麻醉机通气系统的细菌培养与院内感染

Bacteria Culture and Hospital Infection Related to the Ventilation System of the Anesthesia Machine

目的:探讨麻醉机通气系统的细菌培养和气管插管全身麻醉与院内感染的相关问题。方法:对麻醉机的CO2吸收剂钠石灰进行不同时期细菌培养,菌株污染新的钠石灰进行菌落计数,80例气管插管全身麻醉病人在手术麻醉结束前对病人的气管导管端、麻醉机的呼气端、吸气端、钠石灰行细菌培养。结果:静止的不同时期钠石灰取样培养没有细菌生长;菌株污染新的钠石灰菌也无细菌生长;80例气管插管全身麻醉病人在麻醉机呼气端可检出与口腔、气管相同的细菌,且随钠石灰使用时间延长检出率增高,连台手术在吸气端、钠石灰端也均可检出细菌,但检出率较低。结论:钠石灰具有杀菌作用,全身麻醉钠石灰与CO2起化学反应会影响钠石灰的杀菌作用,连台手术气管插管全身麻醉病人气道细菌有污染麻醉机通气系统引起交叉感染的机会,使用一次性呼吸管道,并合理使用一次性病毒/细菌过滤器及时更换纳石灰可预防医院感染。

Objective To explore the relationship between bacteria culture in ventilation system of the anesthesia machine and hospital infection in general anesthesia. Methods The bacteria culture was done for the soda lime in different time, the number of the bacteria groups was counted after the new soda lime had been polluted. The bacteria culture was done for the endotracheal tube, the expiration and inspiration entrance of the anesthesia machine, and the soda lime in eighty general anesthesia patients. Results There are no bacteria growing in the new and the polluted new soda lime at the different stages. The same bacteria can be detected in the expiration side, the ventilation entrance and in the mouth of the eighty patients. The detect rate increased following the using time of soda lime, although the bacteria can also be detected in inspiration entrance and in soda lime at the succeeding procedure, but the rate was very low. Conclusion The anti-bacteria effect of the soda lime can be influenced by the chemical response between soda lime and CO2, the bacteria in the patient airway may be polluting the ventilation system of the anesthesia machine, so the hospital cross-infection was present in this repeat use of soda lime and ventilation tube. The hospital infection can be effectively prevented by using the one time ventilation tube, the virus/bacteria filter utensil and/or rechange the soda lime in the general anesthesia.