洁净手术部浮游菌浓度动态监测结果分析

Analysis on the results of planktonic bacteria concentration by dynamic monitoring in laminar flow operating room

目的用六级空气撞击式采样器对Ⅴ~Ⅶ级洁净手术间空气中的浮游菌采样,监测动态下浮游菌浓度。方法随机抽样在Ⅴ~Ⅶ级洁净手术间内实施的63例患者,采用空气撞击法采取样品,采样空气量为28.3 L/min,采样时间为30 min,分别对静态下、手术60 min时、手术结束时三个时间段手术间浮游菌浓度进行监测;术后随访1个月,观察手术部位感染情况。结果静态下浮游菌浓度监测结果在国标范围内,P﹥0.05,无统计学意义;手术60 min时和手术结束时动态浮游菌监测结果变化幅度大,且手术60 min时浮游菌浓度大于手术结束时。动态监测结果显示:Ⅴ~Ⅶ级手术间手术区均值为(8.40±9.94)cfu/m^3,(35.41±36.88)cfu/m^3,(59.38±29.69)cfu/m^3,周边区均值为(16.60±17.02)cfu/m^3、(61.28±72.83)cfu/m^3和(96.62±61.47)cfu/m^3。其中90%为腾黄微球菌,10%为白色微球菌。术后随访未发生手术部位感染。结论洁净手术间浮游菌动态监测浓度变化大,幅度在20~185 cfu/m^3,但采样结果能表达理论模型下手术间空气洁净度分区。

Objective To monitor dynamic planktonic bacteria concentration by applying air impact sampler in level V to level VII laminar flow operating room.Methods By applying air impact sampler,we sampled 63 patients from level V to level VII laminar flow operating room randomly.The air volume was 28.3 L/min and sampled for 30 min for the following time periods：the static state,60 min after operation,the end of surgery.And we paid visit to postoperative patients in the following month to observe wound infections.Results Concentration of planktonic bacteria was within the range of the national standard under the static state,P〉0.05,so there was no statistical significance for this state.There was a significantly difference of planktonic bacteria concentration between the time period of 60 min after operation and the end of surgery,the number of the former period was more than the later period.Dynamic monitoring results showed that：average number of Planktonic bacteria concentration from level V to level VII laminar flow operating room was（8.40±9.94） cfu/m^3、（35.41±36.88） cfu/m^3 and（59.38±29.69） cfu/m^3,respectively.The average number for surrounding areas was（16.60±17.02） cfu/m^3、（61.28±72.83） cfu/m^3 and（96.62± 61.47） cfu/m^3.90% of those planktonic bacteria were micrococcus lutea,10% were Candida albicans.There was no postoperative wound infection.Conclusion Although there is big concentration range 20-185 cfu/m^3 of planktonic bacteria in laminar flow operating room,it is possible to analyze distribution of planktonic bacteria and cleanliness by applying the sampling model.