波动效应:在内镜中使用无菌水的安全性,成本和环境问题
Deepak Agrawal1, Seth Crockett2, Sonali Palchaudhuri3
1Division of Gastroenterology, Dell Medical School, Dell Seton Medical Center, University Texas at Austin, Austin, Texas.
Gastro hep advances
|April 29, 2025
概括
自来水是内镜镜片清洁和结肠灌的安全和经济有效的替代品,减少医疗保健浪费和环境影响. 建议重新评估在内镜中使用无菌水的指南.
科学领域:
- 胃肠病学 胃肠病学
- 环境科学 环境科学
- 医疗保健废物管理 医疗保健废物管理
背景情况:
- 胃肠病学协会的目标是通过审查产生废物的做法来减少内镜的碳足迹.
- 使用无菌水清洁透镜和灌结肠是受到审查的常见做法.
- 目前关于内镜中无菌水的指导方针缺乏可靠的证据,并严重依赖专家意见.
研究的目的:
- 批判性地审查医学文献和指导方针,以确定无菌水在内镜中的安全性和必要性.
- 评估使用无菌水在内镜程序中的环境影响,特别是碳足迹.
- 评估自来水作为安全,经济有效和环保的替代品.
主要方法:
- 综合审查已发表的医学文献和关于在内镜中使用水的现有指南.
- 无菌水瓶的摇篮到坟墓碳足迹的计算.
- 将无菌水与瓶装饮用水对环境的影响进行比较,并评估临床证据.
主要成果:
- 推无菌水的指导方针是基于有限的证据和专家意见,引用的协议往往没有实施.
- 两项临床研究表明,自来水是胃肠内镜中安全,实用和节省成本的替代方案.
- 瓶装无菌水具有显著的碳足迹 (每升575克二氧化碳相当量),有助于医疗废物和气候变化.
结论:
- 缺乏直接证据支持消化肠道内镜中无菌水的广泛推和使用.
- 切换到自来水来填充无菌水瓶可以减少与内镜相关的环境损害和成本.
- 应该重新评估指南,以纳入环境和社会影响,优先考虑患者护理,避免不必要的风险或浪费.
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