消化器内視鏡の洗浄・消毒標準化に ... - JGES

1 1) 1) 1) 1) 1) 1) 1) 1) 1) 1) 1) 2) 1) 1) 1) 2) Key words 1 1970 1),2). 1980 3),4) 5) 8) 9) 1980 B AGML 10),11) AGML Helicobacter pylori H.

2 Pylori 12) 3 30 70 1,700 13) 2015 9 8 7 14) 2015 8 9,15) 1.

3 Greene WH, Moody M, Hartley R et al. Esophagoscopy as a source of Pseudomonas aeruginosa sepsis in patients with acute leukemia: the need for sterilization of endoscopes. gastroenterology 1974 67 912-9. 2. Silvis SE, Nebel O, Rogers G et al. Endoscopic complications. Results of the 1974 American society for Gastrointestinal Endoscopy Survey. JAMA 1976 235 928-30. 3. Infection control during gastrointestinal endoscopy. guidelines for clinical application. Gastrointest Endosc 1988 34 37S-40S. 4. Cleaning and disinfection of equipment for gastrointestinal flexible endoscopy: interim recommendations of a Working Party of the british society of gastroenterology . Gut 1988 29 1134-51. 5. ASGE Quality Assurance In Endoscopy Committee, Petersen BT, Chennat J, Cohen J et al. Multisociety guideline on reprocessing flexible gastrointestinal endoscopes: 2011.

4 Gastrointest Endosc 2011 73 1075-84. 6. Guideline for Disinfection and Sterilization in Healthcare Facilities (2008). 7. Beilenhoff U, Neumann CS, Rey JF et al. ESGE-ESGENA Guideline: cleaning and disinfection in gastrointestinal endoscopy. Endoscopy 2008 40 939-57. 8. Comit technique des infections nosocomiales et des infections li es aux soins Conseil sup rieur d hygi ne publique de France. Elements d'assurance qualite en hygiene relatifs au contr le microbiologique des endoscopes et la tra abilit en endoscopie. 2007. 9. Verfaillie CJ, Bruno MJ, Voor in 't Holt AF et al. Withdrawal of a novel-design duodenoscope ends outbreak of a VIM-2-producing Pseudomonas aeruginosa. Endoscopy 2015 47 493-502. 10. B HBV 1 Gastroenterol Endosc 1985 27 2727-33. 11. AGML Gastroenterol Endosc 1989 31 785-90.

5 12. Sugiyama T, Naka H, Yabana T et al. Is Helicobacter pylori infection responsible for postendoscopic acute gastric mucosal lesions? Eur J Gastroenterol Hepatol 1992 4 S93-6. 13. 1 . e-Stat . 14. 1 2008 23 S1-21. 15. 27 8 27 0827 15 . 2 I II III IV V CQ Figure 1 3 Table 1 Delphi 1) 3)

6 Delphi 1-3 4-6 7-9 2017 7 17 Delphi RCT Minds 1 2 1. Eddy DM. Clinical decision making: from theory to practice. Designing a practice policy. Standards, guidelines , and options. JAMA 1990 263 3077-82. 2. Fink A, Kosecoff J, Chassin M et al. Consensus methods: characteristics and guidelines for use. Am J Public Health 1984 74 979-83. 3. Naylor CD. What is appropriate care? N Engl J Med 1998 338 1918-20. Table 1 2 4

7 10,500 2,500 13,000 30 1 1 900 1 2,800 1,140 1,550 1 hospital fee doctor s fee hospital fee 1 12 13 28 4 Figure 1 1-1, 1-4 I.

8 1. 3-1 2. 3. AW II. 1. 2. 3-2 3. 3-4 4. 3-5 III. 1. 1-7, 4-1 2. 3-3 3. 4-1 4. IV. 1. 1-8 5 1. 1-1 Spaulding 1) 3) semi-critical Delphi 9 8 9 1 Spaulding 1) 3) Spaulding Spaulding semi-critical 1.

9 1 2008 23 S1-21. 2. Spaulding EH. Chemical disinfection of medical and surgical materials. Disinfection, sterilization and preservation. Eds Lawrence CA, Block SS. Lea & Febiger, Philadelphia 1968 517-31. 3. Rutala WA, Weber DJ, the Healthcare Infection Control Practices Advisory Committee (HICPAC). Guideline for Disinfection and Sterilization in Healthcare Facilities, 2008. 1-2 critical 1) 3) Delphi 9 8 9 1 Spaulding 1) 3) ERCP 1.

10 1 2008 23 S1-21. 2. Spaulding EH. Chemical disinfection of medical and surgical materials. Disinfection, sterilization and preservation. Eds Lawrence CA, Block SS. Lea & Febiger, Philadelphia 1968 517-31. 3. Rutala WA, Weber DJ, the Healthcare Infection Control Practices Advisory Committee (HICPAC). Guideline for Disinfection and Sterilization in Healthcare Facilities, 2008. 1-3 EOG 1) 4) Delphi 9 8 9 EOG 1) 4) 1 2015.