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手术室中电外科手术对外科医生血液指标的影响:一项基于家兔的模拟模型与实验

Effect of electrosurgery in the operating room on surgeons' blood indices: a simulation model and experiment on rabbits.

作者信息

Hui Yu, Yan Jin

机构信息

1 Department of Reproductive Medicine, Puren Hospital Affiliated to Medical College of Wuhan University of Science and Technology, Wuhan, China.

2 Department of Metallurgical Engineering, Wuhan University of Science and Technology, Wuhan, China.

出版信息

J Int Med Res. 2018 Dec;46(12):5245-5256. doi: 10.1177/0300060518804376. Epub 2018 Oct 21.

Abstract

OBJECTIVE

This study aimed to examine the content of surgical smoke in the operating room, and the health effects of exposure to surgical smoke on surgeons.

METHODS

We measured the content of surgical smoke in the operating room. The effect of exposure to surgical smoke on surgeons was examined using rabbits. Surgical smoke distribution was simulated to study the route of spread of surgical smoke. The effect of an evacuator was also evaluated.

RESULTS

In the operating room during electrosurgery, there was a high-content zone of surgical smoke (1.5 × 10%, carbon monoxide; 3.0 × 10%, carbon dioxide). In rabbit experiments, all groups that were exposed to surgical smoke showed significantly higher carboxyhemoglobin levels than did controls. Exposure to a high content of surgical smoke had a greater effect on blood indices than working continuously in the operating room.

CONCLUSIONS

During electro-laparotomy, carbon monoxide in the high-content and low-content zones is higher than the United States Environmental Protection Agency's limit. Carboxyhemoglobin levels may be > 10% with continuous operations over a week in the high-content zone in the operating room. Even with an evacuator, surgeons' blood indices can still be affected by surgical smoke.

摘要

目的

本研究旨在检测手术室中手术烟雾的成分,以及接触手术烟雾对外科医生健康的影响。

方法

我们测量了手术室中手术烟雾的成分。使用兔子来检测接触手术烟雾对外科医生的影响。模拟手术烟雾分布以研究手术烟雾的传播途径。还评估了排烟器的效果。

结果

在电外科手术期间的手术室中,存在手术烟雾高含量区域(一氧化碳含量为1.5×10%;二氧化碳含量为3.0×10%)。在兔子实验中,所有接触手术烟雾的组的碳氧血红蛋白水平均显著高于对照组。接触高含量手术烟雾对血液指标的影响大于在手术室连续工作。

结论

在腹腔镜电切术中,高含量和低含量区域的一氧化碳含量均高于美国环境保护局的限值。在手术室高含量区域连续手术一周以上,碳氧血红蛋白水平可能会超过10%。即使使用排烟器,外科医生的血液指标仍会受到手术烟雾的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9ab6/6300964/f97d3f66f41e/10.1177_0300060518804376-fig1.jpg

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