非接触式眼压计测量产生气溶胶密度变化及其对新冠肺炎疫情防控的意义  

Aerosol formation during non-contact "air-puff" tonometry and its significance for prevention of COVID-19

作　　者：李纯纯 唐媛[2] 陈张艳 王爱孙 黄小琼 陈燕燕[2] 瞿佳 Li Chunchun;Tang Yuan;Chen Zhangyan;Wang Aisun;Huang Xiaoqiong;Chen Yanyan;Qu Jia(Ophthalmology and Optometry,Eye Hospital of Wenzhou Medical University,Wenzhou 325000,China;School of Optometry and Ophthalmology,Wenzhou Medical University,Wenzhou 325000,China)

机构地区：[1]温州医科大学附属眼视光医院,325000 [2]温州医科大学眼视光与生物医学工程学院,325000

出　　处：《中华实验眼科杂志》2020年第3期212-216,共5页Chinese Journal Of Experimental Ophthalmology

基　　金：国家卫生计生委科学研究基金——浙江省医药卫生重大科技计划重点项目(WKJ-ZJ-1727);温州市抗击新冠病毒肺炎应急科研基金项目(ZY2020001)。

摘　　要：目的通过评估疫情期间眼科诊疗中常用的非接触式眼压计工作时产生的可入肺颗粒物(PM)2.5、PM10及气溶胶粒子数变化,为新型冠状病毒肺炎(COVID-19)疫情期间眼科医护人员的日常防护提供参考和指导。方法采用横断面研究方法,于2020年2月22日在温州医科大学附属眼视光医院纳入健康受试者30名,采用非接触式眼压计分别在眼科诊室和大厅对受试者佩戴或不佩戴口罩状态下进行双眼眼压测量,并对受试者单人佩戴与不佩戴口罩状态下进行双眼眼压测量,采用空气质量检测仪实时检测眼压测量室眼压计喷射时产生的PM和气溶胶密度,分析眼压测量人次与PM2.5、PM10及气溶胶粒子数的累积效应,对受试者单人佩戴与不佩戴口罩情况下的PM和气溶胶密度进行比较。结果非接触式眼压计工作时产生的PM2.5、PM10及气溶胶粒子数随着喷射次数的增加而呈波动上升趋势。30名受试者60眼分别于医疗诊室及医疗机构大厅两种环境下连续测量眼压曲线发现,PM2.5、PM10和气溶胶粒子数随眼压测量人次的增加而波动上升,呈现累积效应,且大厅的累积速度快于诊室。受试者不戴口罩时产生的PM2.5和PM10密度分别为(53.417±2.306)和(85.350±3.488)μg/m3,均高于戴口罩时的(50.567±0.862)和(80.617±1.463)μg/m3,差异均有统计学意义(P=0.028、0.019);受试者不戴口罩时产生的气溶胶密度高于戴口罩时,但差异无统计学意义(P=0.123)。结论非接触式眼压计喷射可产生PM和气溶胶,且随喷射次数的增加呈波动上升趋势,有累积效应,空气不够流通的大厅气溶胶密度更高;被测试者不戴口罩时产生的PM和气溶胶密度较戴口罩时增多。Objective To evaluate the aerosol and concentration(PM2.5,PM10 and aerosol particle number)formation in non-contact"air-puff"tonometry and provide suggestions for medical workers to take appropriate daily protection during the prevalence of 2019-nCoV.Methods A cross-sectional study was carried out in this study.Thirty healthy subjects were enrolled on February 22,2020 in Eye Hospital of Wenzhou Medical University.The intraocular pressure(IOP)was measured by non-contact"air-puff"tonometer in the ophthalmic consulting room and the hall with or without masks.Particulate matter(PM)2.5,PM10 and aerosol particles were recorded by air quality detector.The cumulative effects of IOP measurement,PM2.5,PM10 and aerosol particle number were analyzed,and the aerosol density of subjects with and without masks was compared.Results The PM2.5,PM10 and aerosol particles produced by the non-contact"air-puff"tonometry and increased with the increase of spray times.The IOP curves of 60 eyes of 30 subjects were measured respectively in two environments of medical consulting room and medical institution hall.It was found that PM2.5,PM10 and particle number fluctuated and increased with the increase of IOP measurement person times,showing cumulative effect,and the accumulation speed of aerosol density in hall was faster than that in consulting room.The density of PM2.5 and PM10 produced without gauze mask were(53.417±2.306)and(85.350±3.488)μg/m3,which were higher than those of(50.567±0.862)and(80.617±1.463)μg/m3 with gauze mask.The differences were statistically significant(P=0.028,0.019),and significant difference was found in aerosol density between with and without gauze mask,although more aerosol was produced without gauze mask in comparison to gauze mask(P=0.123).Conclusions Aerosol can be produced by non-contact"air-puff"tonometer spraying,and it fluctuates with the increase of spraying times,showing a cumulative effect.The aerosol and particulate matter accumulation is higher in the hall with insufficient air circulation,an

关 键 词：眼压计 非接触式 气溶胶 可入肺颗粒物 感染 传播 新型冠状病毒肺炎 

分 类 号：R563[医药卫生—呼吸系统]