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請問各位大大，消化道內視鏡及輸尿管內視鏡，同屬於軟管內視鏡，那他們的消毒流程會是一樣的嗎？謝謝。

親愛的會員 您好:
以下內容提供給您參考，謝謝您。

1.消化道內視鏡及輸尿管內視鏡，同屬於軟式內視鏡， 根據美國CDC文獻(Guideline for Disinfection and Sterilization in Healthcare Facilities 2008) Flexible cystoscopy 在可行情況下應使用滅菌處理，若滅菌不可行，則可使用高層次消毒方式，但沖洗過程需使用無菌的水。有關ortho phthalaldehyde (ex: cidex opa Metricidex opa等) 有提到cystoscopy使用OPA消毒後，用於膀胱癌病人身上會有過敏反應。
Process endoscopes (e.g., arthroscopes, cystoscope, laparoscopes) that pass through normally sterile tissues using a sterilization procedure before each use; if this is not feasible, provide at least high-level disinfection. High-level disinfection of arthroscopes, laparoscopes, and cystoscopes should be followed by a sterile water rinse.
In April 2004, the manufacturer of OPA disseminated information to users about patients who reportedly experienced an anaphylaxis-like reaction after cystoscopy where the scope had been reprocessed using OPA ,24 cases (17 cases in the United States, six in Japan, one in the United Kingdom), not using OPA for reprocessing urologic instrumentation used to treat patients with a history of bladder cancer

2. 根據WHO文獻(Decontamination and Reprocessing of Medical Devices for Health-care Facilities 2016 ) 有提到建議cystoscopy應使用滅菌處理
Invasive – passed into normally sterile body cavities or introduced into the body through a break in the skin or mucous membrane, example: Cystoscope need Sterilization by steam or a low temperature method( gas plasma)

3.根據2014年美國AUA文獻(Joint AUA/SUNA White Paper on Reprocessing of Flexible Cystoscopes)建議Flexible Cystoscopes應使用高層次消毒方式(HLD)或滅菌處理(sterilization process)，而且提及ortho phthalaldehyde (OPA)禁用於有膀胱癌病史的患者。
REPROCESSING OF FLEXIBLE CYSTOSCOPES – STEPS
As noted above, the minimum recommended practice for cystoscopes is HLD with a liquid sterilant/disinfectant approved by the U.S. Food and Drug Administration (FDA). Alternatively, users may choose to sterilize the scopes when the necessary materials are available
OPA is contraindicated in patients with a history of bladder cancer.

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