充气式保温系统对手术室内层流及空气中菌落总数的影响

目的：探讨充气式保温系统对手术室内层流的风速、风向及空气中菌落总数的影响。方法：选择2020年3月至12月在垂直层流手术室内进行手术的76例模拟患者作为研究对象，随机分为保温层流组和层流组两组，每组38例。应用三维超声风速仪测量两组手术室内层流开启30 min后和空气采样结束后手术床周围63个点位层流的风速及风向变化；分别在手术开始前、手术开始后30、60、90、120 min进行空气采样并分析两组层流手术室内空气中的菌落总数变化。结果：两组不同时间点层流的风向均为向下，两组层流开启后30 min的风速比较差异无统计学意义（P ＞0.05）。空气采样结束后保温层流组的风速小于层流组，差异有统计学意义（P ＜0.05），进一步行亚组分析得出两组非头部区域的风速比较差异无统计学意义（P ＞0.05），但保温层流组头部区域的风速小于层流组（P ＜0.05）。两组内空气中菌落总数随手术时间延长呈增加趋势；两组间在手术开始前、手术开始后30、60、90、120 min时手术室内空气菌落总数比较差异无统计学意义（P ＞0.05）。结论：充气式保温系统设置为38 ℃时虽对手术室内层流的风速有一定影响但对层流的风向及空气中菌落总数无明显影响。

Effect of inflatable insulation system on laminar flow and total bacterial count in air of operating room

Objective: To investigate the effect of inflatable insulation system on laminar wind speed, wind direction and total bacterial count in the air of the operating room. Methods: From March 2020 to December 2020, 76 simulated patients who were operated in vertical laminar flow operating room were selected as subjects and randomly divided as insulation laminar flow group and laminar flow group, with 38 cases in each. In the thermal insulation laminar flow group, inflatable thermal insulation blanket was used as a measure to simulate the patient’s thermal insulation during the whole perioperative period. Three dimensional ultrasonic anemometer was used to measure the wind speed and direction of laminar flow in the two groups at 64 points around the operating bed half an hour after laminar flow opening and after air sampling. Air samples were taken before the operation,30 min, 60 min, 90 min and 120 min after the operation, with an analysis of the changes in total bacterial count in the air of laminar flow of the two groups. Results: The wind direction of laminar flow was downward at different time points of the two groups, and there was no significant difference in the wind speed between the two groups (P>0.05) 30 min after laminar flow was opened. After air sampling, the insulation laminar flow group had lower wind speed than the laminar flow group (P<0.05). Further subgroup analysis showed no significant difference in the wind speed of the non head area between the two groups (P>0.05), but the wind speed of the head area of the insulation laminar flow group was lower than that of the laminar flow group (P<0.05). The total number of bacteria in the air of the two groups increased with the extension of operation time. There was no significant difference inthe total number of bacterial colonies in the air of the operating room between the two groups before operation,30 min, 60 min, 90 min and 120 min after operation (P>0.05). Conclusion: Set at 38 ℃, the inflatable insulation system has no obvious influence on the wind direction of laminar flow or the total number of bacteria in the air,although it affects the laminar wind speed in the operating room to a certain degree.