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口外吸引装置能否减少食管胃十二指肠镜检查期间的气溶胶产生并防止检查者接触飞沫?

Does an Extraoral Suction Device Reduce Aerosol Generation and Prevent Droplet Exposure to the Examiner during Esophagogastroduodenoscopy?

作者信息

Fujihara Shintaro, Kobara Hideki, Nishiyama Noriko, Tada Naoya, Goda Yasuhiro, Kozuka Kazuhiro, Matsui Takanori, Chiyo Taiga, Kobayashi Nobuya, Yachida Tatsuo, Masaki Tsutomu

机构信息

Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Kagawa 761-0793, Japan.

Department of Gastroenterology, Kagawa Prefectural Shirotori Hospital, Kagawa University, Kagawa 769-2788, Japan.

出版信息

J Clin Med. 2023 Mar 29;12(7):2574. doi: 10.3390/jcm12072574.

Abstract

Esophagogastroduodenoscopy (EGD) is an aerosol-generating procedure. A major challenge in the COVID-19 era is how to prevent the spread of aerosols and droplets in endoscopic units. We evaluated the effectiveness of an extraoral suction device in preventing indoor aerosol diffusion and droplet exposure for examiners. The study involved 61 patients who underwent EGD at our institution from 1 February to 31 March 2022. To determine whether aerosol spread increases before or after EGD examination with an extraoral suction device located in front of the patient's mouth, aerosols of 0.3, 0.5, 1, 3, 5, and 10 μm were measured with a handheld particle counter. The degree of contamination of the plastic gowns on the examiners was assessed using the rapid adenosine triphosphate test. The extraoral suction device significantly reduced the diffusion of large particles (3, 5, and 10 μm) after finishing the EGD examination. However, the diffusion of small particles (0.3 and 0.5 μm) was significantly increased. This extraoral suction device was effective in reducing large particle diffusion during EGD examination but was limited for minimizing small particle diffusion or droplet exposure to the examiner.

摘要

食管胃十二指肠镜检查(EGD)是一种会产生气溶胶的操作。在新冠疫情时代,一个主要挑战是如何防止内镜检查单元中气溶胶和飞沫的传播。我们评估了一种口外吸引装置在预防检查者室内气溶胶扩散和飞沫暴露方面的有效性。该研究纳入了2022年2月1日至3月31日在我们机构接受EGD检查的61例患者。为了确定在患者口腔前方放置口外吸引装置进行EGD检查之前或之后气溶胶传播是否增加,使用手持式粒子计数器测量了直径为0.3、0.5、1、3、5和10μm的气溶胶。使用快速三磷酸腺苷检测评估检查者所穿塑料防护服的污染程度。EGD检查结束后,口外吸引装置显著减少了大颗粒(3、5和10μm)的扩散。然而,小颗粒(0.3和0.5μm)的扩散显著增加。这种口外吸引装置在EGD检查期间有效减少了大颗粒扩散,但在最小化小颗粒扩散或检查者的飞沫暴露方面存在局限性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b3ea/10094833/be3a6e7e85f6/jcm-12-02574-g001.jpg

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