Kikuchi Daisuke, Ariyoshi Daiki, Suzuki Yugo, Ochiai Yorinari, Odagiri Hiroyuki, Hayasaka Junnosuke, Tanaka Masami, Morishima Tetsuya, Kimura Keita, Ezawa Hiroshi, Iwamoto Risa, Matsuwaki Yoshinori, Hoteya Shu
Department of Gastroenterology, Toranomon Hospital, Tokyo Japan.
Olympus Medical Systems Corporation, Tokyo, Japan.
Endosc Int Open. 2021 Sep 16;9(10):E1536-E1541. doi: 10.1055/a-1523-8959. eCollection 2021 Oct.
Infection control is essential when performing endoscopic procedures, especially during the COVID-19 pandemic. Therefore, we have developed a new shielding device called STEP for infection control in upper gastrointestinal endoscopy. STEP consists of a mask worn by the patient and a drape that is connected to the mask and covers the endoscope. A suction tube attached to the mask prevents aerosols from spreading. The endoscopist operates the endoscope through the drape. Three endoscopists performed a total of 18 examinations using an upper endoscopy training model with and without STEP. Endoscopic images were evaluated by three other endoscopists, using a visual analog scale. We also simulated contact, droplet, and aerosol infection and evaluated the utility of STEP. All examinations were conducted without a problem. Mean procedure time was 126.3 ± 11.6 seconds with STEP and 122.3 ± 10.0 seconds without STEP. The mean visual analog score was 90.7 ± 10.1 with STEP and 90.4 ± 10.0 without STEP. In the contact model, adherence of simulated contaminants was 4.9 ± 1.4 % without STEP and 0 % with STEP. In the droplet model, the number of simulated contaminants attached to the paper was 338 273 ± 90 735 pixels without STEP and 0 with STEP. In the aerosol model, the total number of particles was 346 837 ± 9485 without STEP and was significantly reduced to 222 ± 174 with STEP. No effect on examination time or endoscopic image quality was observed when using STEP in upper gastrointestinal endoscopy. Using STEP reduced the diffusion of simulated contaminants in all three infection models.
在内镜检查过程中，感染控制至关重要，尤其是在新冠疫情期间。因此，我们开发了一种名为STEP的新型防护装置，用于上消化道内镜检查中的感染控制。STEP由患者佩戴的口罩和连接到口罩并覆盖内镜的布帘组成。连接到口罩的吸管可防止气溶胶扩散。内镜医师通过布帘操作内镜。三名内镜医师使用上消化道内镜训练模型，在有和没有STEP的情况下共进行了18次检查。另外三名内镜医师使用视觉模拟评分法对内镜图像进行评估。我们还模拟了接触、飞沫和气溶胶感染，并评估了STEP的实用性。所有检查均顺利进行。使用STEP时的平均操作时间为126.3±11.6秒，不使用STEP时为122.3±10.0秒。使用STEP时的平均视觉模拟评分为90.7±10.1，不使用STEP时为90.4±10.0。在接触模型中，不使用STEP时模拟污染物的附着率为4.9±1.4%，使用STEP时为0%。在飞沫模型中，不使用STEP时附着在纸上的模拟污染物数量为338273±90735像素，使用STEP时为0。在气溶胶模型中，不使用STEP时颗粒总数为346837±9485，使用STEP时显著减少至222±174。在上消化道内镜检查中使用STEP时，未观察到对检查时间或内镜图像质量有影响。在所有三种感染模型中，使用STEP均可减少模拟污染物的扩散。
