高频电刀烟雾对手术室空气质量的影响

Electrosurgical smoke:Ultra-fine Particle measurements and air quality in Operating Room

目的 :分析高频电刀烟雾对手术室空气质量的影响。方法 :采用PM 2.5粉尘测试仪通过对98台开放手术进行研究,对术前、距切割处2 cm、距切割处30 cm、距切割处150 cm及停止使用电刀10 min后的PM 2.5及颗粒物数值进行采集并分析。结果 :术前、距切割处2 cm、距切割处30 cm、距切割处150 cm的水平及停止使用电刀10 min后PM 2.5中位数分别为16.45μg/m^3、201.73μg/m^3、115.20μg/m^3、25.52μg/m^3、9.18μg/m^3,颗粒物中位数分别为1 289.00个/m^3、17 906.00个/m^3、8 854.00个/m^3、2 896.00个/m^3、929.00个/m^3;不同患者BMI类型、是否负压吸引、手术室是否封闭、不同切割组织类型对使用电刀后的手术室空气质量有影响(P<0.05)。结论 :高频电刀烟雾是手术室空气质量的重要影响因素,手术室医护人员及管理者应采取相应措施,减少手术人员的烟雾职业暴露,保障临床手术人员的身心健康。

Objective：To evaluate the level of Ultra-fine Particle（UFP） contamination caused by electrosurgical tools（ESTs） in operating room and explore the influencing factors.Methods：Measurements performed during 98 open surgical operations by ultrafine particle counters.Measurements have been carried out simultaneously at 2 cm,30 cm and 150 cm away from the source,and also before using and 10 min after stop using ESTs.Results：The densities of UFP before using and 10 min after stop using ESTs were 16.45 μg/m^3 and 9.18 μg/m^3.The densities of UFP at 2 cm,30 cm and 150 cm away from the source are respectively 201.73 μg/m^3,115.20 μg/m^3,and 25.52 μg/m.The densities of fine particles were 1 289.00 m^3,17 906.00 m^3,8 854.00 m^3,2 896.00 m^3 and 929.00 m^3 respectively.Patients＇ BMI,tissue type,vacuum suction,closed operating room were influence factors（P〈0.05）.Conclusion：electrosurgical smoke is a significant airborne contamination in operating room.Strategies of reducing exposure of surgical staff from electrosurgical smoke should be done to guarantee the surgical staff＇s physical and mental health.