手术室取消持物钳效果研究

目的 探讨取消持物钳的效果。方法 将取消持物钳组与传统的干置持物钳组、湿置持和钳组进行比较分析。结果 手术室取消持物钳方法在使用和管理上优于干、湿持物钳组，合格率100％。结论 取消持物钳不需要每天定时、每周更换持物钳消毒液，使用时不易引起无菌持物钳污染，符合医院感染控制要求，节省开支。     

手术室使用干燥式保存无菌持物钳效果分析

无菌持物钳是手术室夹取和传递无菌物品的最基本的器具，使用中必须保持无菌状态。我院手术室自2004年开始取消了传统的湿保存持物钳（将高压灭菌后的持物钳用消毒液浸泡在灭菌的大口容器内），采用高压灭菌干燥式保存法（并规定时限4～6h）。本文对我院手术室紫外线空气消毒手术间和动态空气消毒手术间的干燥式保存持物钳的污染情况进行了细菌培养观察，现报告如下：     

干式无菌持物钳使用时限的调查

无菌持物钳是医务人员在执行医疗护理操作过程中,为夹取和传递无菌物品的器械.无菌持物钳的污染是引起医院感染与交叉感染的因素之一.传统的方法是将无菌持物钳放置在装有消毒液的无菌容器内以保持其无菌性.近年来,国内外一些医院改变了传统的方法,将无菌持物钳放置在无消毒液的无菌容器中,在干燥状态下保持其无菌性.我院手术室自从启用层流手术室后采用此法保持无菌持物钳,并对其使用时间进行细菌监测,现将结果报告如下.     

不同级别洁净手术室内干置无菌持物钳保存时间的研究

目的探讨不同级别洁净手术室内使用的干置无菌持物钳的保存时间。方法选择医院在百级、万级和30万级洁净手术室使用的干置无菌持物钳各80把为研究对象,分别在4、6、8、12 h 4个时间点采样,并进行细菌学检测。结果在百级、万级和30万级洁净手术室使用的干置无菌持物钳12、86、h组分别与4 h组比较,差异无统计学意义。结论不同级别洁净手术室内使用的干置无菌持物钳保存时间应当有区别,在百级、万级和30万级洁净手术室内使用的干置无菌持物钳分别可以保存12、86、h。     

无菌持物钳使用中存在的问题及对策

目前,在诊疗操作过程中夹取无菌物品和医疗器械,医院普遍使用无菌持物钳,因而无菌持物钳的灭菌质量直接关系到医院感染的发生,若使用中受到污染,极易造成医院感染.为了切断持物钳这一可能导致医院感染的环节,我们医院采取的对策是实行无菌物品塑封单包装,全院所有科室取消持物钳泡镊筒及器械浸泡.报告如下.     

干、湿置保存无菌持物钳效果探析

在本院８个病区进行无菌持物钳干、湿置保存效果试验。其中干置２４ｈ分８个时间组，湿置７２ｈ分３个时间组，采样培养。同时进行消毒前后个气细菌培养。试验表明，干置８ｈ可靠，１２ｈ后存在院内交叉感染的可能、湿置４８ｈ可靠，７２ｈ污染超标，样品检出致病菌。应因地制宜界定合理的时效。     

无菌小物品干湿保存效果监测

为探索无菌物品干湿保存方法,对小物品分别进行小包装,采用高压蒸汽灭菌干燥保存和浸泡于戊二醛消毒液两种方法进行细菌学检测,现将结果总结如下。 1 材料与方法 1.1 干燥保存法将清洁的持物钳、刀片、缝针、剪刀分别进行小包装,按常规高压蒸汽灭菌后,放于器械柜内,使用时将小包装打开,按常规方法用持物钳递送医疗器械,记录使用频率,分别于使用2h、4h、6h,对持物钳作细菌监测。 1.2 浸泡法将清洁的持物钳、刀片、缝针、剪刀浸泡于2％戊二醛消毒液中,灭菌时间10h。分别使用的第1周、第2周、第3周,对无菌小物品和消毒液进行细菌学检测。 2 结果 2.1 无菌小物品干燥保存和消毒液浸泡两种方法的细菌检测对于干燥保存的持物钳、刀片、缝合针、剪刀采样40件次,检测细菌阳性率22.3％,其中大于5cFu/cm~2的仅1件次,占2.5％;浸泡组18件次,阳性率47.2％,大于5cFu/cm~2为14.3％,浸泡组的阳性率高达85.7％两种方法保存无菌     

干罐保存使用无菌持物钳的有效时限探讨

随着医院感染链的监测，发现无菌持物钳浸泡的传统方法存在消毒液易被污染，消毒液的浓度及微生物学检测繁杂等缺陷，笔者于2006年开始采用干罐保存使用无菌持物钳，置于不同的区域环境，不同的使用频率及暴露时间，分别在不同的使用时间段采样监测，以了解其在使用过程中被细菌的情况。结果表明手术室连续使用12h，治疗室连续使用8h，此时间段监测均无细菌生长，证明此时间段内临床使用是安全的。     

干式存放无菌持物钳临床使用体会

无菌持物钳是临床无菌操作过程中重要的传递器械,因此,无菌持物钳在使用中的保洁、管理、污染与否直接影响医护工作质量。由于湿式存放无菌钳存在保存、使用周期长、消毒液易污染、器械液浓度及微生物学检测手续繁琐等诸多因素,我院于2000年9月在部分临床科治疗室实行无菌持物钳干式存放受到欢迎,现报道如下。1 干式存放优点1.1 减少污染 湿式存放无菌钳使用期为7d,无菌钳在使用中污染虽可行浸泡消毒,但因保存周期长、使用人员杂、消毒液有效浓度及污染程度等因素,可影响再次消毒效果;干式存放使用期为8h,基本按班次更换,严格无菌操作,再污染机会少;若使用中污染,可更换无菌持物钳,确保安全操作。1.2 节约医疗经费 无菌持物钳的湿式保存,由于消毒剂购买、配制及使用过程中的各项监测费用甚高;而干式存放虽需增加不锈钢器械罐,但因其耐损耗、耐高温、使用周期长、监测方法简单,从总体上降低了使用成本。     

无菌持物钳(镊)保存方法探讨

无菌持物钳（镊）是用来夹取、传递无菌物品的工具,按对人体危险性分类属高度危险性医疗用品,临床应用非常普遍.无菌持物钳（镊）是无菌技术中发生问题最多的操作工具之一,使用、保存不当极易导致医院内感染.现对无菌持物钳（镊）如何无菌保存,报道如下.     

干式激光胶片的结构、成像原理与图像质变原因分析

目的：分析干式激光胶片的结构、成像原理与图像发生质变的原因。方法：抽取干式激光、湿式激光胶片和普通X线胶片各60张,档案室保存的3种胶片各100份,观察3种胶片在相同包装与温、湿度环境中的变化。结果：A组胶片在自然环境中放置300min,有10张无包装、4张塑料袋包装和1张纸袋包装的干式激光胶片图像发生变化;B组胶片在人工温度环境中放置120min,3组干式激光胶片图像都发生变化,对照组的2种胶片在相同环境中试验420min无异常变化;档案室保存的3种胶片均无异常变化。结论：干式激光胶片影像易受存放环境温、湿度条件和包装袋材质种类的影响发生质变,影响图像质量。     

The performance of piezoelectric crystal sensors used to determine aerosol mass concentrations.

Aerosol mass concentration determination using piezoelectric crystal sensors was investigated. Five areas of influence were studied: temperature, humidity, particle collection characteristics, response linearity, and mass sensitivity. A theoretical review is included. Neither air stream temperature nor humidity fluctuations were compensated by the use of a reference crystal. The temperature induced error was satisfactorily reduced by minimizing the inlet temperature change rate. The humidity induced error resulted principally from moisture absorption and desorption by the aerosol deposit. The observed linear response limits ranged from 0.2 to 6 mug/mm2 for various aerosols and instrument designs. No relationship between the linearity limit and the point of complete saturation was apparent. The mass sensitivity was a function of the deposit size and location. Energy trapping theory helped to predict the mass sensitivity distribution. The mass sensing ability decreased for particle sizes beginning at approximately 2 mum diameter, reaching essentially zero at 20 mum. The use of viscous crystal coatings appeared to improve the sensing ability in the 2 to 20 mum size range.     

The effect of a semi-dry processing system on the thermal environment in school lunch kitchens

The thermal conditions of elementary school lunch kitchens applying dry, semi-dry and wet processing systems were studied. We focused especially on the improvement of the microclimate of a kitchen applying a semi-dry processing system. The survey was conducted in two individual school kitchens with a semi-dry system (School A) and a dry system (School B). Air temperature, relative humidity and air velocity were measured at 8 to 13 points every hour in September, 2006 in School A and B, and in February, 2007 in School A. Since a similar survey had been conducted in the kitchen of School A when the cooking work had been going on in a wet manner in February and September, 1990, it was possible to compare the measurement data from this study and those from the former study. The difference between indoor and outdoor absolute humidity was used as an index of the humidification of the cooking work in the kitchen. By comparing the microclimate of School A in 2006/2007 and 1990, it was found that the differences in absolute humidity in the semi-dry systems were significantly lower than those in the wet systems during the working hours in the summer mornings and in the winter afternoons, and the floor was maintained in drier conditions. It is suggested that a reduction of humidity in the kitchen by introducing a semi-dry or a dry processing system would contribute to not only an improvement in the working environment, such as the reduction of foot chill in winter and food sanitation, but also to a reduction in the workloads of cooking workers.     

Evaluation of the environmental stress index (ESI) for hot/dry and hot/wet climates

Recently, a novel environmental stress index (ESI) which is composed from commonly used meteorological variables: ambient temperature (T(a)), relative humidity (RH), and solar radiation (SR) was suggested as follows: ESI = 0.63T(a)-0.03RH+0.002SR+0.0054(T(a) x RH)-0.073(0.1+SR)(-1); (degrees C) The purpose of the present study was to evaluate and validate the ESI for hot dry and hot wet climatic conditions. The ESI was applied to large meteorological databases from 2 different locations resembling hot/wet and hot/dry climates. Data analysis revealed high correlation between ESI and the wet bulb globe temperature (WBGT) index for each of the two databases: P < 0.05, R2 = 0.985 and 0.982, for the hot/dry and hot/wet conditions, respectively. Therefore, it is concluded that ESI, which is constructed from fast response and commonly used weather variables (T(a), RH, SR), and also found in a microsensor format is validated for hot/dry and hot/wet zones and as a potential index to serve as an alternative to the WBGT for heat category assessment.     

低流量恒湿气流的发生

在常温下，用恒定气压与长毛细管向干燥的空气流中供给极小流量的恒流纯净水，水进入空气流立即蒸发。根据输水量与空气流量可计算出空气中水蒸汽的绝对湿度，由当时的温度计算出相对湿度。在空气流量为０．１９～０．４ｍ３／ｈ，相对湿度在３０％～９０％范围内，计算值与测量值相对偏差为±１０．１％     

Low humidity and microtrauma

Low-humidity dermatoses arise in the work place as a result of low water content of the air. At a relative humidity of 10% or less, the horny layer becomes rigid and brittle. The combination of low humidity, high temperature, and, frequently, rapid air movement dehydrates the outer stratum corneum. This leads to pruritus and, finally, to low-grade eczema. A roughened, scaly stratum corneum becomes more susceptible to mechanical trauma. Microtrauma from small particles can aggravate the dry scaly dermatosis. Low-humidity lesions resolve quickly with the simple expedients of routine use of moisturizers and/or raising the relative humidity.     

水帘空调系统作为南方纺织厂除尘降温技术的应用前景

目的探讨水帘空调系统在南方中小型纺织厂的应用前景。方法以南方某纺织厂技改前后的空调系统为研究对象，针对除尘降温效果、土建投资、设备投资、能耗、维护成本等因素进行研究。结果水帘空调系统无需土建投资，可节省80％的运行成本。作业场所夏季高温监测WBGT指数为28℃±1℃、湿度为60％±2％、新风量为〉30m3／（人·h）、粉尘浓度（0．7±0．3）mg／m3，高温和粉尘检测值均低于职业卫生接触限值。结论水帘空调系统可用于南方中小型纺织厂的通风除尘。     

2010年春运期间长途空调旅客列车车厢环境与空气质量综合评价

[目的]了解春运期间旅客列车车厢空气质量。[方法]2010年2月2-5日,在南宁铁路局选择旅客流量大的8趟长途空调列车,检测风速、温度、相对湿度、噪声、二氧化碳、空气细菌总数、可吸入颗粒物,并采用空气质量综合评价方法进行评价。[结果]8趟列车合计检测40个点,风速、温度、相对湿度、噪声、二氧化碳、空气细菌总数、可吸入颗粒物超标率分别为2.50%、97.50%、22.50%、75.00%、32.50%、2.50%、12.50%。综合评价4趟旅客列车车厢的环境、空气质量,Ⅱ级（未污染）的2趟,Ⅲ级（轻度污染）的2趟;最主要污染物3趟是二氧化碳,1趟是相对湿度。[结论]春运期间部分长途空调旅客列车车厢环境和空气受到污染。     

WBGT clothing adjustments for four clothing ensembles under three relative humidity levels

Threshold limit values for heat stress and strain are based on an upper limit wet bulb globe temperature (WBGT) for ordinary work clothes, with clothing adjustment factors (CAF) for other clothing ensembles. The purpose of this study was to determine the CAF for four clothing ensembles (Cotton Coveralls, Tyvek 1424 Coveralls, NexGen Coveralls, and Tychem QC Coveralls) against a baseline of cotton work clothes and to determine what effect relative humidity may have. A climatic chamber was used to slowly increase the level of heat stress by increasing air temperature at three levels of relative humidity (20%, 50%, and 70%). Study participants wore one of the five ensembles while walking on a treadmill at a moderate metabolic rate of 155 W m-2 (about 300 W). Physiological data and environmental data were collected. When the participant's core temperature reached a steady state, the dry bulb temperature was increased at constant relative humidity. The point at which the core temperature began to increase was defined as the inflection point. The environmental temperature recorded 5 min before the inflection point was used to calculate the critical WBGT for each ensemble. A three-way analysis of variance with ensemble by humidity protocol interactions and a multiple comparison test were used to make comparisons among the mean values. Only the vapor-barrier ensemble (Tychem QC) demonstrated an interaction with humidity level. The following CAFs are proposed: Cotton Coveralls (0 degrees C-WBGT), Tyvek 1424 Coveralls (+1), NexGen Coveralls (+2), and Tychem QC Coveralls (+10).