仿生表面湿化防止氧气湿化中微生物传播的试验研究  

Preventing Transmision of Microorganisms by Bionic Humidifier During Oxygen Humidification:Laboratory Study

作　　者：张晓东[1] 段蕴铀[2] 高琳 王洪超 

机构地区：[1]海军总医院感染控制科,北京100048 [2]海军总医院专家组,北京100048 [3]北京东方潮汐科技发展有限公司研发中心,北京100022

出　　处：《中华医院感染学杂志》2009年第21期2826-2828,共3页Chinese Journal of Nosocomiology

摘　　要：目的研究常规氧疗时氧气加湿和输送过程中微生物的传播规律，寻找杜绝微生物传播的方法，探讨解决吸氧相关医院感染肺炎的方案。方法对仿生表面湿化和常规入水湿化两种装置中的湿源物质分别以金黄色葡萄球菌、大肠埃希菌和白色假丝酵母菌污染，在加菌后第1～3天的相同时间均供氧20min，对每个标本瓶分别进行细菌和真菌的培养并计数。结果置入与仿生表面湿化装置连接的吸氧管终端的标本瓶中均未检测到金黄色葡萄球菌、大肠埃希菌和白色假丝酵母菌，置入与常规入水湿化装置连接的吸氧管终端标本瓶中可检测到金黄色葡萄球菌和大肠埃希菌；第1～3天金黄色葡萄球菌的计数分别为低浓度组39．5、52．4、117．3CFU／ml，高浓度组83．1、125．2、263．2CFU／ml，大肠埃希菌的计数分别为低浓度组12．9、29．4、37．3CFU／ml，高浓度组26．5、55．2、65．2CFU／ml，未检测到白色假丝酵母菌；在与两种装置连接的吸氧管终端检测到的金黄色葡萄球菌和大肠埃希菌在统计学上差异有统计学意义（P〈0．01）。结论独特的仿生学表面湿化装置即使在湿源物质遭到污染的情况下仍可以防止污染细菌随氧气通过吸氧管进入患者的呼吸道，这对切断微生物的传播途径，避免与吸氧相关的医院感染肺炎的发生，保证患者安全具有重要意义。OBJECTIVE To investigate the transmission of microorganisms by humidifier during oxygen humidification and search an ideal way to prevent it. METHODS Two kinds of humidifier, the unique bionic humidifier and the bubble humidifier, were involved. The humidification material inside the humidifiers were all contaminated with Staphylococcus aureaus, Escherichia coli and Candida albican at 5 × 10^5/ml and 2.5× 10^6/ml. Oxygen passed through every contaminated humidifier to the end of oxygen tube which was put in the bottle with 100ml normal saline, lasting 20 minutes, on the 1st, the 2nd, and the 3rd day after the humidifiers being contaminated. The fluid in the bottles, lml each, were cultured respectively. RESULTS The S. aureaus count of 39. 5, 52.4, 117.3 CFU/ml in 5 × 10^5/ml group, 83.1, 125.2, 263.2 CFU/ml in 2.5 × 10^6/ml group and E. coli count of 12.9, 29.4, 37.3 CFU/ml in 5×10^5/ml group, 26.5, 55.2, 65.2 CFU/ml in 2.5×10^6/ml group were detected at the end of bubble humidifier on three consecutive day respectively. There were no positive culture of bacteria at the end of bionic humidifier on three consecutive day respectively. The difference of S. aureaus and E. coli count between bubble and bionic humidifier on three consecutive day was significant （P 〈 0.01 ）. CONCLUSIONS The unique bionic humidifier can prevent S. aureaus and E. coli being transmitted to the end of oxygen cannula, even if the humidification material is contaminated with bacteria. It can keep patients with oxygen therapy away from nosocomial pneumonia. The bacteria are carried by micro-aerosol in certain size. No microaerosol is produced in the unique bionic humidifier.

关 键 词：氧疗 湿源物质 微生物 入水湿化 仿生表面湿化 医院感染肺炎 

分 类 号：R378[医药卫生—病原生物学]