七氟烷用于体外循环对手术室环境污染的研究

摘要

目的 检测体外循环中持续性使用吸入性麻醉药七氟烷在手术室不同位置的浓度.方法 随机选取50例体外循环(CPB)下行心脏双瓣或冠状动脉搭桥手术的成年患者,置百级洁净层流手术室中,在CPB开始吹入2%七氟烷,并用中心负压将七氟烷从氧合器排气口直接排至手术室外.于CPB前吹入2%七氟烷20、25、30、40 min时,专用气囊在术野上方30 cm(A组)、患者头侧上方10 cm(B组)、手术室边缘(C组)、膜肺储血罐开口上方50 cm(D组)、膜肺储血罐开口上方1 cm(E组)、氧合器排气口(F组)采集空气,检测采集空气样本中七氟烷的浓度.结果 A、B组各时间点气体浓度差异无统计学意义(P>0.05); C、D、E、F组吹入七氟烷后的各时间点的气体浓度较CPB前增加(P<0.01); C、D、E、F组各组在吹入七氟烷后的4个时间点比较气体浓度差异均无统计学意义(P>0.05).吹入七氟烷后的4个时间点A、B、C、D、E组七氟烷浓度均低于F组(P<0.01); A、B、C、D组七氟烷浓度均低于E组(P<0.01); C、D组与A、B、E、F各组间相比差异有统计学意义(P<0.01); A、B两组间七氟烷浓度差异无统计学意义(P>0.05); C、D组两组间差异无统计学意义(P>0.05).结论 体外循环中使用七氟烷不会对手术室环境造成污染.%Objective To observe the concentration of Sevoflurane in different sites in operation room during using sevoflurane in CPB constantly. Methods 2％ sevoflurane was blown into the oxygenator at the beginning of CPB. At the same time, we used central vacuum to draw the gas from the oxygenator air vent. We used gasbag to collect gas on different time in several sites in the laminar flow operation room. We collected the gas in following times: before the CPB, 20 rain, 25 rain, 30 rain and 40 rain after Sevoflurane was blown. We collected the gas in these sites: 30 em above the surgical field(group A), 10 em above the patient's head( group B), the edge of the operation room (group C), 50 em above the reservoir( group D), 1 em above the reservoir( group E), the oxygenator air vent(group F). Then we measured the concentration of the sevoflurane. Results The gas concentration was not significantly different in the same site on different times after CPB began(P ＞0.05).The gas concentration was significantly different in the air vent ( group F)with the other sites after CPB began( P ＜0. O1 ). Group E was significantly different with the other sites(P ＜0. Ol ). Group D was significantly different with Group A、 B、 E、 F ( P ＜ 0. 01 ). Group C was significantly different with Group A 、B 、E 、F( P ＜ 0.01 ). Group A was not significantly different with Group B (P ＞ O. 05 ). Group C was not significantly different with Group D ( P ＞ O. 05 ). Conclusion Sevoflurane used in CPB could not cause the environmental pollution in the operation room.