Role of endoscopic-ultrasound-guided biliary drainage with electrocautery-enhanced lumen-apposing metal stent for palliation of malignant biliary obstruction

In this editorial,we discuss the article by Peng et al in the recent issue of the World Journal of Gastrointestinal Surgery,focusing on the evolving role of endoscopicultrasound-guided biliary drainage(EUS-BD)with electrocautery lumen apposing metal stent(LAMS)for distal malignant biliary obstruction.Therapeutic endoscopy has rapidly advanced in decompression techniques,with growing evidence of its safety and efficacy surpassing percutaneous and surgical approaches.While endoscopic retrograde cholangiopancreatography(ERCP)has been the gold standard for biliary decompression,its failure rate approaches 10.0%,prompting the exploration of alternatives like EUS-BD.This random-effects meta-analysis demonstrated high technical and clinical success of over 90.0% and an adverse event rate of 17.5%,mainly in the form of stent dysfunction.Outcomes based on stent size were not reported but the majority used 6 mm and 8 mm stents.As the body of literature continues to demonstrate the effectiveness of this technique,the challenges of stent dysfunction need to be addressed in future studies.One strategy that has shown promise is placement of double-pigtail stents,only 18% received the prophylactic intervention in this study.We expect this to improve with time as the technique continues to be refined and standardized.The results above establish EUS-BD with LAMS as a reliable alternative after failed ERCP and considering EUS to ERCP upfront in the same session is an effective strategy.Given the promising results,studies must explore the role of EUS-BD as first-line therapy for biliary decompression.

Functional lumen imaging probe use in a high-volume practice:Practical and technical implications

BACKGROUND The functional lumen imaging probe(FLIP)is a Food and Drug Administration approved tool to aid the diagnosis and management of esophageal disorders.However,widespread adoption of FLIP remains limited and its utility in highvolume practices remains unclear.AIM To analyze large sample data on clinical use of FLIP and provide insight on several technical aspects when performing FLIP.METHODS We conducted a retrospective comparative and descriptive analysis of FLIP procedures performed by a single provider at an academic medical center.There was a total of 398 FLIP procedures identified.Patient medical records were reviewed and data regarding demographics and procedural details were collected.Statistical tests,including chi-squared,t-test,and multivariable logistic and linear regression,were performed.RESULTS There was an increase in FLIP cases with each successive time period of 13 months(n=68,146,184,respectively)with notable rises specifically for indications of dysphagia and gastroesophageal reflux disease.There was a shift toward use of the longer FLIP balloon catheter for diagnostic purposes(overall 70.4%vs 29.6%,P<0.01).Many cases(42.8%)were performed in conjunction with other diagnostics/interventions,such as dilation and wireless pH probe placement.Procedures were nearly equally performed with anesthesia vs moderate sedation(51.4%anesthesia),with no major complications.Patients who had anesthesia were less likely to have recurrent antegrade contractions[odds ratio(OR)=0.4,95%CI:0.3-0.8]and were also more likely to have absent contractility(OR=2.4,95%CI:1.3-CONCLUSION FLIP cases have increased in our practice with expanding indications for its use.Given limited normative data,providers should be aware of several potential technical issues,including the possible impact of sedation choice when assessing esophageal motility patterns.

A Giant Granuloma of the Vocal Process after Double-Lumen Bronchial Catheter Insertion: A Rare Case Report and Literature Review

Background: Double-lumen endotracheal (DLT) is commonly used for one-lung ventilation and lung separation during thoracic surgery. There are case reports of medically induced laryngeal granulomas, mainly in patients after single-lumen endotracheal (SLT) tube intubation and tracheotomy, and giant granulomas of the vocal cords due to double-lumen bronchial tube insertion have rarely been reported. Case presentation: A 49-year-old female patient underwent single-port thoracoscopy after DLT intubation as well as a wedge resection of the lower lobe of the left lung, which caused giant vocal process granulomas (VPGs) postoperatively. Based on a retrospective analysis of the general condition, current medical history, past medical history, and visual laryngoscopic observation of the vocal folds tissue, which ruled out preoperative vocal fold granuloma formation, we hypothesized that double-lumen bronchial catheter intubation may have been the primary cause of her vocal fold granuloma formation. Conclusions: Giant granuloma of the vocal folds after DLT insertion is a rare postoperative complication;therefore, if DLT intubation is to be performed, the anesthesiologist should choose an appropriate intubation plan and deal with it promptly to avoid the risk factors to ensure that the patient’s perioperative period is safe and smooth. In addition, if postoperative complications are encountered, they should be followed up and observed on time.

Use of endolumenal functional lumen imaging probe in investigating paediatric gastrointestinal motility disorders

Investigating gastrointestinal(GI)motility disorders relies on diagnostic tools to assess muscular contractions,peristalsis propagation and the integrity and coordination of various sphincters.Manometries are the gold standard to study the GI motor function but it is increasingly acknowledged that manometries do not provide a complete picture in relation to sphincters competencies and muscle fibrosis.Endolumenal functional lumen imaging probe(EndoFLIP)an emerging technology,uses impedance planimetry to measure hollow organs cross sectional area,distensibility and compliance.It has been successfully used as a complementary tool in the assessment of the upper and lower oesophageal sphincters,oesophageal body,the pylorus and the anal canal.In this article,we aim to review the uses of EndoFLIP as a tool to investigate GI motility disorders with a special focus on paediatric practice.The majority of EndoFLIP studies were conducted in adult patients but the uptake of the technology in paediatrics is increasing.EndoFLIP can provide a useful complementary data to the existing GI motility investigation in both children and adults.

基于实时渲染技术的室内家居设计研究——以Lumen技术为例

长期以来,家居消费需求存在一定的定性,虽然受到不稳定因素影响,但是消费者对定制家具、家居设计的消费需求从未消失.家居消费主体的转变带来消费观念的改变,线上与线下融合的消费方式成为时代主流,成为家居产业的一个重要发展趋势.新冠肺炎疫情迫使人们长期居家办公,进一步加速了家居产业的变革与升级,短视频、直播成为新型线上消费方式,全途径的营销方式成为企业发展的必然选择.与此同时,智能化、信息化、万物互联的新型商业模式,成为家居产业新的发展方向.渲染技术进一步发展,实时渲染技术趋于成熟,根据现阶段家具产品与室内装饰在展示上存在的展示方式单一、展示效果不真实等问题,提出实时渲染技术与室内家居设计结合,探寻室内家居设计的发展方向.文章通过分析现阶段家具产品和室内装饰的展示方式,指出室内家居设计在展示方面存在的问题,分析实时渲染技术的优势,以虚幻引擎(UE5,Unreal Engine 5)Lumen技术为例,结合具体家居设计案例分析,得出实时渲染技术能够弥补家居展示设计不足这一结论.实时渲染技术可以为家居展示设计提供更加便捷高效、展示效果更加出色的实现途径,提高设计效率,优化展示效果,为室内家居设计行业提供技术参考.

Double-Lumen Needle Follicular Flushing System versus Single-Lumen Aspiration Needle in IVF/ICSI Patients with Poor Ovarian Response: A Meta-Analysis

Background: The present study performed a meta-analysis to comprehensively analyze existing randomized controlled trials (RCT) involving the use of double-lumen needle in patients with poor ovarian response to explore whether double-lumen needle was good for specific patients. Methods: The PubMed, EMBASE, Cochrane Library databases and two randomized controlled trials registration centers were thoroughly searched until April 2017. The clinical outcomes of IVF/ICSI cycles were compared between two groups with double-lumen needle and single-lumen needle. Results: Four RCT studies were included in this present meta-analysis. The oocytes yield was similar in two groups (OR 0.88, 95%CI 0.66 - 1.16;I2 = 4%). The procedure time with double-lumen needle was significantly longer than that with single-lumen needle (IV = 1.98, 95%CI 0.95 - 3.00;I2 = 86%). The fertilization rate with double-lumen needle was lower than that with single-lumen needle (OR 0.66, 95%CI 0.44 - 0.97;I2 = 0%). There was no significant difference of live birth rate in two groups (OR 0.76, 95%CI 0.32 - 1.76;I2 = 41%). Conclusion: Double-lumen needle could not benefit patients with a POR in terms of the number of oocytes retrieved, oocyte recovery rate, normal fertilization rate, clinical pregnancy rate, and live birth rate, compared with single-lumen needle.

Vue.js与Lumen组合框架的大创项目管理系统架构方案

针对高校大学生创新创业训练计划项目管理系统的需求,研究了Vue.js前端框架、Lumen后端框架以及前后端分离架构,结合当下主流Web技术,探索并设计出一套适用于大创项目管理系统的,并且应用Vue.js与Lumen框架的前后端分离的具有高效率、高安全系数和低维护成本的系统架构方案。最后将该架构方案应用于实际项目中,通过实际测试验证该架构方案的应用价值。

Lumen apposing metal stents for pancreatic fluid collections:Recognition and management of complications

For patients recovering from acute pancreatitis,the development of a pancreatic fluid collection (PFC) predicts a more complex course of recovery,and introduces difficult management decisions with regard to when,whether,and how the collection should be drained.Most PFCs resolve spontaneously and drainage is indicated only in pseudocysts and walled-off pancreatic necrosis when the collections are causing symptoms and/or local complications such as biliary obstruction.Historical approaches to PFC drainage have included surgical (open or laparoscopic cystgastrostomy or pancreatic debridement),and the placement of percutaneous drains.Endoscopic drainage techniques have emerged in the last several years as the preferred approach for most patients,when local expertise is available.Lumen-apposing metal stents(LAMS) have recently been developed as a tool to facilitate potentially safer and easier endoscopic drainage of pancreatic fluid collections,and less commonly,for other indications,such as gallbladder drainage.Physicians considering LAMS placement must be aware of the complications most commonly associated with LAMS including bleeding,migration,buried stent,stent occlusion,and perforation.Because of the patient complexity associated with severe pancreatitis,management of pancreatic fluid collections can be a complex and multidisciplinary endeavor.Successful and safe use of LAMS for patients with pancreatic fluid collections requires that the endoscopist have a full understanding of the potential complications of LAMS techniques,including how to recognize and manage expected complications.

Lumen-apposing metal stents for malignant biliary obstruction: Is this the ultimate horizon of our experience?

In the last years, endoscopic ultrasonography (EUS) has evolved from a purely diagnostic technique to a more and more complex interventional procedure, with the possibility to perform several type of therapeutic interventions. Among these, EUS-guided biliary drainage (BD) is gaining popularity as a therapeutic approach after failed endoscopic retrograde cholangiopancreatography in distal malignant biliary obstruction (MBO), due to the avoidance of external drainage, a lower rate of adverse events and re-interventions, and lower costs compared to percutaneous trans-hepatic BD. Initially, devices created for luminal procedures (e.g., luminal biliary stents) have been adapted to the new trans-luminal EUSguided interventions, with predictable shortcomings in technical success, outcome and adverse events. More recently, new metal stents specifically designed for transluminal drainage, namely lumen-apposing metal stents (LAMS), have been made available for EUS-guided procedures. An electrocautery enhanced delivery system (EC-LAMS), which allows direct access of the delivery system to the target lumen, has subsequently simplified the classic multi-step procedure of EUS-guided drainages. EUS-BD using LAMS and ECLAMS has been demonstrated effective and safe, and currently seems one of the most performing techniques for EUS-BD. In this Review, we summarize the evolution of the EUS-BD in distal MBO, focusing on the novelty of LAMS and analyzing the unresolved questions about the possible role of EUS as the first therapeutic option to achieve BD in this setting of patients.

Total endovascular repair of an intraoperative stent-graft deployed in the false lumen of Stanford type A aortic dissection: A case report

BACKGROUND A 46-year-old male underwent ascending aortic replacement,total arch replacement,and descending aortic stent implantation for Stanford type A aortic dissection in 2016.However,an intraoperative stent-graft was deployed in the false lumen inadvertently.This caused severe iatrogenic thoracic and abdominal aortic dissection,and the dissection involved many visceral arteries.CASE SUMMARY The patient had pain in the chest and back for 1 mo.A computed tomography scan showed that the patient had secondary thoracic and abdominal aortic dissection.The ascending aortic replacement,total arch replacement,and descending aortic stent implantation for Stanford type A aortic dissection were performed 2 years prior.An intraoperative stent-graft was deployed in the false lumen.Endovascular aneurysm repair was performed to address this intractable situation.An occluder was used to occlude the proximal end of the true lumen,and a covered stent was used to direct blood flow back to the true lumen.A three-dimensional printing technique was used in this operation to guide prefenestration.The computed tomography scan at the 1stmo after surgery showed that the thoracic and abdominal aortic dissection was repaired,with all visceral arteries remaining patent.The patient did not develop renal failure or neurological complications after surgery.CONCLUSION The total endovascular repair for false lumen stent-graft implantation was feasible and minimally invasive.Our procedures provided a new solution for stent-graft deployed in the false lumen,and other departments may be inspired by this case when they need to rescue a disastrous stent implantation.

Alternative uses of lumen apposing metal stents

The advent of lumen apposing metal stents(LAMS)has revolutionized the management of many complex gastroenterological conditions that previously required surgical or radiological interventions.These procedures have garnered popularity due to their minimally invasive nature,higher technical and clinical success rate and lower rate of adverse events.By virtue of their unique design,LAMS provide more efficient drainage,serve as conduit for endoscopic access,are associated with lower rates of leakage and are easy to be removed.Initially used for drainage of pancreatic fluid collections,the use of LAMS has been extended to gallbladder and biliary drainage,treatment of luminal strictures,creation of gastrointestinal fistulae,pancreaticobiliary drainage,improved access for surgically altered anatomy,and drainage of intra-abdominal and pelvic abscesses as well as post-surgical fluid collections.As new indications of endosonographic techniques and LAMS continue to evolve,this review summarizes the current role of LAMS in the management of these various complex conditions and also highlights clinical pearls to guide successful placement of LAMS.

A New Type of Double-Lumen Catheter to Replace Current One in RCA

Objective: To replace the peripheral venous puncture for blood sampling with taking blood samples extracorporally from arterial line before predilution during RCA-CRRT performed. Methods: A new type of double-lumen femoral catheter was used instead of the current tubes. The new type of double-lumen tube had a greater distance from the inner venous ports to the inner arterial ports than current tubes. The minimum distance from the venous port to the arterial port was greatly lengthened. Replacement solution contained citrate, zero Ca2+, zero bicarbonate, low Na+. Blood samples were synchronously collected from the arterial line before the infusion of citrate replacement fluid and from the peripheral vein. The iCa concentration data of two groups were analyzed to observe the difference between iCa concentration levels in the arterial line and in peripheral vein;the anticoagulant effect of RCA and possible complications were observed, such as bleeding, clottings and hypocalcaemia. Results: 28 times of RCA-CRRT were performed on17 AKI and CRF patients with active bleeding or at the high risk of bleeding;336 blood samples were collected. Statistics showed that the difference of iCa concentration between arterial line group and the peripheral vein group was not significant (P = 0.9), there is a high degree of similarity between the iCa concentration of arterial line blood and the peripheral venous blood. None of the patients developed citrate toxicity or metabolic alkalosis. None induced bleeding, or bleeding aggravated. No obvious clotting occurred. Systemic calcium concentration was achieved in the ideal range. Conclusion: In clinical practice, the data of iCa concentration from arterial line can be used to replace that from peripheral vein when the new type of double-lumen femoral catheter is placed in femoral vein. RCA-CRRT therapy is safe and effective.

Sphincterotomy by triple lumen needle knife using guide wire in patients with Billroth Ⅱ gastrectomy

AIM:To investigate the usefulness of a guide wire and triple lumen needle knife for removing stones in BillrothⅡ(B-Ⅱ)gastrectomy patients.METHODS:Endoscopic sphincterotomy in patients with B-Ⅱgastrectomy is challenging.We used a new guide wire technique involving sphincterotomy by triple lumen needle knife through a forward-viewing endoscopy.This technique was performed in nine patients between August 2010 and June 2012.Sphincterotomy as described above was performed.Adequate sphincterotomy,successful stone removal,and complications were investigated prospectively.RESULTS:Sphincterotomy by triple lumen needle knife using guide wire was successful in all nine patients.Sphincterotomy started towards the 4-5 o’clock direction and continued to the upper margin of the papillary roof.Complete stone removal in one session was achieved in all patients.There were no procedure related complications,such as bleeding,pancreatitis,or perforation.CONCLUSION:In patients with B-Ⅱgastrectomy,guide wire using sphincterotomy by triple lumen needle knife through a forward-viewing endoscopy seems to be an effective and safe procedure for the removal of common bile duct stones.

Off label use of lumen-apposing metal stent for persistent gastro-jejunal anastomotic stricture

We are reporting a novel "off-label" use of lumen apposing metal stent(LAMS) for management of refractory gastro-jejunal(GJ) anastomotic stricture after Roux-en-y gastric bypass(RYGB). With increasing prevalence of obesity, bariatric surgery is performed more frequently than ever. RYGB is one of the most commonly performed bariatric procedures. GJ anastomotic stricture is a late complication of this procedure. Our patient, seven years after RYGB developed GJ anastomotic ulcer and subsequently a stricture not amendable to repeated pneumatic dilations. Instead of using the conventional fully covered self-expanding metal stent(fc SEMS) we deployed the relatively new LAMS keeping in mind its novel dumbbell shaped design. Our patient's symptoms were controlled successfully and she remained asymptomatic on follow-up. Despite initial approval for pancreatic pseudocyst drainage, LAMS has been used with increased frequency at various locations within gastrointestinal tract including GJ anastomotic strictures. Future randomized control trials are warranted to compare the efficacy of fcSEMS to LAMS.

Virtues of Using a Double Lumen Tube for Anesthesia in Patients with Endobronchial Tumours Requiring Open Lung Resection or Bronchoplastic Procedures

Objective The benefits and risks of using double lumen tube (DLT) in open thoracotomy are not well studied and the relative contraindication for using it in cases of endobronchial tumours is not proven. In this study, we compared our experience with using DLT versus single lumen tube (SLT) for anesthesia in patients requiring an open thoracotomy for resection of endobronchial tumours. Methods A prospective observational study was performed in a single tertiary care university hospital in patients with endobronchial tumours anesthetized with single and double lumen tubes for open thoracotomy procedures over a period from 2010 till 2018. Results One hundred and six patients with endobronchial tumours were studied. There were 76 males. Median age was 32 years (14 - 62). In 96 cases, endobronchial pathology was a typical carcinoid. 58 patients were anesthetized using a DLT and 48 using a SLT. Four cases of near miss from potentially fatal intraoperative tumour migration occurred in the SLT group (p = 0.025). There was only one case of mild tumour bleeding from the DLT group and time of insertion was longer (16.2 vs. 4.5 min p Conclusions We conclude that it is safe to place a double lumen endo tracheal tube for patients with endobronchial tumours requiring open lobectomies or bronchoplastic procedures. An additional benefit of DLT use is increasing surgical satisfaction by reducing spillage and tidal volume loss during surgical anastomosis of the open airway.

Proximal true lumen collapse in a chronic type B aortic dissection patient:A case report

BACKGROUND In the context of aortic dissection,increasing pressure within the newly formed false lumen can result in the progressive compression of the true aortic channel.However,true lumen collapse in chronic type B aortic dissection(cTBAD)patients is rare,with few clinical or experimental studies to date having explored the causes of such collapse.CASE SUMMARY In the present report,we describe a rare case of true-lumen collapse in an 83-yearold patient diagnosed with cTBAD,and we discuss potential therapeutic interventions for such cases.Following thoracic endovascular aortic repair(TEVAR),computed tomography angiography revealed satisfactory stent-graft positioning,no endoleakage,true lumen enlargement,thrombus formation in the false lumen,and slight enlargement of the true lumen distal to the stent-graft.Computational hemodynamic analyses indicated that the wall shear stress and pressure within the false lumen were significantly reduced following TEVAR.CONCLUSION TEVAR treatment of cTBAD patients suffering from proximal true lumen collapse can facilitate some degree of effective remodeling.

基于HR-MRI分析MCAS患者血管管壁特征与卒中的关系

目的基于三维高分辨率磁共振(HR-MRI)分析大脑中动脉粥样硬化性狭窄(MCAS)患者血管管壁特征与卒中的关系。方法回顾性分析2020年4月~2023年4月我院收治的100例MCAS患者临床资料,根据病变血管是否引发卒中情况,将其分为责任血管组(引发卒中的大脑中动脉,n=100)和非责任血管组(对侧未引发卒中的大脑中动脉,n=77),比较两组大脑中动脉斑块分布情况、斑块类型、斑块强化类型、斑块强化程度及管壁参数。结果100例MCAS患者中共发现227个斑块,其中责任血管组中有106个,非责任血管组中有121个;两组均以前壁斑块最为常见,但责任血管组上壁斑块所占比例(26.42%)明显高于非责任血管组(14.88%)(P<0.05)。责任血管组不规则斑块所占比例(63.21%)明显高于非责任血管组(43.80%)(P<0.05)。责任血管组偏心性强化斑块及高度强化斑块所占比例(84.91%、53.77%)明显高于非责任血管组(30.58%、8.26%),无强化和轻度强化斑块所占比例(7.55%、17.92%)明显低于非责任血管组(16.53%、43.80%),差异均有统计学意义(P<0.05)。责任血管组管腔狭窄程度、最大管壁厚度、管壁面积及斑块负荷均明显大于非责任血管组(P<0.05)。结论HR-MRI可清晰显示MCAS患者血管管壁特征,有助于评估斑块稳定性和识别责任血管,对预防卒中的发生具有一定参考价值。

腔内介入结合硅酮支架置入术治疗Ⅳ、Ⅴ型气管支气管结核的临床研究

目的:研究腔内介入结合硅酮支架置入术治疗Ⅳ、Ⅴ型气管支气管结核(TBTB)的临床效果。方法:选择2019年1月—2023年12月于江西省胸科医院治疗的20例Ⅳ、Ⅴ型TBTB患者。所有患者均采用腔内介入结合硅酮支架置入术治疗。观察治疗前后的临床疗效、呼吸困难程度、肺功能指标、血气分析指标、管腔直径变化及并发症发生情况。结果:20例Ⅳ、Ⅴ型TBTB患者治疗后的总有效率为95.00%(19/20)。治疗后,患者的改良英国医学研究委员会呼吸困难量表(mMRC)评分、二氧化碳分压(PaCO_(2))均低于治疗前,第1秒用力呼气容积(FEV1)、动脉血氧分压(PaO_(2))及管腔直径均高于治疗前,差异均有统计学意义(P<0.05)。20例Ⅳ、Ⅴ型TBTB患者治疗后并发症总发生率为10.00%(2/20)。结论:腔内介入结合硅酮支架置入术治疗Ⅳ、Ⅴ型TBTB效果确切,能够减轻患者呼吸困难程度,改善患者血气指标及肺功能,扩大管腔直径,且并发症发生率低。

改良鼻胃肠双腔管两步置管法在神经外科重症患者中的应用

目的探索一种改良的鼻胃肠双腔管置管两步法,可以床旁徒手完成置管应用于神经外科重症患者;方法收集需行肠内营养的神经外科重症患者120例,采用随机数表法分为传统鼻肠管组(对照组)和改良鼻肠双腔管组(改良组),各60例,分别记录入组时的APACHEⅡ评分及GCS评分、年龄、体质量指数(BMI),收集每例患者鼻肠管置管操作时间,置管前心率及置管过程中的最高心率变化,置管前和置管后14 d的鼻窦CT、胸部CT及营养指标,判断是否出现鼻窦炎、吸入性肺炎、消化道出血、营养液潴留及心律失常等并发症。结果2组入组时APACHEⅡ评分,GCS评分,年龄,BMI比较,差异均无统计学意义(t=1.0598,1.2073,0.3104,0.9268;P=0.2914,0.2297,0.7568,0.3559,P均>0.05)。改良组置管时间(54.4±13)min,对照组置管时间(49.4±12.9)min,改良组置管时间略长于对照组(t=2.1334,P=0.035,P<0.05)。置管过程中,改良组和对照组在心率变化方面比较,差异无统计学意义(P>0.05)。改良组控制鼻窦炎(20.0%,12/60)方面优于对照组(36.7%,22/60)(P<0.05),改良组控制肺炎(26.7%,16/60)方面优于对照组(46.7%,28/60)(P<0.05),改良组控制胃液潴留(5.0%,3/60)方面优于对照组(16.7%,10/60)(P<0.05);2组胃肠道出血及心律失常方面比较,差异无统计学意义(P>0.05)。经过14 d的肠内营养治疗后,改良组白蛋白、前白蛋白、血红蛋白及淋巴细胞计数均好于对照组。结论改良的鼻胃肠双腔管两步置管法可在床头徒手完成,与传统方法比较,尽管置管时间略有延长,但鼻窦炎、吸入性肺炎的发生率明显降低,不增加置管相关并发症发生,同时改良组营养指标明显优于对照组。该两步法安全、有效、便捷,值得临床推广。

便携式医用管腔智能清洗装置的设计与应用

目的:针对管腔器械清洗不彻底、清洗效率低的问题,设计一种便携式医用管腔智能清洗装置。方法:该装置为箱体状,外壳采用304不锈钢材料制作,主要由电路控制板、微型抽水泵、锂电池、充电接口、冲洗管、连接头等组成。其中,电路控制板采用STM32G030C8T6单片机集成电路,电路控制板上装有显示倒计时数码管用以显示清洗倒计时间;微型抽水泵和锂电池安装在箱底内壁,箱底前壁外侧设有电源充电接口和出入水接口,出入水接口连接硅胶冲洗管,冲洗管远端连接转接头,转接头口径由小到大可连接不同口径管腔器械。选取2021年5—10月某院消毒供应中心接收的9672件管腔器械,采用便利抽样方法分为2组,每组4836件,单号为对照组,以超声清洗机加管腔刷进行管腔器械清洗;双号为实验组,以该装置进行管腔器械预处理后再进行常规清洗。对比2组的清洗质量和满意率。结果:在目测+带光源放大镜目测法和白通条检测法下,实验组清洗合格率明显高于对照组,差异有统计学意义(P<0.05);实验组满意率为100%,对照组满意率为86.53%,差异有统计学意义(P<0.05)。结论:该装置操作简单方便,可提高管腔器械清洗质量和清洗效率。