不同布点方法对静态条件下Ⅰ级洁净手术室空气质量检测效果的影响

Analysis on evaluation results of different sampling methods for air microbial contamination in hundred-level laminar flow operating room at rest

目的探讨Ⅰ级洁净手术室静态下不同布点方法与空气质量检测效果的关系。方法按照GB 50333-2013《医院洁净手术部建筑技术规范》规定的沉降法细菌浓度和含尘浓度检测法分5种方案布控采样点,分别对Ⅰ级洁净手术室进行空气检测,比较检测合格率及5种方案采样结果一致性。结果 2015年10月-2016年3月,于静态无人条件下监测5间Ⅰ级洁净手术室,共采样47次,手术区5种不同采样方案空气含菌量无显著性差异(Z=2.522,P=0.641);5种方案手术区与周边区空气含菌量比较,差异均有统计学意义(P<0.05)。手术区5种采样方案合格率分别为85.11%、87.23%、87.23%、82.98%、87.23%,周边区合格率为89.36%,手术区5种采样方案合格率差异无统计学意义(χ2=0.564,P=0.967);5种采样方案全手术室监测合格率差异无统计学意义(χ2=0.391,P=0.983)。结论 5种布点方案检测结果一致性无差异,均可用于Ⅰ级洁净手术室静态无人条件下微生物污染水平的监测评价。可适当缩减手术室常规静态监测成本,减少布点数,加大动态监测投入,有关部门应建立动态监测的操作规程和评价标准。

Objective To explore the results of different sampling methods for air microbial contamination in hundred-level laminar flow operating room at rest. Methods According to the Architectural Technical Code for Hospital Clean Operating Department,we monitored the air microbial contamination using five sampling methods in hundred-level laminar flow operating room in order to compare the detection rate and the consistency of the sampling results. Results From October2015 to March 2016,We sampled 47 times monitoring in 5 hundred-level operating rooms at rest. The air microbial contamination of operating zone showed no significant differences among five sampling methods（ Z = 2. 522,P = 0. 641）. By comparisons of air microbial contamination between surrounding zone and operating zone of five sampling methods,there were statistically significant differences（ P〈0. 05）. The operating zone＇s qualification rates of the five sampling methods were 85. 11%,87. 23%,87. 23%,82. 98% and 87. 23%,respectively; while the surrounding zone＇s qualification rates of the five sampling methods all were 89. 36%. There was no significant difference in the operating zone＇s qualification rate of the five sampling methods（ χ^2= 0. 564,P = 0. 967）. The qualification rate of the whole operation room were no significant difference in the qualified rate（ χ^2= 0. 391,P = 0. 983）. Conclusion There is no difference in the consistency of the five sampling methods at test,which all can be used for the microbial contamination monitoring and evaluation of hundred-level laminar flow operating room. It is recommended to reduce the cost of routine static monitoring and to reduce the number of points in the laminar flow operating room. Investment in dynamic monitoring,and the governmental should be increased. Agencies should establish a dynamic monitoring of the operating procedures and evaluation standards.