口腔诊室不同通风状态下气溶胶类污染物喷溅情况研究  

Study on spraying of aerosol pollutants under different ventilation conditions in dental clinics

作　　者：马辉彬 黎创 池玉珊 许青峰 林华敏 辛蔚妮[1] Huibin Ma;Chuang Li;Yushan Chi;Qingfeng Xu;Huamin Lin;Weini Xin(Clinic of Stomatology·Department of Stomatology,Shantou University Medical College,Shantou 515000,China;School of Public Health,Shantou University,Shantou 515000,China)

机构地区：[1]汕头大学医学院口腔门诊部·口腔医学系,汕头515000 [2]汕头大学公共卫生学院,汕头515000

出　　处：《中华口腔医学研究杂志（电子版）》2023年第3期203-209,共7页Chinese Journal of Stomatological Research(Electronic Edition)

基　　金：广东省科技专项资金“医学教育人才培养及临床技术提升计划”(2019113134);汕头市科技计划(220513116490582)。

摘　　要：目的研究在独立空间内进行口腔诊疗操作时,不同通风状态下气溶胶类污染物的喷溅情况,为降低医患感染风险提供依据。方法选取独立口腔诊室,在3种不同通风状态(自然开窗通风、新风系统和新风系统及空气消毒机)下开展3种不同口腔诊疗操作(龈上洁治、根管预备和牙体预备),定义为9种工况。测定不同位点在不同时点的菌落总数,定量分析不同通风状态的气溶胶类污染物在时间和空间上的轨迹分布。采用Spearman秩相关分析、广义线性混合模型、方差分析和Wilcoxon秩和检验,以及秩次转换后进行多重比较以分析菌落总数的差异和平衡状态。结果方差分析结果表明,各位点的菌落总数差异无统计学意义(F=1.45,P=0.182),即各位点的菌落总数分布在各位点较为均匀。相对于自然开窗通风,开启新风系统进行龈上洁治和牙体预备,菌落总数(N_(工况1)=25.8 CFU/cm^(2);N_(工况2)=10.4 CFU/cm^(2);N_(工况7)=35.7 CFU/cm^(2);N_(工况8)=6.5 CFU/cm^(2))均随着时间的增加呈现降低的趋势(t_(龈上洁治)=2.27,P_(龈上洁治)=0.024;t_(牙体预备)=2.30,P_(牙体预备)=0.022)。所有工况治疗结束后30~60 min内与治疗结束后60~120 min内的菌落总数均无明显差异,即喷溅操作结束30 min后菌落总数趋于动态平衡的状态,且符合《医院消毒卫生标准GB 15982-2012》中的Ⅳ类环境要求。结论开启新风系统能在口腔诊疗喷溅操作中一定程度上有效降低特定空间的气溶胶类污染物。上一患者治疗结束后30 min下一患者方进入该区域进行治疗较安全。Objective To investigate the effect of different ventilation schemes on the concentration of aerosol pollutants in independent space during dental diagnosis and treatment.Methods Independent dental treatment room equipped with ventilation systems and air disinfectors was selected.A total of nine working conditions including three different dental treatments(supragingival scaling,root canal preparation and tooth preparation)were carried out respectively in three different ventilation schemes(natural ventilation,dedicated outdoor air system and dedicated outdoor air system combined with air disinfector).The aerobic bacterial counts were measured at different heights and time points.Spatiotemporal distributions of aerosol pollutants in different ventilation schemes were analyzed quantitatively.The differences and equilibrium states of aerobic bacterial counts were examined using Spearman′s rank correlation analysis,generalized linear mixed models,analysis of variance(ANOVA),Wilcoxon rank sum tests,and multiple comparisons following rank order transformation.Results The results of the ANOVA test revealed no statistically significant variations in the aerobic bacterial counts at each site(F=1.45,P=0.182),indicating that the aerobic bacterial counts were spread uniformly across sites.Compared to natural ventilation,the aerobic bacterial counts(Nworking condition1=25.8 CFU/cm^(2);Nworking condition2=10.4 CFU/cm^(2);Nworking condition7=35.7 CFU/cm^(2);Nworking condition8=6.5 CFU/cm^(2))under dedicated outdoor air system during supragingival scaling and tooth preparation decreased over time(tsupragingival scaling=2.27,Psupragingival scaling=0.024;ttooth preparation=2.30,Ptooth preparation=0.022).There is no significant difference between aerobic bacterial counts of the treatment after 30 minutes to 60 minutes and that after 60 minutes to 120 minutes,indicating the dynamic equilibrium of bacterial accounts was reached at 30 minutes after the spraying treatment,which met the classⅣenvironmental requirements in the Hygie

关 键 词：气溶胶 环境污染物 通风 

分 类 号：R78[医药卫生—口腔医学]