硬性內(nèi)窺鏡的使用是被觀察物體經(jīng)物鏡所成的倒像通過轉(zhuǎn)像系統(tǒng)轉(zhuǎn)為正像，并傳輸?shù)侥跨R，再由目鏡放大后為人眼所觀察。照明傳輸系統(tǒng)由光導(dǎo)纖維組成，工作原理是：將冷光源的光經(jīng)過光導(dǎo)纖維傳輸?shù)絻?nèi)窺鏡前端，照亮被觀察物。那么為什么會說硬性內(nèi)窺鏡的維修成本控制靠保養(yǎng)呢？下面來講講吧。

The use of rigid endoscope is that the inverted image formed by the observed object through the objective lens is converted into a positive image through the image conversion system, which is transmitted to the eyepiece, and then magnified by the eyepiece and observed by the human eye. The lighting transmission system is composed of optical fibers. Its working principle is to transmit the light from the cold light source to the front end of the endoscope through the optical fibers to illuminate the observed object. So why do we say that the maintenance cost of rigid endoscopes depends on maintenance? Now let's talk about it.

鏡體與工作管的連接處是硬鏡的主要受力處，容易出現(xiàn)彎折現(xiàn)象。平時在拿取存放時應(yīng)采取正確的持鏡方法，一手握住鏡體，另一手托住鏡管，輕拿輕放。在手術(shù)過程中，盡量避免與帶有刃口的手術(shù)器械放在一起。禁止鏡子垂直擺放，禁止敲擊鏡身。

The connection between the mirror body and the working tube is the main force bearing part of the hard mirror, which is prone to bending. At ordinary times, when taking and storing, you should take the correct method of holding the mirror, holding the mirror body with one hand and holding the mirror tube with the other hand, and handle it gently. During the operation, try not to put it together with surgical instruments with cutting edges. It is forbidden to place the mirror vertically and knock the mirror body.

正確的保養(yǎng)方法

Correct maintenance method

（1）嚴(yán)格遵循鏡子的保養(yǎng)原則，輕拿輕放，單獨擺放，不能碰撞。

(1) Strictly follow the maintenance principle of the mirror, handle it with care, place it separately, and do not collide.

（2）防止鏡子起霧。手術(shù)前用溫?zé)崴?，涂防霧油，術(shù)中可以在肝或腸壁上蹭一下。

(2) Prevent the mirror from fogging. Soak in warm water before operation and apply antifogging oil. You can rub it on the liver or intestinal wall during operation.

（3）不能使用超聲波清洗內(nèi)窺鏡。

(3) Do not use ultrasound to clean the endoscope.

（4）控制預(yù)真空壓力蒸汽的時間。通?？梢允褂妙A(yù)真空壓力蒸汽的鏡子會在內(nèi)鏡上標(biāo)注Autoclave。溫度在132~134℃時時間應(yīng)少于5min，溫度在121℃時時間應(yīng)少于20min，且在預(yù)真空壓力蒸汽后一定要自然冷卻。

(4) Control the time of pre vacuum pressure steam sterilization. Generally, mirrors that can be sterilized with pre vacuum pressure steam will be marked with autoclave on the endoscope. The sterilization time should be less than 5min when the temperature is 132~134 ℃, and less than 20min when the temperature is 121 ℃, and it must be naturally cooled after pre vacuum pressure steam sterilization.

（5）不要頻繁地更換方法，否則會破壞鏡子的密封性。

(5) Do not change the sterilization method frequently, otherwise the tightness of the mirror will be damaged.

（6）內(nèi)鏡在任何溶液中的浸泡時間不能超過60min。

(6) The immersion time of endoscope in any solution shall not exceed 60min.

大部分內(nèi)窺鏡的損壞都是人為造成的，所以控制維修成本就是控制人為的故障率。所有接觸內(nèi)窺鏡的工作人員，必須對內(nèi)窺鏡的結(jié)構(gòu)有清楚的認(rèn)識，熟練掌握內(nèi)窺鏡的正確使用方法。

Most of the damage of the endoscope is caused by human beings, so controlling the maintenance cost is to control the artificial failure rate. All staff who contact the endoscope must have a clear understanding of the structure of the endoscope and be proficient in the correct use of the endoscope.

這就要求我們對工作人員進(jìn)行相關(guān)知識的學(xué)習(xí)和培訓(xùn)，制定相關(guān)的制度并嚴(yán)格遵守[3]。為此，可以在每臺機器上粘貼了簡易的操作說明，方便大家隨時閱讀。

This requires us to study and train our staff in relevant professional knowledge, formulate relevant systems and strictly abide by them [3]. For this reason, simple operating instructions can be pasted on each machine, which is convenient for everyone to read at any time.

聯(lián)系廠家進(jìn)行不定期的集中式培訓(xùn)，強化使用及時的注意事項，禁止未經(jīng)培訓(xùn)的人員接觸鏡子。手術(shù)室安排專人對內(nèi)窺鏡進(jìn)行管理，負(fù)責(zé)內(nèi)窺鏡日常的清洗、及存放。

Contact the manufacturer for irregular centralized training, strengthen the precautions during use and sterilization, and prohibit untrained personnel from contacting the mirror. The operating room arranges special personnel to manage the endoscope, and is responsible for the daily cleaning, disinfection, sterilization and storage of the endoscope.

內(nèi)窺鏡設(shè)備維修人員認(rèn)為應(yīng)該加強專職人員與維修工程師的相互交流和溝通。工程師在內(nèi)窺鏡的維修模式上應(yīng)強化自行維修和預(yù)防性維修，弱化外送維修和故障后維修。定期對鏡子進(jìn)行巡檢，發(fā)現(xiàn)小故障及時排除，防止故障擴大，大限度地節(jié)省維修成本。

Endoscope equipment maintenance personnel believe that the communication between full-time personnel and maintenance engineers should be strengthened. Engineers should strengthen self maintenance and preventive maintenance in the maintenance mode of endoscope, and weaken delivery maintenance and post failure maintenance. Inspect the mirror regularly, and eliminate small faults in time if found, so as to prevent the expansion of faults and greatly save maintenance costs.

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