researchShown,The qualified rate of disinfection after gastrointestinal endoscopy in hospitals in China is only60％ ～ 80％ ，The qualified rate of disinfection quality is low,One of the most common inspectionThe pathogen was Staphylococcus aureus,Acinetobacter baumannii,patina fakeMonomonas and Escherichia coli, etc.［8］.Therefore,in the digestive tract of our countryMirror cleaning and disinfection situation is grim,Urgent need to develop reasonable normsCleaning and disinfection process,Find the right disinfectant.HBVis a virus that is transmitted primarily by blood,its adoptionThe fact that endoscopically transmitted has been confirmed.liver as a grapeMain metabolic organs of sugar,Storage of glucose in the body,decomposition andimportant role in blood sugar regulation［9］.ByHBV-DNADetection can reflectHBVlevel of replication,thus indicating that it is activeor replication period.HBVAs a addicted
liver diseasePoison,itsDivisionInLiveMovePeriod（HBV-DNALoad≥ 1 × 106 IU／ml）When,MachinebodyPlusStrongIt'sInflammatory response in a state of viral infection,Inflammatory factors suchIN-2 、IL-6 、IL-10 、TNF-αincreased isosecretion,and then induce inflammationShould,Causing hepatocyte necrosis and excessive infiltration of inflammatory cells,liver cell workcan be damaged［10-11］.In addition,HBVWhen replication is active it causes sugarDecreased synthesis of prosynthetase,affect glucose uptake and utilization.Simultaneously,according to reportsHBVInfection may exist with damage to pancreatic cellsContact,HBVInfection damages pancreatic secretory cells,insulin secretionDecreased level,Lead to increased insulin resistance,which leads to blood sugar levelsElevated［12］.The results of this study show,The surface of the gastroscope and the cavity of the gastroscope are strictlyAccording《Technical operation specification for cleaning and disinfection of endoscopes》Cleaning requiredAfter,Clearance rate up99％Above,and literature［13 ］Consistent reporting.Stomachcomplex mirror structure,Its lumen is slender and narrow,Long time use can form a fineBacterial biofilm leads to indicate bumpy,makeHBVEasier to attach着,If the cleaning is not thoroughHBVWithStomachMirrorDiagnosisTreatmentHairBornCrosssenseDyed［14］.Therefore,in clinical workMakeMediumShouldYanLatticePressPhoto《EndoscopyQingWashTechnical operation specification for disinfection》Requirements for gastroscope cleaning and disinfection.GastroscopeOutsideDepartmentofQingWashManyChoose a disposable sterile gauze or sponge brushWait,Cher.BottomQingWasheliminationPoison.Both o-phthalaldehyde and glutaraldehyde are aldehydes,to aldehydebase polymerization form exists,Same concentration of o-phthalaldehyde,its free radical
higher quantity than glutaraldehyde,Disinfection effect is better than glutaraldehyde,Currently clinicallyGradual use of o-phthalaldehyde instead of glutaraldehyde［15 ］.This study concludedThe results showed that both phthalaldehyde and fortified glutaraldehyde could obtain good gastric
mirror disinfection effect,But consider the use of lower concentrations of o-phthalaldehyde,Requiredshorter time,have certain advantages.In addition,o-phthalaldehyde pairMirror corrosive small,Non-toxic to human body,While glutaraldehyde has a strong thornexcitable.
