两种氧疗湿化方式对污染微生物及防腐剂传输规律的研究  

Laboratory study on transmission of microorganism and disinfectant between two kinds of oxygen humidification

作　　者：张晓东[1] 段蕴铀[2] 王洪超 张月梅 

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》2011年第12期2499-2501,共3页Chinese Journal of Nosocomiology

摘　　要：目的研究仿生表面湿化和常规入水湿化两种氧疗湿化方式,对污染的微生物及添加的防腐剂的传输规律。方法对两种装置中的湿源物质分别以金黄色葡萄球菌、大肠埃希菌污染后,将吸氧管终端置于盛有无菌蒸馏水的标本接收瓶内,以3、5、7 L/min的流量分别供氧30、60 min,对终端标本接收瓶内样本和在吸氧管的近段、中段、远段内壁采集的样本进行培养和菌落计数;将10%脱氢乙酸钠溶液作为湿源物质,以3 L/min的流量通气,每1h 30min采样,用高压液相仪定量检测吸氧管终端的脱氢乙酸钠。结果采用入水湿化的方式时,终端氧气中均检测到金黄色葡萄球菌、大肠埃希菌和脱氢乙酸钠,且流量越大、通氧时间越长则菌落数越多,在吸氧管的近段、中段、远段的内壁中也检出了金黄色葡萄球菌和大肠埃希菌,流量小时近段菌落最多,流量大时远段菌落最多;采用表面湿化方式时则终端氧气中及吸氧管的近段、中段、远段的内壁中未检测出金黄色葡萄球菌、大肠埃希菌和脱氢乙酸钠;在统计学上差异有统计学意义(P<0.01)。结论入水湿化方式能传输湿源物质中可能污染的细菌并使吸氧管内有细菌存在,也能传输湿源物质中添加的防腐剂给患者带来的潜在危害,而仿生表面湿化方式则既不传输细菌也不传输防腐剂。OBJECTIVE To investigate the distinct transmission of microorganisms and disinfectant in humidification material inside the bionic humidifier or the bubble humidifier during oxygen humidification.METHODS Two kinds of humidifier,the bionic humidifier and the bubble humidifier,were involved.The humidification material inside the humidifiers were all contaminated with S.aureaus or E.coli.Oxygen passed through every contaminated humidifier to the end of oxygen tube,which was put into the sampling bottle with 100 ml sterilized water.The process were under 3 L/min,5 L/min,and 7 L/min of oxygen respectively and last for 30 min and 60 min.The amount of bacteria in the sampling bottles and on the inner wall of the tubes were detected by culture respectively.Sodium dehydroacetate solution was used as humidification material inside two kinds of humidifier.Oxygen passed through every humidifier under 3 L/min and last for 6 hours to the end of the tube,which was put into the sampling bottle with 200 ml pure water.Sodium dehydroacetate in every sampling bottle was detected every 1.5 hours.RESULTS At the end of bubble humidifier,S.aureaus,E.coli,and sodium dehydroacetate were detected,and either larger flow rate or longer time result in more bacteria.And the amount of bacteria on the inner wall of the tubes varied and related to flow rate： the smaller flow rate,the more bacteria located in the nearer part;the larger flow rate,the more bacteria located in the farer part.None of them was detected both at the end of bionic humidifier and in the tube.CONCLUSION Microorganism can be transmitted by bubble humidifier and located on the inner wall of the tubes in distance and flow rate dependent manner.And disinfectant also can be transmitted by bubble humidifier.But none of them can be transmitted by bionic humidifier.

关 键 词：氧疗 入水湿化 仿生表面湿化 湿源物质 气溶胶 微生物 防腐剂 

分 类 号：R181.32[医药卫生—流行病学]