在日常的維修工作中，醫(yī)用內(nèi)窺鏡系統(tǒng)故障時(shí)有發(fā)生，常見(jiàn)故障主要分為圖像顯示故障、內(nèi)窺鏡故障、其他配套設(shè)備和器械故障。

In daily maintenance work, medical endoscope system failures often occur, and common failures are mainly divided into image display failures, endoscope failures, and other supporting equipment and instrument failures.

圖像顯示故障

Image display failure

圖像顯示故障主要包括圖像異常顯示和監(jiān)視器無(wú)圖像。

Image display faults mainly include abnormal image display and no image on the monitor.

（1） 圖像異常顯示

(1) Abnormal image display

故障現(xiàn)象為監(jiān)視器有圖像輸出，但圖像出現(xiàn)水平或垂直彩色條紋干擾、彩色雪花狀閃爍等，故障分析及處理如下：

The fault phenomenon is that the monitor has image output, but the image shows horizontal or vertical color stripe interference, color snowflake flickering, etc. The fault analysis and handling are as follows:

首先，因檢查高清攝像頭手柄和電纜的連接點(diǎn)，此連接點(diǎn)在使用過(guò)程中反復(fù)彎曲和拉扯容易造成電纜損壞，圖像會(huì)出現(xiàn)水平或垂直彩色條紋，解決方法是更換連接線。

Firstly, due to the inspection of the connection point between the high-definition camera handle and cable, repeated bending and pulling during use can easily cause cable damage, resulting in horizontal or vertical color stripes in the image. The solution is to replace the connection line.

其次，電纜線與主機(jī)相連的插頭經(jīng)過(guò)反復(fù)插拔或操作不當(dāng)，容易出現(xiàn)老化腐蝕，造成接觸不良、圖像也會(huì)出此種故障，應(yīng)對(duì)措施是加強(qiáng)規(guī)范性操作培訓(xùn)和定期維護(hù)保養(yǎng)。由于手術(shù)室內(nèi)的電氣化設(shè)備越來(lái)越多，特別是電刀等高頻高電流設(shè)備的應(yīng)用，可能產(chǎn)生較小的信號(hào)干擾。尤其當(dāng)電凝棒、電刀筆或連接線等器械出現(xiàn)漏電時(shí)，會(huì)出現(xiàn)每次用腳踏開(kāi)關(guān)啟動(dòng)電凝或電切，顯示器圖像就完全變成彩色雪花狀閃爍，松開(kāi)腳踏停止輸出后圖像恢復(fù)正常。像這樣的情況，需要立刻更換一套完好電刀設(shè)備，先保證手術(shù)順利完成。同時(shí)把漏電的電凝棒、電刀筆或連接線等器械進(jìn)行檢測(cè)，及時(shí)修理或更換。

Secondly, the plug connecting the cable to the host is prone to aging and corrosion after repeated insertion and removal or improper operation, resulting in poor contact and similar faults in the image. The response measures are to strengthen standardized operation training and regular maintenance. Due to the increasing number of electrified equipment in the operating room, especially the application of high-frequency and high current equipment such as electric knives, small signal interference may occur. Especially when there is electrical leakage in instruments such as electrocoagulation rods, electric knives, pens, or connecting wires, every time the foot switch is used to start electrocoagulation or electrocoagulation, the display image will completely turn into a colorful snowflake like flashing. After releasing the foot switch to stop outputting, the image will return to normal. In situations like this, it is necessary to immediately replace a set of intact electric knife equipment to ensure the smooth completion of the surgery. At the same time, detect and promptly repair or replace the leaking electric coagulation rod, electric knife pen, or connecting wire.

（2）監(jiān)視器無(wú)圖像

(2) Monitor has no image

故障現(xiàn)象主要是監(jiān)視器無(wú)圖像輸出，可以分為兩種：一種為監(jiān)視器呈黑屏狀態(tài)，無(wú)圖像，無(wú)內(nèi)窺鏡視野框；另一種為監(jiān)視器有內(nèi)窺鏡視野框，但無(wú)圖像。

The main fault phenomenon is that the monitor has no image output, which can be divided into two types: one is that the monitor is in a black screen state, with no image or endoscope field of view frame; Another type is that the monitor has an endoscopic field of view frame but no image.

、針對(duì)第一種故障現(xiàn)象，一般會(huì)考慮是否為監(jiān)視器本身故障或信號(hào)輸入故障造成?，F(xiàn)在的監(jiān)視器多為高清液晶顯示器，對(duì)監(jiān)視器進(jìn)行檢查時(shí)，需測(cè)量外置 12 V 直流電源適配器是否正常供電，若無(wú)正常供電，及時(shí)更換適配器；若正常，重啟設(shè)備，觀察開(kāi)機(jī)自檢畫(huà)面是否正常，如果自檢不通過(guò)則可送至專(zhuān)業(yè)代理商進(jìn)行維修。現(xiàn)在的醫(yī)用高清液晶顯示器技術(shù)成熟、質(zhì)量可靠，一般故障率很低，出現(xiàn)無(wú)圖像現(xiàn)象的故障絕大多數(shù)是由于信號(hào)輸入故障造成的。此時(shí)，應(yīng)從簡(jiǎn)單的操作入手，先檢查液晶顯示 器的信號(hào)輸入模式是否設(shè)置正確，常用信號(hào)輸入模式有 DVI、 HDMI、S-Video、SDI 等格式，然后查看信號(hào)傳輸電纜的種類(lèi)及 其在顯示器上的接入端口種類(lèi)名稱(chēng)來(lái)確定輸入模式，檢查顯示 器輸入菜單中的信號(hào)格式是否設(shè)置成相同，若不同則重新設(shè)置 后故障大多數(shù)可消除。反之，則需要沿著信號(hào)傳輸路徑反向檢 查，查看攝像機(jī)主機(jī)與監(jiān)視器之間的信號(hào)傳輸電纜是否脫落或 損壞，檢查攝像機(jī)主機(jī)和攝像頭是否正常工作，如果上述設(shè)備出 現(xiàn)故障，則需要及時(shí)更換備用部件并進(jìn)行專(zhuān)業(yè)的維修。

Regarding the first fault phenomenon, it is generally considered whether it is caused by a malfunction of the monitor itself or a signal input malfunction. Nowadays, most monitors are high-definition LCD displays. When inspecting monitors, it is necessary to measure whether the external 12V DC power adapter is supplying power normally. If there is no normal power supply, replace the adapter in a timely manner; If it is normal, restart the device and observe whether the power on self-test screen is normal. If the self-test fails, it can be sent to a professional agent for repair. The current medical high-definition LCD display technology is mature and reliable in quality, with a generally low failure rate. The vast majority of failures without image phenomenon are caused by signal input faults. At this point, a simple operation should be started. First, check whether the signal input mode of the LCD display is set correctly. Common signal input modes include DVI, HDMI, S-Video, SDI, etc. Then, check the type of signal transmission cable and the name of the port connected to the display to determine the input mode. Check whether the signal format in the display input menu is set to the same, If different, most of the faults can be eliminated after resetting. On the contrary, it is necessary to check the signal transmission path in the opposite direction, check whether the signal transmission cable between the camera host and the monitor is loose or damaged, and check whether the camera host and the camera are working properly. If the above equipment malfunctions, it is necessary to replace spare parts in a timely manner and carry out professional maintenance.

、針對(duì)第二種故障現(xiàn)象，應(yīng)當(dāng)優(yōu)先考慮的是內(nèi)窺鏡鏡子自身出現(xiàn)問(wèn)題，比如各種電子軟鏡因?yàn)槁┧?，液體進(jìn)入 CCD，造成 CDD 底座腐蝕、嚴(yán)重時(shí) CCD 損壞、無(wú)圖像輸出。而硬鏡出現(xiàn)彎折變形、物鏡碎裂等問(wèn)題時(shí)，也會(huì)造成無(wú)圖像故障。這些問(wèn)題主要由于診察和手術(shù)治療中以及滅菌消毒中的不規(guī)范操作造成。例如，泌尿外科手術(shù)中使用鈥激光時(shí)，操作光纖不到位，擊穿了鏡子管路；硬鏡物鏡被高頻電刀電擊，或被動(dòng)力系統(tǒng)工作部誤撞，造成物 鏡碎裂；或者消毒滅菌時(shí)不慎摔碰造成損壞等。由于自身維修技術(shù)和設(shè)備等限制，出現(xiàn)上述故障的內(nèi)窺鏡大多數(shù)需要外送專(zhuān)業(yè)的維修公司，費(fèi)時(shí)費(fèi)錢(qián)。所以，規(guī)范操作十分必要，對(duì)操作人員要定期進(jìn)行嚴(yán)格的培訓(xùn)和考核，以減少此類(lèi)故障的發(fā)生。

For the second type of malfunction, priority should be given to problems with the endoscope mirror itself, such as various electronic soft mirrors leaking water and liquid entering the CCD, causing corrosion of the CDD base, severe CCD damage, and no image output. When the hard mirror experiences bending deformation, objective lens fragmentation, and other problems, it can also cause no image failure. These problems are mainly caused by non-standard operations in diagnosis, surgical treatment, and sterilization and disinfection. For example, when using holmium laser in urological surgery, the fiber optic cable is not in place and the mirror tube is punctured; The hard lens objective is electrocuted by a high-frequency electric knife or accidentally hit by the power system working part, causing the objective to shatter; Or damage caused by accidental falls or collisions during disinfection and sterilization. Due to limitations in maintenance techniques and equipment, most endoscopes with the aforementioned malfunctions require outsourcing to professional repair companies, which is time-consuming and costly. Therefore, standardized operation is essential, and operators should receive regular and strict training and assessment to reduce the occurrence of such faults.

三、內(nèi)窺鏡故障

3、 Endoscope malfunction

內(nèi)窺鏡故障主要分為硬管內(nèi)窺鏡故障和電子軟鏡故障兩大類(lèi)。硬管內(nèi)窺鏡因其結(jié)構(gòu)和使用特性，故障現(xiàn)象主要以圖像性質(zhì)改變呈現(xiàn)出來(lái)，表現(xiàn)有圖像暗淡、圖像模糊、圖像不全、部分為因外力因素造成鏡體明顯的變形、缺損等；電子軟鏡故障主要表現(xiàn)為漏水、水氣堵塞、角鈕虛位并彎曲角度不足、圖像偏暗等。

Endoscopic malfunctions are mainly divided into two categories: hard tube endoscopic malfunctions and electronic soft endoscope malfunctions. Due to its structure and usage characteristics, the failure phenomena of hard tube endoscopes are mainly manifested by changes in image properties, such as dim images, blurred images, incomplete images, and obvious deformation and defects of the endoscope body caused by external forces; The main manifestations of electronic soft mirror faults are water leakage, water vapor blockage, insufficient bending angle of corner buttons, and dark images.

（1） 硬管內(nèi)窺鏡故障

(1) Hard tube endoscope malfunction

故障現(xiàn)象有圖像暗淡、圖像模糊、圖像不全、因外力因素造成鏡體明顯變形、缺損等，故障分析及處理措施如下：

The fault phenomena include dim images, blurred images, incomplete images, obvious deformation and defects of the mirror body caused by external forces. The fault analysis and handling measures are as follows:

圖像暗淡.先檢查冷光源和光纖是否正常，如果冷光源燈泡累計(jì)使用時(shí)間已經(jīng)到達(dá)500 h，光纖有明顯斷裂或有明顯暗點(diǎn)，都應(yīng)及時(shí)更換。以上兩部件沒(méi)問(wèn)題時(shí)，大多為內(nèi)窺鏡導(dǎo)光束接頭受到污染發(fā)黑、發(fā)黃，解決方法是清洗內(nèi)窺鏡傳像系統(tǒng)

The image is dim. First, check if the cold light source and fiber optic are normal. If the cold light source bulb has been used for 500 hours and there are obvious fractures or dark spots in the fiber optic, it should be replaced in a timely manner. When there are no issues with the above two components, most of them are due to contamination, blackening, and yellowing of the endoscope beam connector. The solution is to clean the endoscope imaging system

圖像模糊.大多數(shù)情況下是因?yàn)殚L(zhǎng)時(shí)間的使用，寶石保護(hù)玻璃磨損老化引起，有時(shí)也因?yàn)槲镧R的密封性破壞造成，定期做好維護(hù)保養(yǎng)可以有效預(yù)防故障發(fā)生。

Image blurring. In most cases, it is caused by long-term use, wear and aging of the gemstone protective glass, and sometimes damage to the sealing of the objective lens. Regular maintenance can effectively prevent malfunctions from occurring.

圖像不全.此故障多數(shù)是因內(nèi)窺鏡內(nèi)部柱狀透鏡斷裂或 崩邊等引起，而人為的摔碰、撞擊等是造成這種損害的主要原因，所在硬管內(nèi)窺鏡的使用、運(yùn)輸、消毒等過(guò)程中，需要輕拿輕放并做好保護(hù)措施。

Incomplete image. This fault is mostly caused by the breakage or edge collapse of the cylindrical lens inside the endoscope, and human impact is the main cause of this damage. During the use, transportation, disinfection, and other processes of the hard tube endoscope, it is necessary to handle it with care and take protective measures.

因外力因素造成鏡體明顯變形、缺損。此種故障相對(duì)嚴(yán)重，一般會(huì)并發(fā)上述 3 種故障，甚至造成無(wú)圖像輸出。主要原因?yàn)椋?操作人員使用鈥激光、高頻電刀、動(dòng)力系統(tǒng)等設(shè)備時(shí)不慎打傷物鏡，造成前端缺損；操作鏡子與鞘管連接時(shí)未對(duì)準(zhǔn)位置，然后在調(diào)整視野或插拔時(shí)用力過(guò)猛，造成變形；消毒滅菌時(shí)不慎撞擊、摔碰亦可造成。因此，加強(qiáng)操作人員規(guī)范化培訓(xùn)可以減少故障發(fā)生。

Due to external forces, the mirror body undergoes significant deformation and defects. This type of fault is relatively serious, usually accompanied by the above three types of faults, and even results in no image output. The main reason is that the operator accidentally injured the objective lens while using equipment such as holmium laser, high-frequency electric knife, and power system, resulting in front-end defects; Improper alignment of the mirror and sheath during operation, and excessive force during adjustment of the field of view or insertion and removal, resulting in deformation; Accidental impact or fall during disinfection and sterilization can also cause damage. Therefore, strengthening standardized training for operators can reduce the occurrence of faults.

電子軟鏡故障

Electronic soft mirror malfunction

故障現(xiàn)象有漏水、水氣堵塞、角鈕虛位并彎曲角度不足、圖像偏暗等。故障分析及處理如下：

The fault symptoms include water leakage, water vapor blockage, missing and insufficient bending angle of the corner knob, and dark image. The fault analysis and handling are as follows:

漏水。電子軟鏡故障以漏水為常見(jiàn)，泄漏點(diǎn)可出現(xiàn)在很多部位：彎曲橡皮處因老化、劃痕、戳刺等破損出現(xiàn)針孔漏水； 插入管因老化、劃傷等破損出現(xiàn)漏水；鉗道管磨損、刺破漏水；角度旋鈕處密封圈老化漏水；按鈕老化破損漏水等。簡(jiǎn)單有效的應(yīng)對(duì)和處理方法是做好測(cè)漏，這樣可以及時(shí)發(fā)現(xiàn)漏水故障和漏水部位，停用鏡子并馬上進(jìn)行維修，避免故障進(jìn)一步擴(kuò)大。

Leakage. The common malfunction of electronic soft mirrors is water leakage, which can occur in many parts: needle hole leakage occurs at the bent rubber due to aging, scratches, punctures, and other damages; The insertion tube leaks due to aging, scratches, and other damages; Wear, puncture, and leakage of the clamp pipe; The sealing ring at the angle knob is aging and leaking water; Button aging, damage, water leakage, etc. A simple and effective response and handling method is to do a good job of leak detection, which can timely detect water leakage faults and areas, stop using the mirror and immediately carry out maintenance to avoid further expansion of the problem.

水氣堵塞。水氣堵塞故障時(shí)有發(fā)生，特別以腸鏡為主。大多因?yàn)橄榷怂畾鈬娮毂晃畚锒氯?，用正確的方法卸下噴嘴，裁剪細(xì)長(zhǎng) X 光膠片，用 X 光膠片拉扯穿過(guò)噴嘴數(shù)次來(lái)清除里面污物，有時(shí)還需要用水槍、氣槍對(duì)氣水管路進(jìn)行沖洗數(shù)次。

Water vapor blockage. Water vapor blockage faults often occur, especially with colonoscopy. Most of the time, it is caused by the blockage of the water and gas nozzle at the front end by dirt. Remove the nozzle using the correct method, cut the thin and long X-ray film, and use the X-ray film to pull through the nozzle several times to remove the dirt inside. Sometimes, it is also necessary to rinse the air and water pipeline several times with a water gun or air gun.

角鈕虛位并彎曲角度不足。因?yàn)殚L(zhǎng)時(shí)間的使用，角度鋼絲會(huì)出現(xiàn)老化變松，牽拉位置變化，造成調(diào)節(jié)角度時(shí)，一開(kāi)始旋轉(zhuǎn)角鈕沒(méi)有角度變化，出現(xiàn)虛位同時(shí)還會(huì)造成彎曲角度不足。不規(guī)范操作是此類(lèi)故障發(fā)生的重要原因，如調(diào)節(jié)角度時(shí)用力過(guò)猛過(guò)快或角度到達(dá)限位后仍然強(qiáng)行調(diào)節(jié)，嚴(yán)重時(shí)會(huì)出現(xiàn)鋼絲斷開(kāi)。定期對(duì)操作人員開(kāi)展規(guī)范化操作培訓(xùn)和對(duì)鏡子進(jìn)行維護(hù)保養(yǎng)是重要的預(yù)防應(yīng)對(duì)方法。

The corner button is missing and the bending angle is insufficient. Due to long-term use, the angle steel wire will age and become loose, and the pulling position will change. When adjusting the angle, the initial rotation of the angle knob will not change the angle, resulting in a virtual position and insufficient bending angle. Unstandardized operation is an important cause of such faults, such as excessive or rapid force when adjusting the angle, or forcefully adjusting the angle even after reaching the limit, which can lead to wire breakage in severe cases. Regular standardized operation training for operators and maintenance of mirrors are important preventive measures.

圖像偏暗。檢查冷光源的亮度、內(nèi)鏡導(dǎo)光束情況、監(jiān)視器亮度及對(duì)比度的設(shè)置。燈泡達(dá)到使用累計(jì)時(shí)間、導(dǎo)光束出現(xiàn)老化 斷裂后需要及時(shí)更換，監(jiān)視器亮度及對(duì)比度設(shè)置好后無(wú)需改變。

The image is dark. Check the brightness of the cold light source, the condition of the endoscopic guide beam, and the setting of the monitor brightness and contrast. The light bulb needs to be replaced in a timely manner after reaching its cumulative usage time and the guide beam has aged and broken. After setting the brightness and contrast of the monitor, there is no need to change it.

其他常見(jiàn)的配套設(shè)備和器械故障

Other common malfunctions of supporting equipment and instruments

氣腹機(jī)故障，主要為壓力錯(cuò)誤和流量不正確報(bào)警，前者是設(shè)備內(nèi)部高低壓閥故障造成，更換壓力傳感器或更換受到油污染的隔膜墊后可以解決；后者是氣體流量傳感器出現(xiàn)偏差或損壞造成，可以對(duì)出現(xiàn)偏差的流量傳感器進(jìn)行校準(zhǔn)或更換新的流量傳感器來(lái)解決。

The main faults of the pneumoperitoneum machine are pressure errors and incorrect flow rate alarms. The former is caused by internal high and low pressure valve failures, which can be solved by replacing the pressure sensor or replacing the diaphragm pad contaminated with oil; The latter is caused by deviation or damage to the gas flow sensor, which can be calibrated or replaced with a new flow sensor to solve the problem.

動(dòng)力系統(tǒng)故障，主要為輸出動(dòng)力不足或無(wú)輸出故障，大多數(shù)是動(dòng)力手柄內(nèi)電機(jī)和傳動(dòng)軸承老化磨損或手柄電纜線損壞 造成的，做好消毒滅菌時(shí)的防護(hù)和定期的維護(hù)保養(yǎng)可以預(yù)防此類(lèi)故障發(fā)生。

Power system failures are mainly caused by insufficient or no output power, and most of them are caused by aging and wear of the motor and transmission bearings inside the power handle, or damage to the handle cables. Proper protection during disinfection and sterilization, as well as regular maintenance, can prevent such failures from occurring.

高頻電刀故障，主要有腳踏開(kāi)關(guān)無(wú)反應(yīng)、連接線斷、電刀漏電等，做好定期維護(hù)檢測(cè)可以減少此類(lèi)故障發(fā)生。

High frequency electric knife faults mainly include unresponsive foot switches, broken connecting wires, and electric knife leakage. Regular maintenance and testing can reduce the occurrence of such faults.