湖南省医院洁净手术室综合性能监测及管理对策研究

Comprehensive Performance Assessment of Hospital Clean Operating Rooms in Hunan Province and Research of Management Countermeasures

目的了解湖南省医院洁净手术室的综合性能和管理现状,发现使用中存在的问题,以保障洁净手术室有效运行。方法依据《医院洁净手术部建筑技术规范》GB50333-2002,采用现场监测方法对15家医院(其中省级8家、地县级7家)共170间洁净手术室的洁净度及相关技术指标进行现场静态监测。结果洁净度指标中的沉降菌合格率分别为Ⅰ级90.5%、Ⅱ级88.0%、Ⅲ级90.9%、Ⅳ级93.1%,尘埃粒子数合格率分别为Ⅰ级100%、Ⅱ级100%、Ⅲ级93.9%、Ⅳ级100%。两项主要参数尘埃粒子与沉降菌菌落数总合格率分别为97.6%和91.8%,尘埃粒子数与沉降菌菌落数结果呈正相关(r=0.9849)。省级沉降菌菌落数量和尘埃粒子合格率分别为92.2%和100%,地县级两项主要参数均为90.2%,省级的沉降菌菌落数和尘埃粒子合格率均高于地县级医院(P<0.05)。截面平均风速、新风量、换气次数、静压差、相对湿度合格率均为100%,温度为91.2%,噪声97.1%、照度99.4%。结论医院洁净手术室主要参数尘埃粒子和沉降菌菌落数未全部合格,还有部分相关技术指标也未合格,说明洁净手术室在建设和使用管理方面还存在薄弱环节,应进一步加强洁净手术室的合理设计、施工、使用和管理力度。

Objective To understand the comprehensive performance and management status of hospital operating rooms in Hunan Province,to find the existing problems and ensure the effective operation of clean operating rooms.Methods According to ＂Hospital Operating Construction Technical Specification＂ （GB50333-2002）,the static monitoring on cleanliness and related technical specifications had been completed by on-site monitoring method in 170 clean operating rooms of 15 hospitals （including 8 provincial level hospitals and 7 county-level hospitals）.Results The passing rate of settlement bacteria was 90.5% in gradeⅠ,88.0% in gradeⅡ,90.9% in grade Ⅲ,and 93.1% in grade Ⅳ.The passing rate of dust particles was 100% in gradeⅠ,100% in grade Ⅱ,93.9% in grade Ⅲ,and 100% in grade Ⅳ.The total passing rates of the two main parameters of dust particles and precipitating bacterial colonies were 97.6% and 91.8%,respectively.There was a positive correlation between dust particles and precipitating bacterial colonies （r=0.9849）.The provincial passing rates of dust particles and precipitating bacterial colonies were 92.2% and 100%,respectively.The prefectural passing rates of dust particles and precipitating bacterial colonies were both 90.2%.And the provincial passing rates were both higher than those of the prefectural passing rate （P〈0.05）.The passing rates of average wind speed of section,fresh wind,air changes,static pressure differential,and relative humidity were all 100%,the rate of temperature was 91.2%,the rate of noise was 97.1%,and the rate of illumination was 99.4%.Conclusions The main parameters of dust particles and the settle-ment of bacterial colonies in hospital clean operating rooms are not fully qualified,and there are still some unqualified relevant technical indicators.The results indicate that there are some weak links in construction,utilization,and management of clean operating rooms.It is necessary to further strengthen rational design,construction,utilization,and management of clean operating room.