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高频电刀烟雾对手术室空气质量的影响

王丽霞 魏永婷 张宝堂 雷隽 吴秀红   

  1. 国家癌症中心/中国医学科学院北京协和医学院肿瘤医院特需医疗部,100021 北京市(王丽霞);手术室(魏永婷,张宝堂,雷隽,吴秀红)
  • 出版日期:2018-02-25 发布日期:2018-02-25

Electrosurgical smoke: Ultra-fine Particle measurements and air quality in Operating Room

  • Online:2018-02-25 Published:2018-02-25

摘要: 目的:分析高频电刀烟雾对手术室空气质量的影响。方法:采用PM 2.5粉尘测试仪通过对98台开放手术进行研究,对术前、距切割处2 cm、距切割处30 cm、距切割处150 cm及停止使用电刀10 min后的PM 2.5及颗粒物数值进行采集并分析。结果:术前、距切割处2 cm、距切割处30 cm、距切割处150 cm的水平及停止使用电刀10 min后PM 2.5中位数分别为16.45 μg/m3、201.73 μg/m3、115.20 μg/m3、25.52 μg/m3、9.18 μg/m3,颗粒物中位数分别为1 289.00个/m3、17 906.00个/m3、8 854.00个/m3、2 896.00个/m3、929.00个/m3;不同患者BMI类型、是否负压吸引、手术室是否封闭、不同切割组织类型对使用电刀后的手术室空气质量有影响(P<0.05)。结论:高频电刀烟雾是手术室空气质量的重要影响因素,手术室医护人员及管理者应采取相应措施,减少手术人员的烟雾职业暴露,保障临床手术人员的身心健康。

Abstract: Objective: To evaluate the level of Ultra-fine Particle (UFP) contamination caused by electrosurgical tools (ESTs) in operating room and explore the influencing factors. Methods: Measurements performed during 98 open surgical operations by ultrafine particle counters. Measurements have been carried out simultaneously at 2 cm, 30 cm and 150 cm away from the source, and also before using and 10 min after stop using ESTs. Results: The densities of UFP before using and 10 min after stop using ESTs were 16.45 μg/m3 and 9.18 μg/m3. The densities of UFP at 2 cm, 30 cm and 150 cm away from the source are respectively 201.73 μg/m3, 115.20 μg/m3, and 25.52 μg/m. The densities of fine particles were 1 289.00 m3, 17 906.00 m3, 8 854.00 m3, 2 896.00 m3 and 929.00 m3 respectively. Patients' BMI, tissue type, vacuum suction, closed operating room were influence factors (P<0.05). Conclusion: electrosurgical smoke is a significant airborne contamination in operating room. Strategies of reducing exposure of surgical staff from electrosurgical smoke should be done to guarantee the surgical staff's physical and mental health.