目的 全程动态了解腹腔镜胆囊切除手术过程中有害物质的浓度及成分,为研究消除手术烟雾的措施提供依据.方法 在电钩切割组织时、切割后5、10、15、20 min、手术结束时检测距地面高度1.5 m、距手术切口30 cm处一氧化碳和二氧化碳的浓度,监测打卡戳卡后10 s内PM2.5和PM10浓度.用气相色谱法检测手术烟雾中有机物成分.结果 在使用电刀切割组织即刻开始CO和CO2浓度随着手术的进行逐渐升高.PM2.5和PM10在打开戳卡阀门均迅速升高,在第4 s时分别达到最高峰(659.42±26.29)μg/m3和(735.41±17.09)μg/m3.手术烟雾中检测出七氟烷、环戊烷、乙苯、壬烯醛、苯乙烯、环己酮、五甲基-庚烷、十烷、2-乙基己醇、十一烷、十二烷等有害物质.结论 手术烟雾含有多种有害物质,部分物质超过环保标准值,长期接触会对人体产生危害,需要全方位防护措施.%Objective To explore the concentration and composition of harmful substances during laparoscopic cholecystectomy so as to provide evidence for elimination of surgical smoke.Methods The concentrations of carbon monoxide and carbon dioxide were detected at the beginning of cutting tissue,5 min,10 min,15 min and 20 min after cutting,at the end of the operation,1.5 m above the ground and 30 cm from the surgical incision.The concentrations of PM2.5 and PM10 within 10 seconds of the punch of the card.The organic components in the surgical smoke were detected by gas chromatography.Results Soon after cutting the tissue,the concentrations of CO and CO2 increased gradually with the extension of the operation.PM2.5 and PM10 increased rapidly in open stamp card valves,reaching the peak of (659.42±26.29) μg/m3 and (735.41±17.09) μg/m3 at the fourth second.We detected sevoflurane,cyclopentane,ethylbenzene,nonenal,styrene,cyclohexanone,2,2,4,4,6-pentamethyl heptane,2-ethyl hexanol,undecane,dodecane and other harmful substances in surgical smoke.Conclusion There are many harmful substances in surgical smoke,some of which exceed the standard of environmental protection.Long-term exposure will cause harm to the human body,and integrated protective measures need to be taken.
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