手术烟雾危害及防护措施研究进展
摘要
<正>手术烟雾(surgical smoke)是外科手术中产生的肉眼可见烟雾状物质,它是在使用电刀(electrocauterydevice)、激光刀(laser)、超声波刀(ultrasonic scalpel)等外科手术设备时,人体组织的蛋白质、脂肪等组分不完全燃烧所致[1-2]。
引文
[1]Fan J K M,Chan F S Y,Chu K M.Surgical Smoke[J].A-sain J Surg,2009,32(4):253-257.
[2]Hensman C,Baty D,Willis R G,et al.Chemical Composi-tion of Smoke Produced by High-Frequency Electrosurgery in a Closed Gaseous Environment.An in Vitro Study[J].Surg Endosc,1998,12(8):1017-1019.
[3]Ball K.Surgical Smoke:Is It Safe to Breathe[J].Todays Surg Nurse,1996,18(5):16-21.
[4]Hoglan M.Potential Hazards from Electrosurgery Plume-Recommendations for Surgical Smoke Evacuation[J].Can Oper Room Nurs J,1995,13(4):10-16.
[5]Hazard Control.Control of Smoke from Laser/Electric Surgi-cal Procedures[S].Niosh,1998.
[6]ANSI.American National Standard Safe Use of Lasers Health Care Facilities[S].American Nationalstandard,2005.
[7]AORN.Recommended Practices for Laser Safety.Recom-mended Practice IV[EB/OL].(2004-04-02).Http://Findarti-cles.Com/P/Articles/Mi_M0fsl/Is_4_79/Ai_N6074242/.
[8]Spearman J,Tsavellas G,Nichols P.Current Attitudes and Practices Towards Diathermy Smoke[J].Ann R Coll Surg Engl,2007,89(2):162-165.
[9]Carbajo-Rodríguez H,Aguayo-Albasini J L,Soria-Aledo V,et al.Surgical Smoke:Risks and Preventive Measures[J].Cir Esp,2009,85(5):274-279.
[10]Weld K J,Dryer S,Ames C D,et al.Analysis of Surgical Smoke Produced by Various Energy-Based Instruments and Effect on Laparoscopic Visibility[J].J Endourol,2007,21(3):347-351.
[11]Capizzi P J,Clay R P,Battey M J.Microbiologic Activity in Laser Resurfacing Plume and Debris[J].Lasers Surg Med,1998,23(3):172-174.
[12]Hallmo P,Naess O.Laryngeal Papillomatosis with Human Papillomavirus DNA Contracted by a Laser Surgeon[J].Eur Arch Otorhinolaryngol,1991,248(7):425-427.
[13]Garden J M,O’Banion M K,Shelnitz L S,et al.Papillo-mavirus in the Vapor of Carbon Dioxide Laser-Treated Verrucae[J].JAMA,1988,259(8):1199-1202.
[14]Johnson G K,Robinson W S.Human Immunodeficiency Virus-1(HIV-1)in the Vapors of Surgical Power Instru-ments[J].J Med Virol,1991,33(1):47-50.
[15]Barrett W L,Garber S M.Surgical Smoke:A Review of the Literature.Is This Just a Lot of Hot Air[J].Surg Endosc,2003,17(6):979-987.
[16]Fletcher J N,Mew D,DesCteaux J G.Dissemination of Melanoma Cells Within Electrocautery Plume[J].Am J Surg,1999,178(1):57-59.
[17]Hoye R C,Ketcham A S,Riggle G C.The Airborne Dis-semination of Viable Tumor Cells by High Energy Neo-dynium Laser[J].Life Sci,1967(6):119-125.
[18]Champault G,Taffinder N,Ziol M,et al.Cells Are Present in the Smoke Created during Laparoscopic Surgery[J].Br J Surg,1997,84(7):993-995.
[19]Oosterhuis J W,Verschueren R C,Eibergen R,et al.The Viability of Cells in the Waste Products of CO 2-Laser E-vaporation of Cloudman Mouse Melanomas[J].Cancer,1982,49(1):61-67.
[20]Nduka C C,Poland N,Kennedy M,et al.Does the Ultra-sonically Activated Scalpel Release Viable Airborne Can-cer Cells[J].Surg Endosc,1998,12(8):1031-1034.
[21]Nezhat C,Seidman D S,Vreman H J,et al.The Risk of Carbon Monoxide Poisoning after Prolonged Laparoscopic Surgery[J].Obstet Gynecol,1996,88(5):771-774.
[22]Anonymous.Acrylonitrile[J].Lancet,1984(8338):1221.
[23]Alp E,Bijl D,Bleichrodt R P,et al.Surgical Smoke and Infection Control[J].J Hosp Infect,2006,62(1):1-5.
[24]Al Sahaf O S,Vega-Carrascal I,Cunningham F O,et al.Chemical Composition of Smoke Produced by High-Fre-quency Electrosurgery[J].Ir J Med Sci,2007,176(3):229-232.
[25]Bigony L.Risks Associated with Exposure to Surgical Smoke Plume:A Review of the Literature[J].AORN J,2007,86(6):1013-1020.
[26]潘静,李亚洁.手术烟雾对职业暴露人群健康影响的初步研究[J].护理学报,2012,19(3A):5-8.
[27]Hallmo P,Naess O.Laryngeal Papillomatosis with Human Papillomavirus DNA Contracted by a Laser Surgeon[J].Eur Arch Otorhinolaryngol,1991,248(7):425-427.
[28]Gloster H M Jr,Roenigk R K.Risk of Acquiring Human Papillomavirus from the Plume Produced by the Carbon Dioxide Laser in the Treatment of Warts[J].J Am Acad Dermatol,1995,32(3):436-441.
[29]Ishida H,Murata N,Idezuki Y.Increased Insufflation Pres-sure Enhances the Development of Liver Metastasis in a Mouse Laparoscopy Model[J].World J Surg,2001,25(12):1537.
[30]王灏,郑民华,张浩波.CO 2气腹对人肿瘤细胞腹腔镜戳口种植的影响[J].外科理论与实践,1999,4(3):141-143.
[31]Leister I,Manegold S,Schüler P,et al.Effect of Laparoto-my and CO 2 Pneumoperitoncum on Tumor Growth of Hu-man Colon Carcinoma and Expression Pattern of Tumor-Associated Proteins in the SCID Mouse[J].Int J Coloreetal Dis,2003,18(10):508-513.
[32]Gatti J E,Bryant C J,Noone R B,et al.The Mutagenicity of Electrocautery Smoke[J].Plast Reconstr Surg,1992,89(5):781-784.
[33]Tomita Y,Mihashi S,Nagata K,et al.Mutagenicity of Smoke Condensates Induced by CO 2-Laser Irradiation and Electro-cauterization[J].Mutat Res,1981,89(2):145-149.
[34]Sugimura T,Wakabayashi K,Nakagama H,et al.Hetero-cyclic Amines:Mutagens/Carcinogens Produced during Cooking of Meat and Fish[J].Cancer Sci,2004,95(4):290-299.
[35]Commoner B,Vithayathil A J,Dolara P,et al.Formation of Mutagens in Beef and Beef Extract during Cooking[J].Science,1978,201(4359):913-916.
[36]Sugimura T,Nagao M,Kawachi T,et al.Mutagen-Carcino-gens in Foods with Special Reference to Highly Mutagenic Pyrolytic Products in Broiled Foods.In:Hiatt HH,Watson JD,Winsten JA,Eds.Origins of Human Cancer.Cold Spring Harbor[M].NY:Cold Spring Harbor Laboratory Press,1977:1561-1577.
[37]张徐军,沈孝兵,汪国雄,等.高频电刀术中烟雾致遗传毒性作用的实验研究[J].南京铁道医学院学报,1999,18(3):166-167.
[38]卫生部.中华人民共和国卫生行业标准-医院空气净化管理规范(WS/T368-2012)[S].
[39]李怡哲.一种医用手术可调电刀吸烟装置:中国,201110459659.2012-08-01[P/OL].[2012-08-02].http://zhuanli.baidu.com/pages/sipo/20111045/96/812f5b7afeeed8c701b32a91c50e 684e_0.html.
[2]Hensman C,Baty D,Willis R G,et al.Chemical Composi-tion of Smoke Produced by High-Frequency Electrosurgery in a Closed Gaseous Environment.An in Vitro Study[J].Surg Endosc,1998,12(8):1017-1019.
[3]Ball K.Surgical Smoke:Is It Safe to Breathe[J].Todays Surg Nurse,1996,18(5):16-21.
[4]Hoglan M.Potential Hazards from Electrosurgery Plume-Recommendations for Surgical Smoke Evacuation[J].Can Oper Room Nurs J,1995,13(4):10-16.
[5]Hazard Control.Control of Smoke from Laser/Electric Surgi-cal Procedures[S].Niosh,1998.
[6]ANSI.American National Standard Safe Use of Lasers Health Care Facilities[S].American Nationalstandard,2005.
[7]AORN.Recommended Practices for Laser Safety.Recom-mended Practice IV[EB/OL].(2004-04-02).Http://Findarti-cles.Com/P/Articles/Mi_M0fsl/Is_4_79/Ai_N6074242/.
[8]Spearman J,Tsavellas G,Nichols P.Current Attitudes and Practices Towards Diathermy Smoke[J].Ann R Coll Surg Engl,2007,89(2):162-165.
[9]Carbajo-Rodríguez H,Aguayo-Albasini J L,Soria-Aledo V,et al.Surgical Smoke:Risks and Preventive Measures[J].Cir Esp,2009,85(5):274-279.
[10]Weld K J,Dryer S,Ames C D,et al.Analysis of Surgical Smoke Produced by Various Energy-Based Instruments and Effect on Laparoscopic Visibility[J].J Endourol,2007,21(3):347-351.
[11]Capizzi P J,Clay R P,Battey M J.Microbiologic Activity in Laser Resurfacing Plume and Debris[J].Lasers Surg Med,1998,23(3):172-174.
[12]Hallmo P,Naess O.Laryngeal Papillomatosis with Human Papillomavirus DNA Contracted by a Laser Surgeon[J].Eur Arch Otorhinolaryngol,1991,248(7):425-427.
[13]Garden J M,O’Banion M K,Shelnitz L S,et al.Papillo-mavirus in the Vapor of Carbon Dioxide Laser-Treated Verrucae[J].JAMA,1988,259(8):1199-1202.
[14]Johnson G K,Robinson W S.Human Immunodeficiency Virus-1(HIV-1)in the Vapors of Surgical Power Instru-ments[J].J Med Virol,1991,33(1):47-50.
[15]Barrett W L,Garber S M.Surgical Smoke:A Review of the Literature.Is This Just a Lot of Hot Air[J].Surg Endosc,2003,17(6):979-987.
[16]Fletcher J N,Mew D,DesCteaux J G.Dissemination of Melanoma Cells Within Electrocautery Plume[J].Am J Surg,1999,178(1):57-59.
[17]Hoye R C,Ketcham A S,Riggle G C.The Airborne Dis-semination of Viable Tumor Cells by High Energy Neo-dynium Laser[J].Life Sci,1967(6):119-125.
[18]Champault G,Taffinder N,Ziol M,et al.Cells Are Present in the Smoke Created during Laparoscopic Surgery[J].Br J Surg,1997,84(7):993-995.
[19]Oosterhuis J W,Verschueren R C,Eibergen R,et al.The Viability of Cells in the Waste Products of CO 2-Laser E-vaporation of Cloudman Mouse Melanomas[J].Cancer,1982,49(1):61-67.
[20]Nduka C C,Poland N,Kennedy M,et al.Does the Ultra-sonically Activated Scalpel Release Viable Airborne Can-cer Cells[J].Surg Endosc,1998,12(8):1031-1034.
[21]Nezhat C,Seidman D S,Vreman H J,et al.The Risk of Carbon Monoxide Poisoning after Prolonged Laparoscopic Surgery[J].Obstet Gynecol,1996,88(5):771-774.
[22]Anonymous.Acrylonitrile[J].Lancet,1984(8338):1221.
[23]Alp E,Bijl D,Bleichrodt R P,et al.Surgical Smoke and Infection Control[J].J Hosp Infect,2006,62(1):1-5.
[24]Al Sahaf O S,Vega-Carrascal I,Cunningham F O,et al.Chemical Composition of Smoke Produced by High-Fre-quency Electrosurgery[J].Ir J Med Sci,2007,176(3):229-232.
[25]Bigony L.Risks Associated with Exposure to Surgical Smoke Plume:A Review of the Literature[J].AORN J,2007,86(6):1013-1020.
[26]潘静,李亚洁.手术烟雾对职业暴露人群健康影响的初步研究[J].护理学报,2012,19(3A):5-8.
[27]Hallmo P,Naess O.Laryngeal Papillomatosis with Human Papillomavirus DNA Contracted by a Laser Surgeon[J].Eur Arch Otorhinolaryngol,1991,248(7):425-427.
[28]Gloster H M Jr,Roenigk R K.Risk of Acquiring Human Papillomavirus from the Plume Produced by the Carbon Dioxide Laser in the Treatment of Warts[J].J Am Acad Dermatol,1995,32(3):436-441.
[29]Ishida H,Murata N,Idezuki Y.Increased Insufflation Pres-sure Enhances the Development of Liver Metastasis in a Mouse Laparoscopy Model[J].World J Surg,2001,25(12):1537.
[30]王灏,郑民华,张浩波.CO 2气腹对人肿瘤细胞腹腔镜戳口种植的影响[J].外科理论与实践,1999,4(3):141-143.
[31]Leister I,Manegold S,Schüler P,et al.Effect of Laparoto-my and CO 2 Pneumoperitoncum on Tumor Growth of Hu-man Colon Carcinoma and Expression Pattern of Tumor-Associated Proteins in the SCID Mouse[J].Int J Coloreetal Dis,2003,18(10):508-513.
[32]Gatti J E,Bryant C J,Noone R B,et al.The Mutagenicity of Electrocautery Smoke[J].Plast Reconstr Surg,1992,89(5):781-784.
[33]Tomita Y,Mihashi S,Nagata K,et al.Mutagenicity of Smoke Condensates Induced by CO 2-Laser Irradiation and Electro-cauterization[J].Mutat Res,1981,89(2):145-149.
[34]Sugimura T,Wakabayashi K,Nakagama H,et al.Hetero-cyclic Amines:Mutagens/Carcinogens Produced during Cooking of Meat and Fish[J].Cancer Sci,2004,95(4):290-299.
[35]Commoner B,Vithayathil A J,Dolara P,et al.Formation of Mutagens in Beef and Beef Extract during Cooking[J].Science,1978,201(4359):913-916.
[36]Sugimura T,Nagao M,Kawachi T,et al.Mutagen-Carcino-gens in Foods with Special Reference to Highly Mutagenic Pyrolytic Products in Broiled Foods.In:Hiatt HH,Watson JD,Winsten JA,Eds.Origins of Human Cancer.Cold Spring Harbor[M].NY:Cold Spring Harbor Laboratory Press,1977:1561-1577.
[37]张徐军,沈孝兵,汪国雄,等.高频电刀术中烟雾致遗传毒性作用的实验研究[J].南京铁道医学院学报,1999,18(3):166-167.
[38]卫生部.中华人民共和国卫生行业标准-医院空气净化管理规范(WS/T368-2012)[S].
[39]李怡哲.一种医用手术可调电刀吸烟装置:中国,201110459659.2012-08-01[P/OL].[2012-08-02].http://zhuanli.baidu.com/pages/sipo/20111045/96/812f5b7afeeed8c701b32a91c50e 684e_0.html.