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研究生:徐崇祐
研究生(外文):Hsu, TsungYu
論文名稱:電刀煙霧有效吸引與防制效率研究探討
論文名稱(外文):Evaluation Of The Effectiveness And Control Efficiency Of The Capture Of Electrocautery Smoke.
指導教授:劉希平劉希平引用關係
指導教授(外文):Liu, Shi-Ping
口試委員:劉希平鄭福田張能復
口試委員(外文):Liu, Shi-PingJeng, Fu-TienChang, Len-Fu
口試日期:2012-09-13
學位類別:碩士
校院名稱:輔仁大學
系所名稱:公共衛生學系碩士班
學門:醫藥衛生學門
學類:公共衛生學類
論文種類:學術論文
論文出版年:2012
畢業學年度:101
語文別:中文
論文頁數:100
中文關鍵詞:排煙器電刀煙霧
外文關鍵詞:Vacuum FlowrateElectrocautery Smoke
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手術電刀是外科醫生進行手術時不可或缺的器具,手術電刀可切割組織外,亦可同時進行止血的功能,提高手術效率、減少病患失血與感染問題。然而手術煙霧是醫院手術電刀的負面產物,其產生之煙霧不只影響了醫生手術的視線,更危害醫護人員的呼吸系統與健康。
本研究為了降低醫護人員暴露於手術煙霧的危害,於無塵室中模擬電刀煙霧產生,設計固定開口大小的抽氣風罩抽引電刀煙霧,利用雷射粒子計數器與煙霧可視化設備分別評估風罩開口風速、抽風高度、抽風角度評估環境微粒濃度上升之趨勢與抽風煙霧流場變化,藉此探討抽風參數對排除手術電刀煙霧的效果。最後利用PAHs氣粒狀採樣,評估利用活性碳濾網與HEPA集塵系統是否具手術煙霧防之制效果。
環境微粒上升趨勢與煙霧流場觀察結果發現,抽風量越大、風罩高度與手術位置相同、抽引角度為30度至45度時,有較佳的煙霧抽引效果。利用此最佳抽風參數與無抽引狀況之手術室環境微粒濃度相比,電刀煙霧去除效率可達90%以上,可有效減少電刀煙霧對醫護人員之健康威脅。PAHs分析結果顯示,設備中的活性碳網因風速過快無法有效捕捉氣狀手術煙霧;且HEPA集塵系統對粒狀手術煙霧防制效率有限,故建議抽引後的氣體不回流於手術室中以減少二次汙染。

Electrocautery is a necessary equipment in modern surgery, the equipment not only makes resection easier but also makes hemostatic faster to promote surgery efficiency and reduce blood loss of patients. The electrocautery smoke(ES) generated by electrocautery hinders surgeon’s vision and has been known as a great harm in operating rooms. This hazard significantly affects the respiratory system and health of surgical personnels.
This study was to reduce ES to surgical personnels, in a laboratory simulated clean room. By designing a hood combined with a vacuum exhaust machine, ES can be collected under controlled conditions. Ventilation vacuum flowrates, hood heights and angles were target parameters in evaluating the ES removal efficiency.
The study applied a Laser particle counter to measure environment particles in clean room. Under various vacuum scenarios, the result showed higher vacuum flowrates with the same heights of hood and patient’s surgerical portion could obtain better removal efficiency up to 70%.
So this study suggested that perform an electrocautery operation in clean room, must whit effective smoke removal equipment to protected surgical personnels.

目錄...........................1
誌謝...........................8
摘要...........................10
ABSTRACT...........................11
第一章 前言...........................12
1-1 研究背景...........................12
1-2 研究目的...........................14
第二章 文獻探討...........................15
2-1手術電刀應用與原理...........................15
2-2 電刀煙霧...........................17
2-2-1 電刀煙霧產生機制...........................17
2-2-2 電刀煙霧危害 ...........................17
2-3 活性碳的原理與應用...........................19
2-4 排煙器...........................21
2-4-1 排煙器使用現況...........................21
2-4-2 排煙器的設計與標準...........................23
2-5 氣罩...........................23
2-6 多環芳香族碳氫化合物 (POLYCYCLIC AROMATIC HYDROCARBONS,PAHS)...........................24
2-6-1多環芳香族碳氫化合物介紹...........................24
2-6-2 PAHs來源與分布...........................29
第三章 研究方法與實驗設備...........................32
3-1實驗架構與研究方法...........................32
3-1-1 參數設定...........................33
3-1-1-1 抽氣量參數...........................33
3-1-1-2 高度參數...........................33
3-1-1-3 抽氣角度參數...........................35
3-1-2 環境微粒數目濃度趨勢評估...........................37
3-1-3 煙霧可視化流場觀察...........................38
3-1-4 設備噪音音量評估...........................40
3-1-5 以PAHs評估設備去除煙霧效率...........................41
3-1-6 PAHs採樣與分析...........................41
3-1-6-1 氣粒狀物採樣...........................41
3-1-6-2 樣本前處理...........................42
3-1-6-3 PAHs分析...........................43
3-2 實驗環境...........................45
3-2-1模擬手術環境...........................45
3-2-2模擬手術環境...........................46
3-2-3模擬手術室相對位置...........................47
3-3 實驗設備與器材...........................48
3-3-1 抽風設計...........................48
3-3-1-1風罩...........................48
3-3-1-2 活性碳設備...........................50
3-3-1-3 風壓測量孔與風量調節裝置...........................51
3-3-1-4 無塵室專用吸塵器...........................55
3-3-1-5 HEPA集塵網...........................56
3-3-2 實驗器材...........................56
3-3-2-1 雷射粒子計數器(LPC)...........................56
3-3-2-2 手術電刀設備...........................57
3-3-2-3 煙霧可視化設備...........................59
第四章 結果與討論...........................61
4-1 無抽風之電燒環境手術環境 ...........................61
4-2 實驗參數評估...........................62
4-2-1 最佳手術電刀煙霧抽引位置之評估...........................62
4-2-1-1不同手術煙霧抽引位置,環境微粒數目濃度之變化...........................63
4-2-1-2 不同手術煙霧抽引位置之環境微粒去除效率...........................68
4-2-1-3 不同手術煙霧抽引位置之煙霧抽引流場觀察情形...........................71
4-2-2 評估開口風速參數的重要性...........................73
4-2-2-1 手術煙霧抽引設備有效抽引風量探討...........................74
4-2-2-2 不同開口風速,手術煙霧抽引流場觀察...........................79
4-2-2-3 手術煙霧抽引設備音量與有效抽風量評估...........................80
4-3 局部通風設備對電刀手術室的重要性...........................81
4-3-1 有效抽引煙霧微粒...........................81
4-3-2 手術室增置本研究手術煙霧抽引設備之煙霧流場比較...........................82
4-3-3 環境氣粒狀PAHs濃度比較...........................82
4-4 煙霧處理設備效率...........................87
第五章 結論與建議...........................89
5-1 結論...........................89
5-2 建議...........................90
5-3 研究限制...........................90
參考文獻...........................92

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