空气细菌监测对维护和管理洁净手术部空气质量的影响

 目的 探讨实施空气细菌监测对维护和管理洁净手术部空气质量的意义。方法 对某院洁净手术部的45间手术间进行沉降菌静态、动态空气监测。参照《医院洁净手术部建筑设计规范》GB 50333进行静态空气监测,参照《医院洁净手术部污染控制规范》DB/11408—2007要求进行动态空气监测。其中动态空气监测选择第一台手术不同时间段(手术切皮时、手术2 h或缝合结束、接台-麻醉-皮肤消毒时)进行采样,记录手术过程中可能影响室内空气质量的相关因素。遇动态、静态空气监测合格率较低时即查找原因,制定并实施管理措施。结果 2010年5月—2021年9月静态空气采样共782间次,合格763间次,合格率97.57%。其中2018年6月静态空气采样6间,合格率为33.33%,针对不合格情况进行原因分析,采取整改措施, 2018年11月—2021年9月静态空气监测合格率为99.48%。动态空气监测结果显示,2010年5月不同级别手术间动态空气监测结果均不合格, 2010年6月—2011年6月,共进行空气动态采样103台次,Ⅰ、Ⅱ、Ⅲ级手术间合格率分别为90.00%、89.80%、95.45%。Ⅱ、Ⅲ级手术间不同位置回风口菌落数比较,进门处回风口菌落数均高于内侧回风口,差异均有统计学意义(均P＜0.05)。Ⅰ、Ⅱ、Ⅲ级手术间不同时段动态空气采样菌落数比较,差异均有统计学意义(均P＜0.001),且各级手术间菌落数均随手术进程而逐渐增加。结论 洁净手术室静态、动态空气监测对维护和管理洁净手术部空气质量起到很好的督促作用;进行动态空气监测可及时掌握运行状态手术部细菌污染状况。

Effect of air bacterial monitoring on air quality of clean operating department

Objective To explore the significance of air bacterial monitoring in the maintenance and management of air quality in clean operating department. Methods Static and dynamic air monitoring of sedimentated bacteria was carried out in 45 operating rooms in the clean operating department of a hospital. Static air monitoring was conducted based on Code for architectural design of hospital clean operating department (GB 50333) and dynamic air monitoring was conducted according to Code for control of contamination of hospital clean operating department (DB/11408-2007). Dynamic air monitoring was performed during different time periods of the first operation (at skin incision, 2 hours after the operation or at the end of suture, consecutively occupied operating room-anesthesia-skin disinfection), relevant factors that might affect the indoor air quality during operation was recorded. When qualified rate of dynamic and static air monitoring was low, the causes was found out, and the management mea-sures were formulated and implemented. Results From May 2010 to September 2021, 782 static air specimens of operating rooms were taken, and 763 (97.57%) were qualified. Static air sampling of six room were taken in June 2018, with a qualified rate of 33.33%, the causes for the non-qualified result was analyzed, and measures were taken, qualified rate of static air monitoring from November 2018 to September 2021 was 99.48%. Dynamic air monitoring results show that dynamic air monitoring results of different grades of operating rooms in May 2010 were all unqualified, from June 2010 to June 2011, 103 dynamic air specimens were taken, qualified rates of grade Ⅰ, Ⅱ and Ⅲ operating rooms were 90.00%, 89.80% and 95.45% respectively. Colony number of the return air outlet at different positions in grade Ⅱ and Ⅲ operating rooms was compared, colony number of the return air outlet at the entrance was higher than that of the inner return air outlet, differences were all significant (all P<0.05). The dynamic air sampling colony numbers of grade Ⅰ, Ⅱ and Ⅲ operating rooms in different periods were compared, differences were all significant (all P<0.001), and the colony number in all grades of operating rooms increased gradually with the operation progress. Conclusion Static and dynamic air monitoring in clean operating room plays a good role in maintaining and managing the air quality in clean operating room; dynamic air monitoring can timely grasp the operating status and bacterial contamination in operating department.