一次性PE手套防止活检帽漏液污染的效果评价与相关消化道压力测试

Evaluation of disposable polyethylene gloves in preventing contamination from biopsy valve cap leakage and associated gastrointestinal pressure testing

  • 摘要:
    目的 评价一次性PE手套用于活检帽漏液污染防控中的应用效果,并通过自制压力监测装置,探究消化道不同部位压力与漏液的关联性。
    方法 采用随机数字表法选取解放军总医院第一医学中心2025年7月份行胃肠镜检查的患者,分别纳入试验组、对照组,各50例。试验组采用一次性PE手套防止旧活检帽漏液,对照组未采取预防性防护措施。比较两组漏液喷溅范围、面积、漏液量及污染平均菌落数,并对45名医护人员开展满意度问卷调查。同时给予对照组患者进行消化道多部位压力监测。
    结果 对照组50例胃镜、肠镜检查时旧活检帽漏液会导致污染共89、104处部位。单次液体喷溅总面积平均为(4.59±3.53)cm2、(10.52±11.95)cm2,差异有统计学意义(P<0.001)。对照组胃镜、肠镜平均菌落数的中位数分别为33.00(3.00,120.00)、266.00(34.80,1 275.00)×103CFU/件高于试验组(P<0.001)且检出条件致病菌。胃镜和肠镜检查过程中,出现首次漏液的高发部位依次为十二指肠、胃、食管和升结肠、横结肠、降结肠、乙状结肠、直肠。胃镜检查时十二指肠降段腔道压力最大,波动在6.00(6.00,10.00)~10.00(8.00,12.00)mmHg。肠镜检查时横结肠腔道压力最大,波动在8.00(6.00,8.50)~10.00(8.00,12.00)mmHg。不同部位压力均值与漏液喷溅次数呈正相关(ρ=0.741),差异有统计学意义(P<0.05);试验组未发生上述污染,胃镜、肠镜检查时漏液收集量均为0.10(0.00,0.10)ml。一次性PE手套防喷溅总体满意度评分为(4.60±0.50)分。
    结论 应用一次性PE手套包绕活检帽可有效防止胃肠镜检查时漏液污染环境,便捷经济,医护人员满意度高。胃肠镜检查时消化道不同部位压力值不同,活检帽漏液与消化道压力存在一定相关性。

     

    Abstract:
    OBJECTIVE  To evaluate the efficacy of disposable polyethylene (PE) gloves in preventing contamination from biopsy valve cap leakage, and to investigate the correlation between pressure variations in different gastrointestinal segments and leakage incidents through a self-designed pressure monitoring device.
    METHODS  Patients undergoing gastroscopy and colonoscopy at the First Medical Center of the Chinese PLA General Hospital in Jul. 2025 were randomly assigned to the experimental group (n=50) and the control group (n=50) via a random number table. The experimental group utilized disposable PE gloves to prevent leakage from biopsy valve cap, while the control group received no preventive measures. Parameters compared included leakage spray range, area, volume and average bacterial colony count. Additionally, satisfaction questionnaires were administered to 45 medical staff. Pressure monitoring across multiple gastrointestinal segments was conducted for the control group.
    RESULTS  In the control group (n=50), leakage from the old biopsy valve cap during gastroscopy and colonoscopy resulted in contamination in 89 and 104 instances, respectively. The average total area of single liquid spray was (4.59±3.53) cm2 and (10.52±11.95) cm2, showing a statistically significant difference (P<0.001)and conditionally pathogenic bacteria were detected. The median bacterial colony counts in the control group were 33.00 (3.00, 120.00) and 266.00 (34.80, 1 275.00) ×103 CFU/item for gastroscopy and colonoscopy, respectively, significantly higher than those in the experimental group (P<0.001). During gastroscopy and colonoscopy, the initial leakage sites with the highest frequency were the duodenum, stomach and esophagus. Ascending colon, transverse colon, descending colon, sigmoid colon and rectum. During gastroscopy, the highest luminal pressure was in the descending duodenum, fluctuating between 6.00 (6.00, 10.00) and 10.00 (8.00, 12.00) mmHg. During colonoscopy, the highest luminal pressure was in the transverse colon, fluctuating between 8.00 (6.00, 8.50) and 10.00 (8.00, 12.00) mmHg. There was a positive correlation between mean pressure at different digestive tract and frequency of leakage and splashing (ρ=0.741), with Statistical significance (P<0.05). No contamination occurred in the experimental group, and leaked fluid volume was 0.10 (0.00, 0.10) ml. Questionnaire results indicated an overall satisfaction score of (4.60±0.50) for the disposable PE gloves in terms of spray prevention, with scores exceeding 4.5 in spray prevention effectiveness, work efficiency improvement, ease of installation, adaptability, operational flexibility and cost-effectiveness.
    CONCLUSIONS  The application of disposable PE gloves to wrap the biopsy valve cap effectively prevents environmental contamination from leakage during gastroscopy and colonoscopy, offering convenience, cost-effictiveness and high satisfaction among medical staff. Luminal pressure varies across different gastrointestinal segments during gastroscopy and colonoscopy procedures, and a certain correlation exists between biopsy valve cap leakage and the pressure of gastrointestinal segments.

     

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