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目的探讨洁净手术室质量控制对策,以重视洁净手术室的管理,确保手术安全。方法按照《医院洁净手术部建筑技术规范》对徐州市11所医院洁净手术室综合性能进行每年1次定期监测;并对尘埃粒子数超标的洁净手术间整改干预。结果监测2006-2011年共216间洁净手术室的尘埃粒子、沉降菌、压差、温度、相对湿度、噪声和照度,合格率分别为56.48%、95.83%、55.56%、63.89%、51.85%、66.67%、72.69%,其中Ⅰ级57间,工作区截面平均风速合格率为45.83%;Ⅱ、Ⅲ级159间,换气次数合格率为62.04%;启用1年洁净手术室共42间,其尘埃粒子、沉降菌和压差3项指标的合格率分别是85.71%、97.62%、90.48%,与启用2～3年共78间的对应合格率57.69%、94.87%、51.28%比较,尘埃粒子和压差差异均有统计学意义(P<0.05),空气沉降菌差异无统计学意义;共65间次尘埃粒子超标洁净手术间整改前、后尘埃粒子数比较差异有统计学意义(P<0.05)。结论洁净手术室使用不可能一劳永逸,应进行有效维护和严格管理,医院感染管理应做好全面监测,不能仅用沉降菌单一指标作为可以安全使用的依据。
Objective To explore the quality control measures of clean operating room and pay attention to the management of clean operating room to ensure the safety of operation. Methods The comprehensive performance of the clean operating room in 11 hospitals in Xuzhou City was monitored regularly every year according to the Technical Code for Construction of Clean Operation Department of Hospital and the intervention of clean operation room with excessive dust particle count was conducted. Results A total of 216 clean operating rooms were monitored for dust particles, settling bacteria, pressure drop, temperature, relative humidity, noise and illuminance from 2006 to 2011. The pass rates were 56.48%, 95.83%, 55.56%, 63.89%, 51.85% 66.67%, 72.69%, of which 57 were Grade I, the average wind speed passing rate in the working area was 45.83%, 159 were in Grade II and III, and the passing rate of ventilation was 62.04%. There were 42 clean operation rooms for one year The pass rates of dust particles, sedimentation bacteria and pressure drop were 85.71%, 97.62% and 90.48% respectively. Compared with the corresponding pass rates of 57.69%, 94.87% and 51.28% (P <0.05). There was no significant difference in airborne sedimentation bacteria between the two groups (P <0.05). There were significant differences in the number of dust particles before and after rectification of 65 surpassed clean air surgeries (P < 0.05). Conclusion The use of clean operation room can not be once and for all, and should be effectively maintained and strictly managed. The hospital infection management should be fully monitored. Single indicator of sedimentation can not be used as the basis for safe operation.