沈有舟, 高瑞君, 周伟, 胡振宇, 李文静. 深圳市手术室吸入麻醉废气污染状况[J]. 环境与职业医学, 2013, 30(2): 137-139.
引用本文: 沈有舟, 高瑞君, 周伟, 胡振宇, 李文静. 深圳市手术室吸入麻醉废气污染状况[J]. 环境与职业医学, 2013, 30(2): 137-139.
SHEN You-zhou , GAO Rui-jun , ZHOU Wei , HU Zhen-yu , LI Wen-jing . Waste Anesthetic Gas Pollution in Operating Rooms in Shenzhen[J]. Journal of Environmental and Occupational Medicine, 2013, 30(2): 137-139.
Citation: SHEN You-zhou , GAO Rui-jun , ZHOU Wei , HU Zhen-yu , LI Wen-jing . Waste Anesthetic Gas Pollution in Operating Rooms in Shenzhen[J]. Journal of Environmental and Occupational Medicine, 2013, 30(2): 137-139.

深圳市手术室吸入麻醉废气污染状况

Waste Anesthetic Gas Pollution in Operating Rooms in Shenzhen

  • 摘要: 目的 调查深圳市手术室麻醉废气污染状况。


    方法 选择深圳市各级医院 30家、手术间 240间,麻醉期间抽取手术室麻醉机工作平台位置空气样本 240份。按采样期间是否吸入麻醉和医院全麻是否常规采用吸入麻醉分为吸入组(采样当时用吸入麻醉)、非吸入 A组(采样期间未用吸入麻醉,但医院全麻常规中采用静脉吸入复合全麻)和非吸入 B组(采样期间未用吸入麻醉,且医院全麻很少采用吸入麻醉或者完全不采用吸入麻醉)。同时采集 30家医院麻醉医生办公室空气样本 30份为对照组。用溶剂解析-气相色谱法检测其中常用吸入麻醉剂安氟烷、异氟烷和七氟烷的浓度。


    结果 对照组全部未检出麻醉废气。吸入组 63间,未检出麻醉废气者 4间,检出麻醉废气者 59间,检出率93.65%,31间达到或超过 2 mg/L,占 49.21%。非吸入 A组 104间,未检出麻醉废气者 33间,检出麻醉废气者 71间,检出率 68.27%,13间 ≥ 2 mg/L,占 12.50%。非吸入 B组 73间,未检出麻醉废气者 67间,检出麻醉废气者 6间,检出率 8.22%,全部 <2 mg/L。3组间麻醉废气检出率以及浓度 ≥ 2 mg/L的比例比较,差异均有统计学意义(P<0.01)。吸入麻醉手术间麻醉废气污染程度高于无吸入麻醉手术间。全麻常规采用或较多采用吸入麻醉医院的无吸入麻醉手术间,其麻醉废气污染程度高于全麻较少采用或完全不用吸入麻醉的医院。


    结论 吸入麻醉可造成手术间麻醉废气污染,应该采取切实有效的措施降低手术间麻醉废气浓度。

     

    Abstract: Objective To investigate waste anesthetic gas (WAG) pollution of operating rooms in Shenzhen.


    Methods A total of 240 operating rooms in 30 hospitals at various levels in Shenzhen were selected for this study. For each of the selected operating rooms one air sample was collected on the working platform of anesthesia machine when anesthesia was administrated. According to whether inhalation anesthesia was delivered during air sampling and whether inhalation anesthesia was used in routine general anesthesia in the hospitals, 240 air samples were divided into 3 groups:inhalation group (Yes), non-inhalation group A (No/Yes), and non-inhalation group B (No/No). Another 30 air samples were collected from 30 anesthetist offices as controls. Concentrations of sevoflurane, isoflurane, and enflurane in the air samples were determined by solvent desorption gas chromatography.


    Results WAG was detected in none of the 30 control samples, 59 samples (93.65%) of the inhalation group (n=63), 71 samples (68.27%) of the non-inhalation group A (n=104), and 6 samples (8.22%) of the non-inhalation group B (n=73). There were 31 samples of inhalation group (49.21%) and 13 samples of non-inhalation group A (12.50%) attaining or exceeding a maximum allowable concentration of 2 mg/L. There were significant differences in the detectable rates of WAG and the proportion of WAG concentrations equal to or above 2 mg/L between any of the two exposure groups (P<0.01). The highest WAG pollution level was found in the operating rooms delivering inhalation anesthesia, followed by the ones using inhalation anesthesia as routine general anesthesia.


    Conclusion The WAG that leaks out during delivery of inhalation anesthesia may cause WAG pollution issues in operating rooms. Effective measures are required to control WAG.

     

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