工作人员戴帽子口罩与否对洁净ICU空气质量的影响

Effect of worker＇ s respirator and hat wearing method on ICU air quality

目的探讨工作人员是否戴帽子口罩对10万级洁净ICU空气质量的影响，为洁净ICU的感染管理提供依据。方法第1天、第3天进入ICU病房所有人员全部戴帽子口罩，所得数据为对照组，第2天、第4天进入ICU病房所有人员除进行操作外均不戴帽子口罩，所得数据为观察组，采用平板自然沉降法、浮游菌测定法、尘埃粒子计数法对10万级洁净ICU的空气质量进行采样，监测空气中尘埃数、浮游菌、沉降菌数，连续监测4d，比较结果。结果ICU环境中尘埃粒子数的监测情况，0．5μm尘埃粒子数对照组与观察组比较，差异有统计学意义（F=40．95，P〈0．05），5．0μm尘埃粒子数对照组与观察组相比，差异无统计学意义（F=2．86，P〉0．05）；O．5μm尘埃粒子在不同时间段及不同组别间，差异有统计学意义（F=7．49，P〈0．05），不同时间段0．5μm尘埃粒子数比较，差异有统计学意义（F=80．72，P〈0．05），两组间比较，观察组0．5μm尘埃粒子数高于对照组，差异有统计学意义（F=68．84，P〈0．05）；5．0μm尘埃粒子在不同时间段及不同组别间，差异有统计学意义（F=80．84，P〈0．01），不同时间段5．0μm尘埃粒子数比较，差异有统计学意义（F=98．17，P〈0．01）；不同病房0．5，5．0μm尘埃粒子数比较，差异有统计学意义（P〈0．01）；观察组环境中浮游菌、沉降菌数均明显低于对照组，差异均有统计学意义（P〈0．01）；不同时间段ICU环境中沉降菌及浮游菌数均不同，差异均有统计学意义（P〈0．01）。结论在ICU病房中，戴帽子12I罩比不戴帽子口罩空气中0．5μm尘埃粒子数少，而对5．0μm尘埃粒子数没有影响。在其他条件不变的情况下，ICU大厅在上午查房、护理等室内人员较多时是导致空气中尘埃、浮游菌、沉降菌数量增加的主要原因，是否戴帽子口罩不是影响动态10万级洁净ICU空气质量的主要因素，因此在不进行任何操作的情况下工作人员是否戴帽子口罩可以不作为医院感染管理的重点内容。

Objective To investigate the effect of employers＇ respirator and hat wearing method on class 100 000 clean ICU air quality, in order to provide basis for hospital infection management in ICU. Methods For the control group, the first day （ dl ） and third day （ d3）, every employer was demanded to wear a respirator and a hat before entering the ICU. For the observation group, the second day （d2） and forth day （d4）, employers were demanded not to wear any respirator or hat. During all four days, they must wear respirator and hat before any nursing operation. Air quality was sampled by class 100 000 clean air using flat panel natural settlement method, dust planktonic bacteria method and particle counting method. The amount of dust, plankton bacterium and descending bacteria were monitored for 4 days and compared between two groups. Results The difference of 0.5 tun dust particles in ICU between the control group and the observation group were statistically significant （ F = 40.95, P 〈 0.05 ）. As to 5.0μm dust particles, there was no significant difference between two groups （F = 2.86,P 〉 0.05 ）. 0.5μm dust particles in ICU was lower at dl and d3, and the difference was statistically significant （ F = 40.95 ,P 〈 0.05）. The number of 0.5μm dust particles had significant difference between different periods of a day ： the morning time segment 〉 evening 〉 afternoon （ F = 80.72,P 〈 0.05 ）. The number of 0.5 μm dust particles in the observation group was higher than that in the control group, and the difference was statistically significant （ F = 68.84, P 〈 0.05 ）. The number of 5.0μm dust particles had significant difference between different time periods of a day： the morning time segment 〉 afternoon 〉 evening （F = 98.17,P 〈 0.01 ）. The number of dust particles at hall was larger than that at single and double rooms （P 〈0.01 ）, but the number had no difference between single room and double room. More subsidence bacteria and floating bacteria was detected during dl and d3 in the control group, and the difference was statistically significant （P 〈 0.01 ）. Besides, the difference of the number of subsidence bacteria and floating bacteria in ICU between different time periods was also statistically significant （ P 〈 0. 05 ）. Conclusions The number of 0. 5 μm dust particles in ICU is smaller when workers wear hats and respirators, while the number of 5.0 μm dust particles remains the same. Under the other conditions remain unchanged, the mainly cause of number increase of dusts, planktonic bacteria and sedimentation bacteria in the morning rounds is the increasing number of working staff. ICU staff has no apparent effect on dynamic class 100 000 clean ICU air quality whether they wear respirators or hats. This kind of behavior is not the key management dements in clean ICU environment.