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层流手术室净化技术及相关知识

来源:http://www.henganjh.cn │ 发表时间:2019-05-29 

  层流手术室净化技术及相关知识
  Laminar Flow Operating Room Purification Technology and Related Knowledge净化的概念The concept of purification
  所谓净化,就是通过过滤器对室外空气进行过滤,使其达到几乎无菌、无尘的状态,然后由通风机送入手术室,同时将污浊的空气吹出。净化并不等于杀菌,只是通过过滤器杀菌、除尘,必须配合地面、墙面、物体表面的清洁、消毒,并注意及时清洁空气过滤装置,以保持空气的运行清洁,满足各种操作的需要。空气净化也用于重症监护室和烧伤病房。
  The so-called purification means that the outdoor air is filtered through high-efficiency filters to make it almost sterile and dustless, and then sent to the operating room by the ventilator, at the same time, the dirty air is blown out. Purification does not mean sterilization, but sterilization and dust removal through filters. It must cooperate with the cleaning and disinfection of the ground, wall and surface of objects, and pay attention to cleaning the air filter in time to keep the air clean and meet the needs of various operations. Air purification is also used in intensive care units and burn wards.
  2. 空气净化目的
  2. Purpose of air purification
  通过空气净化创建一个合适的温度和湿度,空气新鲜和无菌的微环境,清洁、优质,将整个环境设施和设备在手术室织物科学,使其底部,方便,安全,清洁和无菌程度达到理想水平,手术的成功提供保障。净化设备:净化空调系统主要由空气处理器、一次、中、过滤器、压力风机、空气加热器、加湿器、进风口和出风口组成。
  Through air purification to create a suitable temperature and humidity, fresh and sterile air microenvironment, clean, high quality, the entire environmental facilities and equipment in the operating room fabric science, so that its bottom, convenient, safe, clean and sterile degree to achieve the desired level, the success of surgery to provide protection. Purification equipment: Purification air conditioning system is mainly composed of air processor, primary, medium and high efficiency filters, pressure fan, air heater, humidifier, air inlet and outlet.
  3.手术室空气净化分类
  3. Classification of Air Purification in Operating Room1. 按气流分类:
  1. Classification by airflow:
  (1)平行层流线、流量均匀、单向的气流通过房间工作区。它分为垂直层流和水平层流。垂直层流:hepa过滤器安装在顶板上,整个顶板为过滤层,气流垂直向下,回风口位于靠近地面的平面上。水平层流:过滤器安装在手术患者足端侧壁,气流水平吹。进风口位于对面墙体附近的屋顶上。
  (1) Parallel laminar streamline, uniform flow, one-way air flow through the room working area. It is divided into vertical laminar flow and horizontal laminar flow. Vertical laminar flow: Hepa filter is installed on the roof, the whole roof is a filter layer, the air flow is vertical downward, and the return air outlet is located on the plane near the ground. Horizontal laminar flow: The filter is installed on the side wall of the foot end of the operation patient, and the air flow is blown horizontally. The air intake is located on the roof near the opposite wall.
  在水平气流中,气流被机体或布料阻挡,影响操作区域的清洁。垂直气流,当切口在外科医生头部的逆风处时,也增加了细菌污染的机会,而且投资很高。由于重力作用,细菌粉尘颗粒容易在水平面上沉降,而在垂直面上不易聚集。垂直表面的细菌污染约为水平表面的1/25。在一定风速下,水平层流模式下的细菌浓度大于垂直层流模式下的细菌浓度。垂直表面容易保持清洁。
  In horizontal airflow, airflow is blocked by airframe or cloth, which affects the cleaning of operation area. Vertical airflow, when the incision is against the wind in the surgeon's head, also increases the chance of bacterial contamination, and the investment is high. Because of gravity, bacterial dust particles are easy to settle on the horizontal plane, but not easy to accumulate on the vertical plane. The bacterial contamination on the vertical surface is about 1/25 of that on the horizontal surface. At a certain wind speed, the concentration of bacteria in horizontal laminar flow mode is higher than that in vertical laminar flow mode. Vertical surfaces are easy to keep clean.
  (2)紊流型流线不平行,流速不均匀,方向不单一,具有交叉旋转的气流通过工区各截面。
  (2) The turbulent streamlines are not parallel, the velocity is not uniform, and the direction is not single. The Cross-Rotating airflow passes through all sections of the work area.
  (3)径向流动的流线似乎是单向流动,性能接近水平单向流动。
  (3) The streamline of radial flow seems to be unidirectional, and its performance is close to that of horizontal unidirectional flow.
  (4)混合流类型又称局部单向流,其区别在于整个区域的比值。垂直流动小于60%,水平流动小于40%,均为局部单项流动。
  (4) Mixed flow type is also called local unidirectional flow, and its difference lies in the ratio of the whole region. Vertical flow is less than 60%, horizontal flow is less than 40%, all of them are local single flow.
  2. 按净化空间分类
  2. Classification by Purification Space
  (1)全室净化采用吊顶或单壁送风,使整个手术室达到要求的洁净。这是一种较为先进的净化方法,但由于手术室外空气清洁度对切口污染不大,且全室空气净化室造价较高,因此施工受到限制。
  (1) The whole room is cleaned by ceiling or single-wall air supply, so that the whole operating room can meet the requirements of cleanliness. This is an advanced purification method, but because the cleanliness of the air outside the operating room does not pollute the incision, and the cost of the whole room air purification room is high, the construction is limited.
  (2)局部净化仅对手术区域采用局部顶送风或侧送风,仅使手术区域达到所需的洁净。一般认为以手术台为中心2.4m*1.2m的范围是手术室无菌要求比较高的部位。因此,局部净化在我国手术室空气净化中得到了广泛的应用。
  (2) Local cleaning only uses local top or side air supply in the operation area, which only makes the operation area clean. It is generally believed that the range of 2.4m*1.2m centered on the operating table is the highest requirement for sterility in the operating room. Therefore, local purification has been widely used in air purification of operating rooms in China.
  3.分类的目的
  3. Purpose of classification
  (1)工业洁净室以无生命粒子的控制为对象。它主要控制无生命粒子对工作物体的污染。
  (1) The control of inanimate particles is the object of industrial cleanroom. It mainly controls the pollution of inanimate particles to working objects.
  (2)生物洁净室分为一般生物洁净室和生物安全洁净室。前者主要控制活粒子对工作物体的污染,保持室内正压力。后者主要控制生活颗粒物对外界和人体的污染,对室内产生负压。
  (2) Biological clean rooms are divided into general biological clean rooms and biosafety clean rooms. The former mainly controls the contamination of working objects by living particles and maintains positive indoor pressure. The latter mainly controls the pollution of domestic particulate matter to the outside world and human body, and produces negative pressure to the indoor environment.
                         层流手术室净化
  4. 手术室空气净化水平
  4. Air Purification Level in Operating Room空气清洁度是由尘埃浓度来衡量的。粉尘浓度越高,清洁度越低,反之亦然。洁净空气手术室是指空气清洁度不低于10万级的手术室。根据空气中粉尘离子的粒径大于或等于0.5um /立方米,洁净手术室可分为100级、1000级、10000级和100000级四种类型。数量越多,净化水平越低。
  Air cleanliness is measured by dust concentration. The higher the dust concentration, the lower the cleanliness, and vice versa. Clean air operating room refers to the operating room whose air cleanliness is not less than 100,000. According to the particle size of dust ions in the air greater than or equal to 0.5um/cubic meter, the clean operating room can be divided into four types: 100 grade, 1000 grade, 10000 grade and 100000 grade. The more the quantity, the lower the purification level.
  与清洁有关的基本概念
  Basic concepts related to cleanliness
  浮游植物法中细菌浓度:在空气中随机采样,采样培养基培养后得到菌落数(cfu),代表空气中细菌数/m。沉降菌浓度:在直径为90mm的培养皿中,暴露于空气中30分钟后培养得到的菌落数量。表示可在空气中定居的细菌数量。手术室空气净化培养方法:取直径均为90mm的培养皿,静置室内30分钟,然后在每个培养皿中培养细菌数。每个手术室放置13个培养皿,中间放置5个(局部净化区,相当于手术床的位置),四周每面墙放置2个培养皿,放置位置和高度符合常用采样方法的要求。
  Bacterial concentration in phytoplankton method: random sampling in the air, sampling culture medium after culture to obtain the number of bacteria (cfu), representing the number of bacteria in the air / m. Concentration of sedimentation bacteria: The number of colonies cultured 30 minutes after exposure to air in a dish with a diameter of 90 mm. Indicates the number of bacteria that can settle in the air. Operating room air purification culture method: take a 90 mm diameter Petri dish and leave it in the room for 30 minutes, then culture the number of bacteria in each Petri dish. Each operating room is equipped with 13 Petri dishes, 5 Petri dishes are placed in the middle (local purification area, equivalent to the position of the operating bed), and 2 Petri dishes are placed on each wall around the operating room. The location and height of the Petri dishes meet the requirements of common sampling methods.
  1. 100级0.5 m粉尘粒数:350-3500 /m?,粒径为5 m的粒子数为0。浮游植物5 / m?,沉降菌1 /?90毫米。2。尘粒数1000级0.5 m -35,000 /m?,粒径为5m300 /m的粉尘粒子数?。浮游植物75 / m ?,沉降菌2 /?3.尘粒数为10000级0.5级,尘粒数为粒径5 m 3000 /m?。浮游植物150 / m ?沉降细菌5 /?尘粒粒径0.5,尘粒粒径5 m 30000 /m的数量?。浮游植物400 / m ?沉降菌10 /?100级(特别洁净)适用于心脏手术、器官移植、人工关节置换术等无菌要求较高的手术。
  1. 100 grade 0.5 m dust particle number: 350-3500/m?, particle size of 5 m is 0. Phytoplankton 5/m?, sedimentation bacteria 1/90 mm. 2. The number of dust particles in 1000 grades is 0.5 m-35,000/m, and the particle size is 5 m 300/m. Phytoplankton 75/m?, sedimentation bacteria 2/3. The number of dust particles is 10 000 grade 0.5 grade, and the size of dust particles is 5 m 3000/m?. Phytoplankton 150/m? Sedimentary bacteria 5/? Dust particle size 0.5, dust particle size 5 m 30000/m? Phytoplankton 400/m? Sedimentation bacteria 10/? 100 grade (especially clean) is suitable for aseptic surgery such as heart surgery, organ transplantation, artificial joint replacement and so on.
  空气过滤器空气过滤器由KLC研发生产空气过滤器,空气过滤器的细节,批发空气过滤器,空气过滤器解决方案,空气过滤器,空气过滤器,空气过滤器规格、尺寸的空气过滤器,优惠供应空气过滤器空气过滤器制造商,研发空气过滤器…HEPA过滤器| ULPA超过滤器| KLC过滤器KLC - 00002001过滤器| ULPA超过滤器| KLC过滤器由广州金田过滤器厂专业生产空气、HEPA过滤器| ULPA超过滤器| KLC过滤器主要用于高清洁度要求的地方,我们有一个专业的过滤器制造技术人才,能够满足。
  Air filter air filter developed by KLC produces air filters, details of air filters, wholesale air filters, air filter solutions, air filters, air filters, air filter specifications, size air filters, preferential supply air filter manufacturer, research and development of air filters. HEPA High Efficiency Filter | ULPA Ultra High Efficiency Filter | KLC High Efficiency Filter KLC - 00002001 High Efficiency Filter | ULPA Ultra High Efficiency Filter | KLC High Efficiency Filter is specially produced by Guangzhou Jintian Filter Factory for air and HEPA High Efficiency Filter | ULPA Ultra High Efficiency Filter | KLC High Efficiency Filter is mainly used in places with high cleanliness requirements. We have a professional Foot.
  1000级(标准洁净)
  Class 1000 (Standard Clean)
  适用于骨科、整形外科、普通外科Ⅰ操作。
  It is suitable for orthopaedics, plastic surgery and general surgery.
  10000级(一般洁净)
  Class 10000 (general cleanliness)
  胸外科、妇产科、泌尿外科、胃肠外科。
  Thoracic surgery, obstetrics and gynecology, urology, gastrointestinal surgery.
  10万级(一般洁净程度)
  100,000 (general cleanliness)
  感染手术,门诊手术,急诊手术。
  Infection surgery, outpatient surgery, emergency surgery.
  6. 洁净手术室布局
  6. Layout of clean operating room
  手术室分为两部分,手术室和辅助室。手术室洁净操作室平面位置包括端子布置、侧边布置、核心布置和圆形布置。划分洁净走廊,完成消毒分流,减少交叉感染;污染廊道,除了作为污物通道外,还作为参观廊道,减少了进出手术室的人数,减少了对手术室空气的干扰。
  The operating room is divided into two parts, the operating room and the auxiliary room. The plane position of clean operating room in operating room includes terminal layout, side layout, core layout and circular layout. Divide clean corridors, complete disinfection diversion, reduce cross-infection; Pollution corridors, in addition to as a dirt channel, but also as a visiting corridor, reducing the number of people entering and leaving the operating room, reducing the interference of the air in the operating room.
  同时,污物走廊使手术室的门不直接向外打开,减少了室外环境对手术室的污染,有利于手术室固定窗的清洗。
  At the same time, the dirt corridor makes the door of the operating room not open directly, reduces the pollution of the outdoor environment to the operating room, and is conducive to cleaning the fixed windows of the operating room.
  7. 工作过程
  7. Working process
  洁净手术室的人流量和物流量是影响室内空气清洁度的重要媒介。因此,划分去污流线是生物洁净手术室平面组合的重要原则。手术人员、手术病人和手术用品应严格控制在洁净手术室内外,并采取适当的隔离程序。
  The flow of people and logistics in a clean operating room is an important medium affecting indoor air cleanliness. Therefore, it is an important principle to divide the decontamination streamline for the planar combination of the bio-clean operating room. Operators, patients and surgical supplies should be strictly controlled in clean operating rooms and outdoors, and appropriate isolation procedures should be adopted.
  8. 手术期间保持空气清洁的措施:
  8. Measures to keep the air clean during operation:
  1. 比较关键的措施是控制人员流动。实验结果表明,手术室浮游植物数量在手术过程中变化明显,其特点是手术开始时细菌数量比较多,手术结束时达到一个高峰。这说明人员流动是手术室空气中细菌数量变化的主要原因。
  1. The most critical measure is to control the flow of people. The experimental results showed that the number of phytoplankton in the operating room changed significantly during the operation, which was characterized by the highest number of bacteria at the beginning of the operation and a peak at the end of the operation. This indicates that the movement of personnel is the main reason for the change of bacterial quantity in the air of operating room.
  2. 病人不允许参与手术。
  2. Patients are not allowed to participate in the operation.
  3.限制患者在手术台上的走动:进入手术室前,患者应脱下鞋袜,换上干净的衣服,戴上帽子。手术前,脱掉衣服和裤子,尽量减少病人在手术台上的翻身。为了避免细菌漂浮物落在无菌的手术区域,必须轻柔地盖住病人。
  3. Restrict the patient's movement on the operating table: Before entering the operating room, the patient should take off his shoes and socks, change into clean clothes and put on his hat. Before the operation, take off your clothes and pants to minimize turning over on the operating table. In order to avoid bacterial floats falling on sterile surgical areas, patients must be gently covered.
  4. 手术间门禁:手术期间尽量减少人员活动,不打开通向外走廊的门禁。严格控制大气污染。
  4. Operating room entrance guard: during the operation period to minimize personnel activities, do not open access to the outward corridor. Strict control of air pollution.
  5. 消毒控制:无菌手术和污染手术必须分开在不同的房间。如需在同一房间内进行,应先进行无菌手术,后进行污染手术。操作人员应严格洗手、消毒手臂,并在两组之间更换无菌操作服和手套。两次手术前应尽可能进行环境净化和药液的湿式消毒,包括湿式试验场。
  5. Disinfection control: Sterile and contaminated operations must be separated in different rooms. If it needs to be performed in the same room, sterile operation should be performed first, and then contamination operation. Operators should strictly wash hands and disinfect arms, and replace aseptic operating clothes and gloves between the two groups. Before the two operations, the environment should be purified and the liquid should be disinfected by wet method, including wet test site.
  6. 着装要求:进入房间前,医护人员必须戴一顶能遮住所有头发的干净帽子;衣服应覆盖全身皮肤,戴上特制的清洁口罩,遮住整个口鼻。
  6. Dress requirements: Before entering the room, medical staff must wear a clean hat that can cover all hair; clothing should cover the whole body skin, wear a special cleaning mask, covering the whole mouth and nose.
  7. 清洁:除术前、术后每日湿式清洁外,每周至少应彻底清洁手术室一次。每月进行一次细菌培养,检测净化效果,分析不合格原因,找出纠正措施。
  7. Cleaning: The operating room should be cleaned thoroughly at least once a week, in addition to wet cleaning before and after operation. Bacterial culture was conducted once a month to test the purification effect, analyze the reasons for the unqualified, and find out the corrective measures.
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