随着现代医疗技术的进步,越来越多的设备被用于外科手术的切割和止血过程中,但其中很多设备,如电刀、超声刀、激光等处理组织时产生的烟雾也为手术环境造成了严重的污染。手术烟雾包含有毒有害的烟雾颗粒、生物成分、化学物质等。提高对手术烟雾的认知对于手术相关医疗人员的健康有重要意义,本文就手术烟雾的性质和防护等方面作一综述。
With the development of modern medical technology, while increasing devices are being used in surgical cut and coagulation, surgery smoke produced by such devices as electrotomes, ultrasonic scalpels, and laser pollute surgical environment at the same time. Studies show that surgical smoke contains harmful particles, biotic components, and chemical components. To increase the awareness of the harm of surgical smoke and reduce the health risk of medical staff, this article reviewed the properties of surgical smoke and related protection measures.
[1] Bree K, Barnhill S, Rundell W.The dangers of electrosurgical smoke to operating room personnel: a review[J]. Workplace Health Saf, 2017,65(11):517-526.
[2] Mathias JM.Hiding in plain sight: Surgical smoke threatens health of OR staff[J]. OR Manager, 2015,31(9):15-17.
[3] 丁雪梅,程月娥,叶志霞,等.不同电外科器械在肝脏离断中产生烟雾成分的对比及防护对策[J]. 海军医学杂志, 2019,40(5):455-458.
[4] Lee T, Soo JC, LeBouf RF, et al. Surgical smoke control with local exhaust ventilation: Experimental study[J]. J Occup Environ Hyg, 2018,15(4):341-350.
[5] Schultz L.Can efficient smoke evacuation limit aerosolization of bacteria?[J]. AORN J. 2015,102(1):7-14.
[6] Wu YC, Tang CS, Huang HY, et al.Chemical production in electrocautery smoke by a novel predictive model[J]. Eur Surg Res, 2011,46(2):102-107.
[7] 胡文娟,陈宗南,王伟力. 术中电刀产生烟雾的粒径分布及扩散特点[J]. 解放军护理杂志, 2012(22),64-65.
[8] 唐翠明,罗俊青,练敏.手术烟雾的危害及防护措施研究进展[J]. 黑龙江医学, 2019(7):849-851.
[9] 王丽霞,魏永婷,张宝堂,等. 高频电刀烟雾对手术室空气质量的影响[J]. 中国护理管理, 2018,18(2):196-201.
[10] Kwak HD.Detecting hepatitis B virus in surgical smoke emitted during laparoscopic surgery[J]. Occup Environ Med, 2016,73(12):857-863.
[11] 马瑛. 整形美容中激光与高频治疗烟雾的危害和控制[J].护士进修杂志,2004,19(9):839-842.
[12] Ott DE.Carboxyhemoglobinemia due to peritoneal smoke absorption from laser tissue combustion at laparoscopy[J]. J Clin Laser Med Surg, 1998,16(6):309-315.
[13] 杜显峰,刘新明,卢光泽.医用口罩的合理选择与应用[J]. 中华医院感染学杂志, 2010,20(7):983-984.
[14] 张海伟,季萍.手术室医护人员外科手术烟雾认知与防护的调查研究[J]. 全科护理, 2016,14(8):851-853.
[15] 彭红,廖思兰,莫恋.手术室医护人员外科手术烟雾认知与防护的调查研究[J]. 临床医学工程, 2018,231(5):687-688.
[16] 潘静,林玉秀,张玉清.手术烟雾职业暴露人群对手术烟雾基础知识的认知情况及培训效果分析[J]. 国际护理学杂志, 2015,(12):1585-1588.
[17] 先会,谢飞,杨晓莹.电外科烟雾对手术环境及其暴露人群健康影响的研究进展[J]. 西南医科大学学报, 2018,41(6): 571-573.
