JZUS - Journal of Zhejiang University SCIENCE

Journal of Zhejiang University SCIENCE B 2024 Vol.25 No.7 P.628-632

Potential effects of aerosol generation and transmission during bedside endoscope cleaning

Author(s): Tingting SHENG, Xin WU, Li CEN, Ye LU, Chenying ZHOU, Qing GU
Affiliation(s): Nursing Department, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China; more
Corresponding email(s): 1191016@zju.edu.cn
Key Words: Endoscopy, Endoscopic surgery, Aerosol transmission, Bedside endoscope precleaning

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Abstract: Airborne transmission is among the most frequent types of nosocomial infection. Recent years have witnessed frequent outbreaks of airborne diseases, such as severe acute respiratory syndrome (SARS) in 2002, Middle East respiratory syndrome (MERS) in 2012, and coronavirus disease 2019 (COVID-19), with the latter being on the rampage since the end of 2019 and bringing the effect of aerosols on health back to the fore (Gralton et al., 2011; Wang et al., 2021). An increasing number of studies have shown that certain highly transmissible pathogens can maintain long-term stability and efficiently spread through aerosols (Leung, 2021; Lv et al., 2021). As reported previously, influenza viruses that can spread efficiently through aerosols remain stable for a longer period compared to those that cannot. The World Health Organization (WHO) has stated that aerosol-generating procedures (AGPs) play an important role in aerosol transmission in hospitals (Calderwood et al., 2021). AGPs, referring to medical procedures that produce aerosols, including dental procedures, endotracheal intubation, sputum aspiration, and laparoscopic surgeries, have been reported to be significantly associated with an increased risk of nosocomial infection among medical personnel (Hamilton, 2021).

内镜床旁预处理过程中气溶胶产生和传播的潜在影响

盛婷婷¹，吴昕¹，岑莉²，陆烨³，周晨颖¹，顾青¹
¹浙江大学医学院附属第一医院护理部，中国杭州市， 310003
²浙江大学医学院附属第一医院消化内科，中国杭州市， 310003
³浙江省疾病预防控制中心，中国杭州市， 310051
摘要：自2019冠状病毒病（COVID-19）大流行以来，气溶胶的产生已成为一个无法回避的医疗保健问题。本研究旨在确定床旁内窥镜清洁过程中气溶胶产生和传播的特征，并制定相关预防和控制措施。在洁净的内窥镜室中，我们模拟了软式内窥镜的床边清洁程序，并使用粒子计数器在三维空间中测量了与预清洁桶不同距离处的气溶胶浓度。我们还设计了一种可重新密封的袋子，并对其效率进行了评估。实验前内窥镜室平均背景气溶胶浓度为138颗粒每升。16次独立实验后，我们发现气溶胶数量随垂直和水平距离的增加而减少，且在175 cm的垂直或水平距离之外，无法检测到气溶胶。基于上述数据，我们计算了气溶胶的传播范围。此外，我们发现可重复密封的袋子可有效减少气溶胶的传播，距封口10 cm处气溶胶浓度为（99.94±57.36）颗粒每升，显著低于无袋时测得的气溶胶浓度。综上，床旁内窥镜清洁程序会产生大量气溶胶，且气溶胶浓度随着与预清洁桶距离的增加而降低，采用可重复密封袋子可有效减少气溶胶传播。因此，建议患者戴上口罩，并在手术完成后离开气溶胶暴露的危险区域。

关键词：内镜；内窥镜手术；气溶胶传播；床边内窥镜预清洁

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