① 自然老化或人為故障;② 機械或電子故障;③靜態或動態故障;④ 設備本身或周邊環境引起的故障;⑤還有一些是形式多種、故障交叉同時發生的故障。
① Natural aging or artificial faults; ② Mechanical or electronic faults; ③ Static or dynamic faults; ④ Faults caused by the equipment itself or the surrounding environment; ⑤ There are also faults that occur in multiple forms and cross over simultaneously.
造成內鏡故障發生的因素可能歸納為三個主要因素:
The factors that cause endoscopic malfunctions may be summarized into three main factors:
① 醫護人員操作習慣,清洗消毒人員的習慣,病人的配合程度等;② 設備本身的特性,清洗消毒、配合診治等相關設備情況;③使用環境、保管環境,還有重要的管理制度環境。
① The operating habits of medical staff, the habits of cleaning and disinfecting personnel, and the level of patient cooperation; ② The characteristics of the equipment itself, as well as the situation of related equipment such as cleaning, disinfection, and coordinated diagnosis and treatment; ③ The usage environment, storage environment, and important management system environment.
故障判斷的方法故障判斷的方法包括:
The methods for fault diagnosis include:
①排除法:常規使用的基本方法、但必須對工作原理要非常了解;②跟臺發現法:針對一些人為因素導致的故障使用中才發現;③點檢檢測法:針對未發現故障,排查潛在故障避免故障擴大及延變;④故障推理法:針對發現了問題,故障如何產生的;⑤經驗判斷法:根據多年的工作經驗積累進行總結及分析。
① Exclusion method: a basic method commonly used, but one must have a thorough understanding of the working principle; ② Follow up discovery method: only discovered during use for faults caused by human factors; ③ Point inspection and detection method: for undetected faults, identify potential faults to avoid fault expansion and extension; ④ Fault reasoning method: targeting the problem discovered and how the fault occurred; ⑤ Empirical judgment method: Summarize and analyze based on years of work experience accumulation.
使用、清冼、消毒注意事項使用、清洗、消毒注意事項:
Precautions for use, cleaning, and disinfection:
手術時嚴禁大力彎折或碰撞;
During surgery, strong bending or collision is strictly prohibited;
使用輔助治設備時要保證在視野內安全操作,當窺鏡配合激光汽化、高頻電切、微波等光電技術進行手術時,應注意窺鏡前端與治療點的距離,保證窺鏡前端不被電擊或燒灼;
When using auxiliary treatment equipment, it is necessary to ensure safe operation within the field of view. When the endoscope is used in conjunction with optoelectronic technologies such as laser vaporization, high-frequency electrocautery, and microwave for surgery, attention should be paid to the distance between the front end of the endoscope and the treatment point to ensure that the front end of the endoscope is not electrocuted or burned;
術中調整視野角度時需保護好鏡子本身,鏡子與鞘管鏈接時必須對準位置并用卡鎖固定,不易過猛;4.建議單獨存放避免與其它器械碰撞,必須輕取輕放以免碰撞鏡子,鏡子傳像系統是玻璃柱體易碎;
Protect the mirror itself when adjusting the visual field angle during operation. When connecting the mirror with the sheath, it must be aligned and fixed with a lock, which is not easy to be too violent; 4. It is recommended to store it separately to avoid collision with other instruments. It must be handled with care to avoid collision with mirrors. The mirror image transmission system is made of fragile glass columns;
建議手術前用溫水浸泡,涂防霧油;
Suggest soaking in warm water and applying anti fog oil before surgery;
在清洗和消毒的時候,建議把鏡子和別的手術器械分開,用塑料盆清洗;
When cleaning and disinfecting, it is recommended to separate the mirror from other surgical instruments and use a plastic basin for cleaning;
消毒前要把鏡頭清洗干凈,否則異物在消毒后積累在鏡頭上,以至影響圖像質量。當鏡頭上異物過多時,可用棉簽涂一些鏡子附帶的清潔劑在鏡面上,然后用清水清洗干凈;8.盡量不要頻繁更換消毒滅菌方法,這樣對鏡子的密封有好處;
Before disinfection, the lens should be cleaned thoroughly, otherwise foreign objects will accumulate on the lens after disinfection, which may affect image quality. When there are too many foreign objects on the lens, you can use a cotton swab to apply some cleaning agent attached to the mirror surface, and then clean it with clean water; 8. Try not to frequently change the disinfection and sterilization methods, as this is beneficial for the sealing of the mirror;
禁止用超聲波清洗鏡子,盡量不要用生理鹽水清洗鏡子,否則容易生銹跡;
It is prohibited to use ultrasound to clean mirrors, and it is advisable not to use physiological saline to clean mirrors, otherwise they may rust easily;
當高溫高壓消毒完鏡子后,一定要讓鏡子自然冷卻,禁止用冷水冷卻;
After high-temperature and high-pressure disinfection of the mirror, it is necessary to allow the mirror to cool naturally, and it is prohibited to use cold water for cooling;
所以的鏡子浸泡消毒時間不能超過60分鐘;12.高溫高壓消毒:建議盡量不要用高溫高壓消毒,但在緊急時也可以進行高溫高壓消毒。
So the soaking and disinfection time of the mirror should not exceed 60 minutes; 12. High temperature and high pressure disinfection: It is recommended not to use high temperature and high pressure disinfection as much as possible, but high temperature and high pressure disinfection can also be carried out in emergency situations.
高溫高壓消毒的條件:建議控制高溫高壓消毒滅菌時間及充分的自然冷卻。
The conditions for high-temperature and high-pressure disinfection: It is recommended to control the sterilization time of high-temperature and high-pressure disinfection and sufficient natural cooling.
內鏡維護、維修的概念與策略
The concept and strategy of endoscopic maintenance and repair
預防性維護通過對產品的系統性檢查、設備測試和更換以防止功能故障發生,使其保持在規定狀態所進行的全部活動。它可以包括調整、潤滑、定期檢查等。
Preventive maintenance is all activities carried out by systematically inspecting, testing, and replacing products to prevent functional failures and maintain them in a specified state. It can include adjustment, lubrication, regular inspections, etc.
預見性維護通過運用各種手段進行數據和信號的采集、分析和判斷設備的劣化趨勢、故障部位、原因并預測變化發展、提出防范措施,防止和控制可能的故障出現。
Predictive maintenance involves the use of various means to collect, analyze, and determine equipment degradation trends, fault locations, causes, predict changes and developments, propose preventive measures, and prevent and control possible failures.
改善維修又稱糾正性維修,主要應用在設備耗損故障期。按照設備的“浴盆曲線”,設備在耗損故障期,存在著老化、磨損、硬化、變形、開裂、腐蝕、疲勞等各種失效狀況,繼續運行將造成較嚴重的故障后果。
Improvement maintenance, also known as corrective maintenance, is mainly applied during equipment wear and tear periods. According to the bathtub curve of the equipment, there are various failure conditions such as aging, wear, hardening, deformation, cracking, corrosion, fatigue, etc. during the wear and tear failure period. Continuing to operate will cause more serious consequences of the failure.
事后維修又稱為故障修理,即設備發生故障或性能、精度降低到合格水平以下時所進行的非計劃性修理。
Post maintenance, also known as fault repair, refers to unplanned repairs carried out when equipment malfunctions or its performance or accuracy drops below the qualified level.
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