固定持续负压吸引对开放手术电刀烟雾浓度的影响  

Effect of fixed continuous negative pressure suction on the electrosurgical smoke concentration during open surgery

作　　者：姚丽伟[1] 王华琴 蒋燕红 刘晓霞[1] 卢亚飞[1] Yao Liwei;Wang Huaqin;Jiang Yanhong;Liu Xiaoxia;Lu Yafei(Nursing Department,Hangzhou Red Cross Hospital,Hangzhou 310003,China;Operating Room,Hangzhou Red Cross Hospital,Hangzhou 310003,China)

机构地区：[1]杭州市红十字会医院护理部,310003 [2]杭州市红十字会医院手术室,310003

出　　处：《中华现代护理杂志》2021年第14期1880-1883,共4页Chinese Journal of Modern Nursing

基　　金：杭州市卫生计生科技计划(2018A44)。

摘　　要：目的探讨在层流手术间行开放手术中术野暴露时进行固定式持续负压吸引对手术室烟雾浓度的影响。方法采用便利抽样的方法,选择2019年7—12月杭州市红十字会医院手术室开展的120例直肠黏膜环切术手术,随机分为对照组(n=60)和观察组(n=60),两组均使用手术室层流负压吸引系统,对照组采用常规手术助手持负压吸引方法进行吸引,观察组在手术切口旁开5 cm、高度10 cm处应用固定式烟雾吸引装置实施持续负压吸引。比较两组手术切口垂直高度10、20、40 cm共3处采样点的电刀烟雾中粒径≤3.0μm的颗粒(PM_(3.0))浓度变化。结果持续使用电刀3~5 s时,观察组10、20、40 cm处采样点电刀烟雾PM_(3.0)浓度分别为(5802.03±2268.36)、(3487.98±1807.94)、(3224.28±2022.35)μg/m^(3),均低于对照组,差异有统计学意义(t值分别为9.735、11.886、5.634;P<0.01)。停止使用电刀5 min后,观察组3处采样点电刀烟雾PM_(3.0)浓度均低于对照组,差异有统计学意义(P<0.05)。结论开放手术使用高频电刀时,在暴露术野实施固定式持续负压吸引能有效吸引电外科烟雾,降低层流手术间手术区域电刀烟雾浓度。Objective To explore the effect of fixed continuous negative pressure suction on the smoke concentration in the Operating Room when the surgical field was exposed during open surgery in the laminar flow operating room.Methods From July to December 2019,convenience sampling was used to select 120 cases of rectal mucosal circumcision performed in the Operating Room of Hangzhou Red Cross Hospital.Cases were randomly divided into control group(n=60)and observation group(n=60).Both groups all used the laminar flow negative pressure suction system in the Operating Room.Control group carried out conventional negative pressure suction by the surgical assistant.In observation group,a fixed smoke suction device was used to implement continuous negative pressure suction at a position 5 cm beside the surgical incision and 10 cm in height.The changes in the concentration of particles(PM_(3.0))with a size≤3.0μm(PM_(3.0))in electrosurgical smoke from 3 sampling points at the vertical height of 10,20,and 40 cm of the surgical incision were compared between the two groups.Results When the electrosurgery was used continuously for 3 to 5 s,the PM_(3.0)concentration of electrosurgery smoke from sampling points at 10,20,and 40 cm in observation group was(5802.03±2268.36)μg/m^(3),(3487.98±1807.94)μg/m3 and(3224.28±2022.35)μg/m3 respectively,all lower than those in control group,the difference was statistically significant(t=9.735,11.886,5.634;P<0.01).After stopping using the electrocautery for 5 minutes,the PM_(3.0)concentration of electrocautery smoke at 3 sampling points in observation group was lower than those in control group,and the differences were statistically significant(P<0.05).Conclusions When using high-frequency electrosurgical surgery in open surgery,the implementation of fixed continuous negative pressure suction in the exposed surgical field can effectively attract electrosurgical smoke and reduce the concentration of electrosurgical smoke in the operating area of the laminar flow operating room.

关 键 词：烟雾 开放手术 负压吸引 电外科 PM_(3.0) 

分 类 号：R616.1[医药卫生—外科学]