手术烟雾对手术室规培护士健康影响的研究

目的 探讨传统开腹手术与腹腔镜手术产生的手术烟雾对新入职手术室规培护士健康的影响.方法 遴选2017年1—12月西南医科大学附属第一和第二医院普外科和手术室新入职规培护士150名作为研究对象.依据手术烟雾熏扰程度,分为3组,暴露于传统开腹手术烟雾的护士50名为高暴露组,暴露于腹腔镜手术烟雾的护士50名为低暴露组,从未接触过手术烟雾的护士50名为对照组.测定不同工作环境的 PM2.5,并对3组人群的血常规、血液生化、肝功能进行检测.结果 不同工作环境 PM2.5值差异有统计学意义(F=128.52,P<0.001),其中传统开腹手术比腹腔镜手术的房间 PM2.5峰值浓度高(P<0.05)、手术室比一般外科病房高(P<0.05).高、低暴露组在手术烟雾长时间侵扰后胆固醇的测定值、低密度脂蛋白-胆固醇含量、谷丙转氨酶浓度、胆红素总测定值、血色素测定值、红细胞比积均高于对照组(P<0.05),高密度脂蛋白-胆固醇检测数据低于对照组(P<0.05),且低暴露组的谷丙转氨酶浓度、红细胞比积、血色素测定值均低于高暴露组(P<0.05),而血常规检测提示,各类细胞计数差异无统计学意义(P>0.05).结论 手术烟雾对护士身体造成了影响,且传统手术产生的手术烟雾更严重,腔镜手术由于创伤小,有专用腔镜排烟系统,护士身体受到的影响更轻,但手术烟雾对其健康影响仍不容忽视.

Effect of Surgical Smoke on the Health of Standardized Training Nurses in Operating Room

Objective To explore the effect of the surgical smoke in the traditional open surgery and the laparoscopic surgery on the health of standardized training nurses in the operating room.Methods A total of 150 nurses beginning to receive the standardized training in Department of General Surgery and Operating Room from January to December of 2017 in The First Affiliated Hospital and The Affiliated Chinese Medicine Hospital of Southwest Medical University were selected as the research objects and divided into three groups according to the exposure degree to the surgical smoke.50 nurses exposed to the surgical smoke of the traditional open surgery were divided into the high exposure group,another 50 nurses exposed to the surgical smoke of the laparoscopic operation were divided into the low exposure group,and the other 50 nurses who had never been exposed to the surgical smoke were divided into the control group.The peak concentration of PM2.5 was detected in the environment of the three groups respectively,and the blood routine,blood biochemistry and liver function of the nurses in the three groups were examined.Results The PM2.5 values in the different environments were statistically different(F=128.52,P<0.001).The peak concentration of PM2.5 was significantly higher in the open surgery than in the laparoscopic operation (P<0.05),and it was significantly higher in the operating room than in the general surgical ward (P<0.05).The total determination value of cholesterol and bilirubin,the content of low density lipoprotein cholesterol, the concentration of glutamic pyruvic transaminase,the value of hemoglobin and the hematocrit were all significantly higher and the content of high density lipoprotein cholesterol was significantly lower in the high and low exposure groups than in the control group (P<0.05).The concentration of glutamic pyruvic transaminase,the value of hemoglobin and hematocrit were significantly lower in the low exposure group than in the high exposure group (P<0.05).The results of blood routine tests showed no significant differences in cell counts (P>0.05).Conclusion The surgical smoke in the operating room exerts a detrimental effect on nurses'health and the effect is more serious in the traditional open surgery.Even though the detrimental effect is less serious in the laparoscopic surgery due to the small trauma and smoke evacuation system,the effect of surgical smoke on the health should not be ignored.