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手术室体外模拟实验与仿真研究中的电外科设备温度对手术烟雾分布影响的研究。

The research on the effect of temperature of electro-surgical unit to surgical smoke distribution in theatre-in vitro and simulation study.

机构信息

Department of Gynaecology and Obstetrics, Huazhong University of Science and Technology Hospital, Wuhan, Hubei Province, China.

出版信息

PLoS One. 2024 Mar 8;19(3):e0299369. doi: 10.1371/journal.pone.0299369. eCollection 2024.

Abstract

In electro-surgery, surgical smoke was hazard to surgeons and patient in theatre. In order to institute effective countermeasures, quantifying of the effect of tip temperature of electro-surgical unit to surgical smoke distribution in theatre was studied. The relation of tip temperature to power of electro-surgical unit through in vitro cutting experiment. Based on experiment data, the mathematical model was established to simulate the electro-surgery in laminar operation room. As the power of electro-surgical knife increased, the knife tip temperature increased. Total content of (CO, CO2, CH4, NH3) in waste gas and net flow rate of waste gas at outlet increased with the rising temperature of knife tip and formation rate of condensed tar droplets and non-viable particles also increased. Based on simulation, it was found that The maximum height of surgical smoke rising right above the incision of electro-surgical unit was increased with rising temperature of electro-surgical knife tip. There was a spread route of dispersed surgical smoke near the walls of theatre through natural convection. The polynomial fitting relationship was derived. As the tip temperature of knife increased from 200 to 500°C, maximum ascending height of surgical smoke right above the incision position of electro-surgical unit increased from 1.1 m to 1.45 m. When the tip temperature of electro-knife was more 400°C, the CO content in the surgeon's operating zone was more than 200 ppm, which would cause the surgeon's HbCO level increased. As the patient's tissue in the wound during operation was open, when the electro-knife of more than 400°C, the content of condensed tar droplets and in-viable particle was higher than 20 g/m3 and 12 g/m3 in the zone around patient's wound of open tissue, which should be hazard to health of patient.

摘要

在电外科手术中,手术烟雾会对手术室中的外科医生和患者造成危害。为了采取有效的对策,研究了电外科器械尖端温度对手术室中手术烟雾分布的影响,通过体外切割实验研究了尖端温度与电外科器械功率的关系。基于实验数据,建立了数学模型来模拟层流手术室中的电外科手术。随着电外科刀功率的增加,刀头温度升高。废气中(CO、CO2、CH4、NH3)总含量和出口废气的净流量随着刀头温度的升高而增加,凝结焦油滴和非存活颗粒的形成率也随之增加。基于模拟,发现随着电外科刀头温度的升高,电外科器械切口正上方的手术烟雾上升的最大高度增加。由于自然对流,手术烟雾在手术室墙壁附近有一个分散的传播路径。得出了多项式拟合关系。随着刀头温度从 200°C 升高到 500°C,电外科器械切口正上方手术烟雾的最大上升高度从 1.1m 增加到 1.45m。当刀头温度从 200°C 升高到 500°C 时,电外科器械切口正上方手术烟雾的最大上升高度从 1.1m 增加到 1.45m。当刀头温度超过 400°C 时,手术医生操作区域的 CO 含量超过 200ppm,会导致手术医生的 HbCO 水平升高。由于手术中患者伤口处的组织是开放的,当电刀温度超过 400°C 时,凝结焦油滴和非存活颗粒的含量在患者开放组织伤口周围区域超过 20g/m3 和 12g/m3,这对患者的健康是有害的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e2f9/10923457/29de88c1b8b3/pone.0299369.g001.jpg

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