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评估加热腹腔内化疗(HIPEC)手术期间铂的环境污染和医护人员的暴露风险。

Evaluation of environmental contamination by platinum and exposure risks for healthcare workers during a heated intraperitoneal perioperative chemotherapy (HIPEC) procedure.

机构信息

Service de Chirurgie Digestive, Hôpital Lariboisière-AP-HP & Université Paris-Diderot/Paris 7, Hôpital Lariboisière-AP-HP 2 rue Amboise Paré, Paris, France.

出版信息

J Surg Oncol. 2011 Jan 1;103(1):6-9. doi: 10.1002/jso.21740.

Abstract

UNLABELLED

The study was plan to assess platinum (Pt) contamination in the operating room and its exposure to health workers during heated intraperitoneal perioperative chemotherapy (HIPEC) using oxaliplatin.

MATERIALS AND METHODS

Pt was measured in urinary and environmental (air and surfaces) samples via inductively coupled plasma mass spectrometry (ICP-MS). Urinary samples were obtained from 11 members of the staff before and after the procedure and from 6 controls. Samples from 15 surfaces and from 3 filters from the air extractors were also analyzed for Pt contamination.

RESULTS

Before HIPEC, Pt levels in urinary samples were similar in both the exposed and control groups; concentrations were below the limit of detection (i.e., 1.5 ng/L). No elevation was observed in the exposed group at the end of the procedure. Surgeon gloves were heavily contaminated. On other analyzed surfaces, lesser amounts of Pt were measured, ranging from 2 ng on the surgeon's hands to 183 ng on the forceps. All three air filters tested negative.

CONCLUSION

No contamination of healthcare workers or of the air in the operating room was detected. However, the heavy contamination of the surgeon's gloves demonstrates why doubling of specialized gloves for the surgeon should be mandatory.

摘要

目的

评估使用奥沙利铂进行腹腔内热化疗(HIPEC)时,手术室中铂(Pt)污染及其对医护人员的暴露情况。

材料和方法

通过电感耦合等离子体质谱法(ICP-MS)测量尿液和环境(空气和表面)样本中的 Pt。在手术前后,从 11 名工作人员和 6 名对照者中获得尿液样本。还分析了 15 个表面和 3 个空气提取器过滤器的 Pt 污染情况。

结果

在 HIPEC 之前,暴露组和对照组的尿液样本中 Pt 水平相似;浓度低于检测限(即 1.5ng/L)。在手术结束时,暴露组没有观察到升高。手术手套受到严重污染。在其他分析的表面上,测量到的 Pt 量较少,范围从手术者手上的 2ng 到钳子上的 183ng。所有三个空气过滤器均呈阴性。

结论

未检测到医护人员或手术室空气中存在污染。然而,手术手套的严重污染表明,为什么必须为外科医生加倍使用特殊手套。

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