医院层流洁净手术部运行初期引起医务人员身体不适原因调查与分析

Investigation and analysis of medical staff physical discomfort caused by the initial operation of hospital laminar flow clean operation

目的了解医院层流洁净手术部运行初期,对医务人员身体产生的危害因素提出预防控制措施。方法通过调查分析一起由医院层流洁净手术部运行初期引起的医务人员身体不适的原因,采用现场卫生学调查与实验室检测相结合的方法进行综合分析。结果未能严格执行操作规程,导致动态下手术室内麻药七氟醚残留(1.56~1.78 mg/m^3)是引起医务人员不适的主要原因;部分室内虽然受到苯的污染(分别是1.70 mg/m^3和0.16mg/m^3),经临床症状及体检结果、实验室检测结果、接触史及流行病学分析,不是引起本次事件的主要原因;排除环氧乙烷、甲苯、二甲苯、甲醛、CO和CO_2中毒。结论要确保层流洁净手术室的使用安全,必须重视使用前的全面调试,使检测结果符合相关标准要求;医务人员必须熟悉层流洁净手术室的工作流程,严格执行操作规程;落实专人负责层流洁净手术室的维护和管理。

Objective To understand the harmful factors to the medical personnel in the early days of the hospital running laminar flow clean operating department,put forward prevention and control measures. Methods Through investigating and analyzing the cause of the physical discomfort of the hospital staff caused by the hospital laminar flow clean operating department running in the early days,on-site hygiene investigation and laboratory testing methods were carried out for comprehensive analysis. Results Failed operation procedures caused anesthetic sevoflurane residued（ 1. 56-1. 78 mg /m3） in the operating room in the dynamic was the main reason of medical staff were unwell. Some rooms polluted by benzene（ 1. 7 mg/m3 and 0. 16 mg / m3） was analyzed by the clinical symptoms and physical findings,laboratory testing results,the history of contact and epidemiological analysis,the results showed that benzene was not the main cause of the incident. Pollutants including epoxy ethane,toluene,xylene,formaldehyde,CO and CO_2 were excluded. Conclusion It must pay attention to comprehensive debugging before use to ensure safe use of clean laminar flow operating room; Medical personnel must be familiar with the working process of the laminar flow clean operating room,strictly implement the operation procedures and carry out the personnel responsible for the maintenance and management of the operating room.