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<p style="max-width: 100%; min-height: 1em; white-space: normal; color: rgb(62, 62, 62); text-indent: 0em; font-family: 微软雅黑; line-height: 25.6px; box-sizing: border-box !important; word-wrap: break-word !important; background-color: rgb(255, 255, 255);"><span style="max-width: 100%; font-family: 宋体; color: rgb(51, 51, 51); letter-spacing: 0px; font-size: 14px; box-sizing: border-box !important; word-wrap: break-word !important;"> 硬管内窥镜是目前为止医务人员观察人体内部病变组织最方便、最直接、最有效的医疗器械，具有图像清晰度高、色彩逼真等优点，而且容易操作。随着使用硬管内窥镜的范围扩大，各科医生使用硬管内窥镜频率越来越高。硬管内窥镜是比较娇贵的医疗器械，很容易造成损坏。下面就怎样使用、维护、保养硬管内窥镜做一介绍，以帮助医护人员更好地使用这一器械，延长硬管内窥镜的使用寿命。<br style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;" /><br style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;" /><strong style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;"><span style="max-width: 100%; letter-spacing: 0px; color: rgb(255, 169, 0); box-sizing: border-box !important; word-wrap: break-word !important;"> <span style="max-width: 100%; letter-spacing: 0px; box-sizing: border-box !important; word-wrap: break-word !important;"><strong style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;"> 一、硬管内窥镜的结构</strong></span><br style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;" /></span></strong><br style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;" /> 要想正确使用硬管内窥镜就应该了解它的结构。目前世界上各个硬管内窥镜生产厂的产品虽然光路不同、外观不同，但是其基本结构都是一致的：由工作镜管部分、结构部分、眼罩部分、光缆接口部分组成。结构主体部分、眼罩部分、光缆接口部分除了受到剧烈的磕碰一般不易受损。最容易损坏的部分就是工作镜管部分。以φ4mm硬管内窥镜为例：工作镜管主要由四个部分组成：外镜管、内镜管、光学镜片、光导纤维。<br style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;" /><br style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;" /> 光学镜片放在内镜管组成光学系统，光导纤维放在内、外镜管之间负责照明。外镜管是0.1mm厚φ4mm不锈钢管，受到磕碰或挤压都会变形。光学镜片大部分是φ2.8mm长25mm左右的玻璃柱，受到轻微的磕碰和挤压就会开裂、崩边或者光轴偏移，我们常见的内窥镜视野模糊、边缘发黑多是此类原因。光导纤维是由极细的光学玻璃制成，一支φ4mm窥镜要装1500根以上，在外镜管内受到外力回造成断丝，影响光照度。硬管内窥镜各机构的连接大都是用环氧树脂胶粘接，胶的质量和封装技术也影响窥镜的使用寿命。硬管内窥镜虽然娇贵，但是只要能够正确的使用和维护，就不会损坏。<br style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;" /><br /><img data-s="300,640" data-type="jpeg" src="http://mmbiz.qpic.cn/mmbiz/dx3KibwtDhvfcWgibQ4fHRnLb7DKpNSF8WPs0YsZbQF0ibwYaIg6uen9ofggBrhV4jlX4OnauX3TZknwlMPibbILhw/0?wx_fmt=jpeg" data-ratio="0.2988929889298893" data-w="" /><br /> </span></p><p style="max-width: 100%; min-height: 1em; white-space: normal; color: rgb(62, 62, 62); text-indent: 0em; font-family: 微软雅黑; line-height: 25.6px; box-sizing: border-box !important; word-wrap: break-word !important; background-color: rgb(255, 255, 255);"><span style="max-width: 100%; font-family: 宋体; color: rgb(51, 51, 51); letter-spacing: 0px; font-size: 14px; box-sizing: border-box !important; word-wrap: break-word !important;"><strong style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;"><span style="max-width: 100%; letter-spacing: 0px; color: rgb(255, 169, 0); box-sizing: border-box !important; word-wrap: break-word !important;"></span></strong></span><span style="max-width: 100%; font-family: 宋体; color: rgb(51, 51, 51); letter-spacing: 0px; font-size: 14px; box-sizing: border-box !important; word-wrap: break-word !important;"> <span style="max-width: 100%; letter-spacing: 0px; box-sizing: border-box !important; word-wrap: break-word !important;"><strong style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;"> <span style="max-width: 100%; letter-spacing: 0px; color: rgb(255, 169, 0); box-sizing: border-box !important; word-wrap: break-word !important;">二、硬管内窥镜的使用及维护</span><br style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;" /></strong></span><br style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;" /> <span style="max-width: 100%; letter-spacing: 0px; color: rgb(255, 41, 65); box-sizing: border-box !important; word-wrap: break-word !important;"> 1．使用中的注意事项</span><br style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;" /><br style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;" /> 硬管内窥镜在手术过程中受到损坏的现象并不多，虽然会与人体的组织如肌肉、黏膜、骨骼等有接触和磕碰，但是这些磕碰是轻微的，不会造成窥镜的损坏，因为它只是起观察的作用，不是其他器械的受力点。但是在使用其他器械时，尤其是咬合力较大的钳、剪类器械应注意镜管的前端不要伸进器械的咬合区内，以免误伤镜管。在使用这类器械时，有时医生为了看清楚咬合区的组织，把窥镜伸得很靠近组织，器械咬合时窥镜没有退回，误伤了窥镜。手术时如注意让器械的咬合口全部都在窥镜的观察范围内就可以避免此类事故发生。<br style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;" /><br style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;" /> 有些手术窥镜是在鞘管内使用，在更换其他角度窥镜或插拔器械时，应注意动作要轻，不可用力过猛。尤其是插拔窥镜过程中，当遇到阻力拔不动时应仔细查找原因，必要时应连同鞘管一起拔取，不要用蛮力。<br style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;" /><br style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;" /> 当窥镜配合激光汽化、高频电切、微波等光电技术进行手术时，应注意窥镜前端与治疗点的距离，保证窥镜前端不被电击或烧灼。首次使用这些器械时，主刀医生应反复练习，掌握窥镜图像中物距和实际物距的关系，确认窥镜前端与治疗点的最近距离，以便在实际手术中应用自如。<br style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;" /><br style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;" /> 目前在耳鼻喉科、骨科的临床手术中已经广泛使用刨削器来切除病变组织。其刀头锋利、硬度高、旋转速度快、力矩大，如果削到内窥镜，窥镜必损无疑。在此类手术中要注意调整冲洗和吸引的速度，随时保证窥镜图像清晰不被血污遮挡，控制刀头的旋转部分始终在窥镜的观察范围内，在手术范围较大时，应先停止刀头转动，再移动窥镜，然后在窥镜监视下移动刀头，到合适部位后再开机刨削。当感觉到刨刀工作异常或照度突然降低时，有可能窥镜已经受损，应及时更换，以免造成更大损失。<br style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;" /><br style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;" /> 一般重要手术，应有一套备用窥镜和关键器械，在发现问题时可以从容地更换；如果使用角度不合适的窥镜或不配套的器械勉强手术，也容易造成窥镜的损坏。<br style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;" /><br style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;" /> <span style="max-width: 100%; letter-spacing: 0px; color: rgb(255, 41, 65); box-sizing: border-box !important; word-wrap: break-word !important;"> 2．怎样维护硬管内窥镜</span><br style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;" /><br style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;" /> 硬管内窥镜应有专人专柜保管，放在专用的包装箱内，内衬柔软的海绵或聚氨酯泡沫。所有窥镜和手术器械都要码放整齐，不得交叉重叠放置，确保箱盖盖好后，内部的窥镜和器械不会在搬运时相互撞击。由于内窥镜的镜管很薄，受到挤压、磕碰、折弯、落地等情况就会弯曲变形，导致镜片破损或光轴偏移而造成图像不清楚或不能使用，所以从包装箱中取出或放入硬管内窥镜时，应双手平托，轻轻地取出或放入，切忌提起一段拽出。窥镜放在托盘等硬质容器内移动时，注意与其他器械分开放置，不要过分颠簸，以免碰撞到窥镜。包装箱内应备有干燥剂保持箱内干燥。<br style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;" /><br style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;" /> 普通的硬管内窥镜都不耐高温高压，主要是由于封装胶在高温下会变质、变形，窥镜就会开胶进水，所以不可用煮沸和高压蒸汽等高温高压的方法消毒。大多数硬管内窥镜的损坏都是由于不注意保养、磕碰、落地等原因造成的。也有个别生产厂的封装胶、封装技术、封装结构有问题，造成窥镜进水、开胶的现象，这些都是可以修复的<br style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;" /><br style="max-width: 100%; box-sizing: border-box !important; word-wrap: break-word !important;" /> 硬管内窥镜虽然是娇贵的医疗器械，但是在正常的临床手术或观察中是不容易出现问题的。只要使用得法、精心维护、细心保养，医生们可以放心使用，硬管内窥镜也会发挥最大的效益。 </span></p><p><span style="max-width: 100%; font-family: 宋体; color: rgb(51, 51, 51); letter-spacing: 0px; font-size: 14px; box-sizing: border-box !important; word-wrap: break-word !important;"><br /></span></p><p style="max-width: 100%; min-height: 1em; color: rgb(62, 62, 62); line-height: 25.6px; box-sizing: border-box !important; word-wrap: break-word !important; background-color: rgb(255, 255, 255);"><span style="max-width: 100%; font-family: Arial, Verdana, sans-serif; font-size: 14px; line-height: 24px; box-sizing: border-box !important; word-wrap: break-word !important; background-color: rgb(249, 249, 249);">广州市设备维修有限公司</span></p><p style="max-width: 100%; min-height: 1em; color: rgb(62, 62, 62); font-size: 12px; line-height: 24px; font-family: Arial, Verdana, sans-serif; box-sizing: border-box !important; word-wrap: break-word !important; background-color: rgb(255, 255, 255);"><span style="max-width: 100%; font-size: 14px; box-sizing: border-box !important; word-wrap: break-word !important;">地址：广州市天河区银利街银利茶叶博览中心E栋4楼E4030室 邮编：510507</span></p><p style="max-width: 100%; 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发表于 2020-10-19 23:51:52