Arthroscopy is a rod-shaped optical instrument with a diameter of about 5mm to observe the internal structure of the joint. It is an endoscope for the diagnosis and treatment of joint diseases. As a medical device that also enters the human body, its cleaning and disinfection are very important. The following is a set of professional procedures for arthroscopic cleaning and disinfection.

　　工具/材料

　　Tools / raw materials

　　關(guān)節(jié)鏡，關(guān)節(jié)鏡清洗

　　Arthroscopic cleaning

　　洗消流程

　　Decontamination process

　　清洗

　　clean

　　清洗是一個(gè)非常重要的環(huán)節(jié)，是保證消毒滅菌效果的首要條件。

　　Cleaning is a very important link and the first condition to ensure the effect of disinfection and sterilization.

　　鏡頭是整個(gè)關(guān)節(jié)鏡系統(tǒng)中為之昂貴，也是特容易損傷的儀器，所以必需首先清洗、妥善保管。其清洗辦法較其他器械不同，不能用毛刷以及任何鋒利利器去碰擊，以免劃傷鏡頭，只能在活動(dòng)水下沖洗，清洗終了后用柔軟塑料泡沫盒放置保管。

　　Lens is an expensive and easily damaged instrument in the whole arthroscopic system, so it must be cleaned first and kept properly. The cleaning method is different from other instruments, and can not be brushed with any brush or any sharp tool to avoid scratching the lens. It can only be washed under the moving water. After the cleaning is finished, it is placed in a soft plastic foam box.

　　鏡頭之外的其他器械要用專用關(guān)節(jié)鏡清洗刷清洗，清洗刷要將各種器械狹縫內(nèi)的殘留組織肅清掉；各種管腔通道用高壓水槍沖洗，以便將各種管道中殘留的組織沖凈；其他器械的軸節(jié)局部要拆開(kāi)清洗，使清洗更為徹底。保證器械的清潔，為展開(kāi)下面的工作奠定根底。

　　Other instruments outside the lens shall be cleaned with special arthroscopic cleaning brush, which shall remove the residual tissue in the slit of various instruments; various lumen channels shall be washed with high-pressure water gun, so as to clean the residual tissue in various pipelines; the coupling parts of other instruments shall be disassembled for cleaning to make the cleaning more thorough. Ensure the cleaning of the equipment and lay the foundation for the following work.

　　浸泡

　　soak

　　將清洗后的關(guān)節(jié)鏡器械全部浸泡在40℃～60℃的多酶溶液中5～10min。浸泡時(shí)將各種器械的閥門完整翻開(kāi)，使多酶溶液可以完整灌注到各種管腔內(nèi)，從而到達(dá)多酶溶液浸泡的目的。同時(shí)，應(yīng)留意線纜接頭的帽蓋要旋緊，以免進(jìn)水形成儀器短路等不用要的損壞。

　　All the cleaned arthroscopic instruments were immersed in the multienzyme solution at 40 ℃ ~ 60 ℃ for 5 ~ 10min. When soaking, the valves of all kinds of instruments are completely opened, so that the multi enzyme solution can be completely poured into all kinds of lumens, so as to achieve the purpose of multi enzyme solution soaking. At the same time, it should be noted that the cap of cable connector should be tightened to avoid unnecessary damage such as short circuit of instrument caused by water inflow.

　　過(guò)濾

　　filter

　　將浸泡后的一切器械置于盛有蒸餾水的容器中再次浸泡，去除物體上的微粒及熱源。

　　Put all the soaked instruments into a container containing distilled water and soak them again to remove the particles and heat source on the object.

　　再次清洗

　　Clean again

　　依照上述清洗辦法，再次將關(guān)節(jié)鏡器械在活動(dòng)水下沖洗，目的是使多酶溶液完整沖凈，從而到達(dá)器械的干凈，為消毒滅菌發(fā)明良好的條件。

　　According to the above cleaning method, the arthroscopic instrument is rinsed under the active water again, so as to make the multi enzyme solution completely rinsed, so as to achieve the cleanness of the instrument, and create good conditions for disinfection and sterilization.

　　枯燥

　　Boring

　　保證每一種儀器的枯燥，是環(huán)氧乙烷消毒滅菌必需具備的前提。

　　To ensure the dryness of each instrument is the prerequisite for ethylene oxide sterilization.

　　（1）先將各種器械的外表用枯燥柔軟的治療巾擦干，鏡頭用特地的布料擦拭；

　　(1) First, dry the appearance of various instruments with dry and soft treatment towel, and wipe the lens with special cloth;

　　（2）再用吹風(fēng)器，或者在烘烤箱內(nèi)將其管腔內(nèi)的水滴烘干，留意攝像頭、巧合器不能用持續(xù)高溫烘烤，由于在高溫條件下，會(huì)將鏡片接口處的硅膠熔解，形成巧合器進(jìn)水起霧,視野含糊。

　　(2) Then use a hair dryer or dry the water drops in the lumen of the oven. Pay attention that the camera and the coincidence device cannot be baked with continuous high temperature. Under high temperature conditions, the silica gel at the lens interface will be melted, forming the coincidence device with water and fog, and the field of vision is ambiguous.

　　保養(yǎng)與檢查

　　Maintenance and inspection

　　確保儀器在下次手術(shù)運(yùn)用時(shí)的平安性。

　　Ensure the safety of the instrument during the next operation.

　?。?）將各種線纜銜接在關(guān)節(jié)鏡儀器上,開(kāi)機(jī)檢查攝像頭的明晰度以及鏡頭能否形成了磨損;

　　(1) Connect all kinds of cables on the arthroscopic instrument, turn on the machine to check the clarity of the camera and whether the lens is worn;

　?。?）檢查各種器械的軸節(jié)處能否靈敏,線纜的接頭處能否光滑;

　　(2) Check whether the couplings of various instruments are sensitive and the joints of cables are smooth;

　?。?）將檢查結(jié)果停止記載,做到心中有數(shù),以備日后查詢。

　　(3) Stop recording the inspection results and know them well for future reference.

　　打包

　　pack

　　將各種器械分類整理，使其有序排列。

　　Classify and arrange all kinds of instruments in order.

　?。?）鏡頭要放置在特地的泡沫盒子內(nèi)，輕拿輕放；

　　(1) the lens should be placed in a special foam box and gently handled.

　?。?）攝像頭要用棉質(zhì)物品包裹打包，防止碰撞；

　　(2) The camera shall be wrapped and packed with cotton materials to prevent collision;

　?。?）光纖導(dǎo)線不能打折，只能盤曲地放置，其彎曲水平不能超越90°，以免將光纖折斷，并用含有軟泡沫的盒子包裹好；

　　(3) optical fiber conductors can not be discounted, and can only be placed in a bent place. The bending level can not exceed 90 degrees, so as not to break the optical fibers and wrap them in boxes containing soft foam.

　?。?）停止打包，并在包布上標(biāo)明“請(qǐng)勿擠壓、碰撞”等字樣，再次預(yù)防在搬運(yùn)過(guò)程中形成儀器的損傷。

　　(4) Stop packing, and mark the words "do not squeeze, collision" on the cloth, so as to prevent the damage of the instrument in the process of handling again.

　　消毒滅菌

　　Disinfection and sterilization

　　運(yùn)用的消毒方式是環(huán)氧乙烷消毒滅菌。但需留意，當(dāng)濃度到達(dá)3%～10%（30000PPM）時(shí)，EO即燃；急性吸入可惹起呼吸道刺激；皮膚接觸可惹起皮炎和水泡；消化道接觸具有腐蝕性；眼睛接觸可惹起嚴(yán)重刺激形成損傷等。

　　The disinfection method used is ethylene oxide disinfection. However, it should be noted that when the concentration reaches 3% - 10% (30000ppm), EO will burn; acute inhalation can cause respiratory irritation; skin contact can cause dermatitis and blisters; digestive tract contact is corrosive; eye contact can cause serious irritation and damage.