福島医学雑誌 58 巻 3 号　2008

〔原　　著〕

内視鏡チャンネル洗浄における従来型リユーザブルブラシと
2種類の新型シングルユースブラシの有用性の検討

山田ゆき江^1,2,4)，引地　拓人^1,5)，佐藤美智子³⁾
中條　麻理^1,3,4)，水野　順子^1,3,4)，橋本　ひさ^3,4)
鈴木　史子^3,4)，末永　洋子^3,4)，渡辺美恵子^3,4)
平野　典子³⁾，　先崎美起子³⁾，　小原　勝敏¹⁾

¹⁾福島県立医科大学附属病院内視鏡診療部，²⁾検査部，³⁾看護部，⁴⁾消化器内視鏡技師，
⁵⁾福島県立医科大学医学部内科学第2講座

（受付2008年2月12日　受理2008年5月16日）

Comparison of Usefulness between a Conventional Reusable Brush and Two Kinds of
New Single-use Brushes in Cleaning the Working Channel of the Endoscope

YUKIE YAMADA^1,2,4), TAKUTO HIKICHI^1,5), MICHIKO SATO³⁾,
MARI NAKAJYO^1,3,4), YORIKO MIZUNO^1,3,4), HISA HASHIMOTO^3,4),
FUMIKO SUZUKI^3,4), YOKO SUENAGA^3,4), MIEKO WATANABE^3,4),
NORIKO HIRANO³⁾, MIKIKO SENZAKI³⁾ and KATSUTOSHI OBARA¹⁾

¹⁾Department of Endoscopy, and ²⁾Division of Clinical Laboratory, and ³⁾Division of Nursing, and ⁴⁾Gastroenterological Endoscopy Technician, Fukushima Medical University Hospital, and ⁵⁾Department of Internal Medicine II, Fukushima Medical University, Fukushima Fukushima, 960-1295, Japan

要旨: 【目的】 内視鏡チャンネル洗浄における新しい洗浄方法の2種類のシングルユースブラシの有用性を，従来から使用しているリユーザブルブラシと比較し検討した。【方法】 消化管出血例や治療内視鏡を除く連続90例に対して使用した鉗子孔径2.8 mmの上部消化管用内視鏡の内視鏡チャンネルを，従来型リユーザブルブラシ（RB)，1方向引き抜き型シングルユースブラシ（DispoClean: DC)，吸引型シングルユース球状ブラシ（MagicBall: MB）で各々30例ずつ洗浄した。3種類のブラシの洗浄時間，洗浄効果（ATP法)，費用を比較検討した。【結果】 平均洗浄時間は，RB 86.3±6.3秒，DC 98.7±6.9秒，MB 66.9±5.0秒であり，MBが最も短く（p<0.01)，RBに比べDCは長かった（p<0.01）。全例の平均洗浄効果は，RB 456±789 RLU，DC 457±686 RLU，MB 763±1,111 RLUであり差がなかった。しかし，生検例では，RB 543±712 RLU，DC 387±336 RLU，MB 2,225±1,792 RLUであり，MBが最も洗浄効果が低かった（p<0.05）。費用は，RB 80円（1本あたり50例)，DC 350円，MB 412円であった。【結論】 MBは最も洗浄時間が短かったが，生検例での洗浄効果に問題があった。DCはRBと同等の洗浄効果だったが，洗浄時間は長かった。費用は，DCもMBもRBより高価であった。以上から，DCとMBは，RBに比べて有用であるとは言えなかった。

索引用語: 内視鏡洗浄，洗浄，ブラッシング，シングルユースブラシ，ATP

Abstract: [Aim] To test the usefulness of two kinds of new single-use brushes for cleaning the working channel of the endoscope by comparing them with a conventional reusable brush (RB). [Methods] The endoscopes used were upper gastrointestinal endoscopes with working channels 2.8 mm in diameter, which were used in 90 consecutive patients, excluding those who either had endoscopy for treatment, or developed gastrointestinal bleeding. The cleaning brushes were RB, a set of three connected single-use brushes to be pulled out in one direction, named DispoClean (DC), and a set of three separate single-use spherical brushes suctioned up through the working channel, named MagicBall (MB). RB, DC and MB were each used in 30 endoscopic procedures. Then, the cleaning times, cleaning effectiveness (ATP method), and costs of RB, DC and MB were evaluated. [Results] The mean cleaning times of RB, DC, and MB were 86.3±6.3, 98.7±6.9, and 66.9±5.0 seconds, respectively: the mean cleaning time of MB was significantly shorter than that of RB, or DC (p<0.01), and that of DC was significantly longer than that of RB (p<0.01). As for the cleaning effectiveness, the ATP values of the channels used for biopsy, and cleaned by RB, DC, and MB were 543±712, 387±336, and 2,225±1,792 RLU, respectively: the cleaning effectiveness of MB was significantly lower than that of RB, or DC (p<0.05). Supposing that RB is usable in 50 endoscopic procedures, the costs per procedure of RB, DC, and MB were 80, 350, and 412 yen, respectively: those of DC, and MB were significantly higher than that of RB. [Conclusion] Neither DC nor MB is truly more useful than RB.

Key words: endoscope cleaning, disinfection, brushing, single-use brush, ATP