超音波儀器使用之感染管制

Infection Control Measures for Using Ultrasound Instruments

超音波檢查在現代醫學的應用十分廣泛，不管是經皮膚、食道、陰道、肛門等接觸黏膜的超音波檢查，或是經由超音波儀器定位，取病變部位做組織切片以助診斷，因為超音波探頭往往會直接接觸病人皮膚及黏膜，故相關儀器使用的清潔及消毒滅菌措施便相形重要。若某個環節未落實，則可能造成微生物的交叉傳播甚至群突發。在超音波檢查過程中，根據消毒滅菌之需要，區分為高度風險、中高度風險、中度風險及低風險。若為高度風險，應使用滅菌探頭或高層次消毒之探頭包覆無菌套膜。若為中高度風險以上之無菌侵入性檢查，應採用高層次消毒之探頭或中層次消毒探頭包覆無菌套膜，高度及中高度風險建議超音波傳導膠應採用無菌單包裝；儀器區被病人血、體液及分泌物汙染時，儘快進行清潔消毒維護；若為接觸性隔離之病人應儘量安排最後順位檢查。儀器使用後，須立刻擦拭探頭，避免傳導膠殘留。相關工作人員應對超音波儀器的感染管制有正確認知，並評估醫療行為的風險等級，採取適當的管理措施，以減少因使用超音波造成之醫療照護相關感染或多重抗藥性俊之感染或移生，方能維護病人安全。

Ultrasound is widely used in modern medicine. Ultrasound probes tend to come into direct contact with the skin and mucous membranes of patients through the skin, esophagus, vagina, and anus, or via ultrasound positioning and lesion biopsies that assist in diagnosis. Therefore, regular instrument cleaning and sterilization measures are highly important. If appropriate measures are not implemented, cross-transmission of microorganisms may occur. According to the necessity of sterilization in the ultrasound examination process, there are 4 levels: high risk, medium-high risk, moderate risk, and low risk. For high risk, high-level disinfection or sterilization of the probe coated with a sterile probe cover film should be implemented. For sterility in medium-high risk invasive procedures, high-level disinfection and disinfection of the probe should be implemented or the probe should be coated with layers of sterile film sets. For high-risk and medium-high risk, we recommend that sterile ultrasound transmission gel should be used in a single package. If the instrument area is contaminated by a patient’s blood, body fluids, or secretions, it should be cleaned and disinfected as soon as possible; patients in contact isolation should undergo ultrasound examination after all other patients. After using the instrument, the probe should be immediately wiped to avoid conducting glue residues. For the safety of patients, the staff involved should be aware of the relevant infection control measures, assess the level of risk of medical practices, and take appropriate measures to manage and reduce the incidence of the associated infections, multidrug-resistant bacterial infections, or colonization owing to the use of ultrasound examinations.