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내시경 소독 절차 - gie.or.kr

대한소화기내시경학회지 2008;36(Suppl. 1):79-84 79 내시경 소독 절차 서울대학교 의과대학 내과학교실, 보라매병원

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2008;36(Suppl. 1):79-8479 , Fiber-optic 1950 60 . . . . , (liquid chemical sterilant, LCS) . , B , C . HIV . , . , . , , . , , . 1. 1) (Manual cleaning): , . . , , . , flush / . / . ERCP . ERCP ( m ) . . / ERCP . . , , . . . (brush) 80 2008;36(Suppl. 1):79-84 / . . 3 . 3 . . . . flush . (leak test) . . . 2) (manual disinfection): . , . 2% glutaraldehyde 10 . . flush . . . 3) : flush , 30 . (automated endoscope reprocessors, AERS) . , , , . . ( , , / ) . / . . ERCP elevator wire . , . 2. , Spaulding . 1968 Earl Spaulding 3 Critical , , ( endospore ) Semicritical ( , , fungus, , endospore ) . Non critical . Semic-ritical Critical . , FDA . 2% glu-taraldlehyde , , 81 glutaral-dehyde 1 . 2% glutaraldehyde 25oC 10 20 . AIDS . 3. . . . (SGNA, 2003). 1) (1) . (2) . (3) . (4) flush . (5) . (6) . 2) : (autoclave) . Ethylene oxide . Critical . 3) : . . , . critical . pseudomonas . , (SGNA) . 1) . ( (ASGE), 1999; SGNA, 2003). 2) (ASGE, 1999). 3) ERCP (SGNA, 2003). . . . . . , . . 1. 1) : . 3% hydrogen peroxide glutaral-dehyde . pseudomonas mycobac-82 2008;36(Suppl. 1):79-84teria pseudomonas . . 2) : . 70% . , , , 70 90% Isopropyl alcohol flush . , , . . 3) : . , . 1. 1) (1) ( ) ; , . . 200 mL . , ( , ) . / . bottle , . , . (2) ; . . . . , . (3) ; . . . (pulsatile flow) . (4) ; , , , . (5) (brushing); . , 3 ( - , - , - ) . . (6) ; . . 2 5 , 35 40 . (7) ; . (8) ; . GA (glutaraldehyde), futaral, . , , . GA , 2% GA 10 . (9) ; , 200 mL . (10) ; 70% 70% 10 mL 83Table 1. (1995 8 )1. . , (biopsy channel) . . . (insertion tube) . 70% . . , , .2. 1 ( ). EO , .3. . (water bottle) , . . . . GA . (11) ; hanger . (12) ; , . 2) (1) ; 30 . . Autoclave , EO . (2) , ; (3) ; wire sheath . 30 . . (4) 1 ; . (5) bottle; bottle bottle . (6) ; , . 3) : , , , , . (1) ; . . (2) ; B 1 . . (3) ; bottle B C GA , . B C GA GA . 2. 1995 8 (Table 1). 3. 1) , / . 2) . 84 2008;36(Suppl. 1):79-84 . . . 3) . . . . 4) . 5) . 6) Critical . 7) FDA / . 8) Glutaraldehyde 20 70% . 9) . 10) . 11) . 12) FDA, , . 1. . . 2004;29(suppl 1):99-105. 2. . . 20 1999;29-34. 3. SGNA Practice Committee. Reprocessing of water bottles used during endoscopy. Gastroenterol Nurs 2006;29:396-397. 4. SGNA Practice Committee. Reprocessing of endoscopic accessories and valves. Gastroenterol Nurs 2006;29:394-395. 5. Muscarella LF. Inconsistencies in endoscope-reprocessing and infection-control guidelines: the importance of endoscope drying. Am J Gastroenterol 2006;101:2147-2154. 6. . , 2 . (2004 3 ) 2004;1-17. 7. ESGE, ESGENA. Guidelines on cleaning and disinfection in GI endoscopy update 1999. Endoscopy 2000;32:77-80. 8. Alvarado CJ, Reichelderfer M. The 1997 1998 1999 APIC Guidelines Committees. APIC guideline for infection preven-tion and control in flexible endoscopy. Am J Infect Control 2000;28:138-55. 9. ASGE. Multi-society guideline for reprocessing flexible gastro-intestinal endoscopes. Gastrointest Endosc 2003;58 Tandon RK. Disinfection of gastrointestinal endoscopes and accessories. J Gastroenterol Hepatol 2000;15(S) Ogoshi K. Reprocessing of gastrointestinal endoscopic accessories. J Gastroenterol Hepatol 2000;15(S):G82-G85.

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