传染性隔离病房空气环境特性研究
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摘要
“非典”疫情爆发初期,由于医院等卫生设施内通风空调系统不合理,造成了大量的空气交叉污染,使其成为了最主要的感染源之一。为了长期应对“非典”及其它类似的潜在危机,从而有效地预防和控制传染性疾病的传播和蔓延,当今社会对于医疗机构包括医疗设施都提出了新的、更高的要求。传染性隔离病房作为其中的重要组成部分,承担着为患者提供安全舒适的治疗场所、保护医护人员和周围环境安全的重要使命,因此,对传染性隔离病房给予足够重视并对其进行更深入的研究是十分必要的。
     但是长期以来,我国传染性隔离病房的建设就一直缺乏统一的监督和管理,国家也缺乏相应的建设和验收标准。就目前国内外有关传染性隔离病房的规范、指南而言,也只是规定了一些原则上的内容,而缺乏具体的操作细则;其次,各国标准之间也相互存在有歧异。因此,针对目前传染性隔离病房建设中遇到的主要问题,本文在深入调查传染病医院等重点场所的基础上,利用中国建筑科学院空调所的传染性隔离病房试验室,结合各相关学科知识,特别是现有的比较成熟的生物安全建筑技术,从污染控制与节约能源的角度出发,通过理论分析、试验研究和数值模拟相结合的方法开展了以下几个方面的工作:
     (1)、对各国目前在传染性隔离病房方面取得的成果及其相关的建设标准(各设计参数指标和技术措施)进行了分析和比较。同时,对传染性隔离病房等负压洁净室应采用静态控制手段与全过程动态控制手段相结合的理念进行了研究和探讨。
     (2)、利用流体力学、空气洁净技术、污染控制技术、数学物理回归分析等基本原理和经验公式或方法对传染性隔离病房的主要设计指标以及影响污染物外泄的各种因素进行了相关的理论探讨;与此同时,利用隔离病房试验室对其主要技术参数进行了烟雾气溶胶以及微生物气溶胶的试验研究,对典型的试验工况进行了分析总结;最后,应用室内流场数值分析理论和CFD软件对上述隔离病房实体模型进行了1:1的三维紊流流动模拟,通过研究病房在不同送、排风组合工况下病患污染物排出的典型流线图、送风口到排风口的典型流线图以及病患污染物浓度无量纲分布图,分析了不同工况下主要参数指标对降低污染物浓度以及减少交叉感染的具体效果。
     (3)、综合考虑实际病房内病人的数量、病人发菌浓度以及病房的体积等因素,对理论探讨和试验研究以及数值模拟的结果进行了比较分析,并得到了一些定量和定性的有益结论,对今后合理设计单病床及多病床传染性隔离病房具有一定的参考价值。
In the early days of SARS epidemic situation, it is very clear that cross infection which is the main headstream happened frequently because of the poor ventilating and air conditioning systems for infectious isolation wards in hospitals. After that, some unprecedented and rigorous demands have been put forward for the disease control and prevention. As the most important factor, firstly, it provides a safe and comfortable treat environment; Secondly, it can protect doctors keeping away from any risks; The last but not least, it can ensure that outside setting is also in safe conditions. In conclusion, it is very necessary to pay attention to infectious isolation ward and do some embedded research for it.
    However, it is short of surveillance and administration for the construction of infectious isolation wards for a long time, accordingly, design and test standards are also inexistent. As far as codes or guidelines are concerned, some basic principles can be found but detailed rules; besides this, there are some obvious differences among the standards existed. So, aimed at main problems we have fell across in the actual projects and based on research in some places such as infectious disease hospitals etc, we have done a lot of tasks in the laboratory which was built by CABR according to correlative information especially biosafety and building technique. In this paper, theoretic analysis, testing study and numerical simulation have been done in term of contamination control and energy conservation. The main contents are as follows:
    (1)、 Some research productions and relative building standards(including design parameters and technical measures) existed in some representative countries have been analyzed and compared. And then, a new concept which combined static state controlling measures with dynamic state controlling measures in the whole process has also been done. (2) 、 Using of some basic principles and experimental formulae or methods of hydrodynamics、 air cleaning technique、 contamination controlling、 mathematical and physical regression function, theoretic analysis have been done about different design indexes and detailed impacts on contamination leakage that resulted from each possible ingredient; And then, a lot of experiments employed by smog aerosol and microorganism aerosol have been done in the laboratory that was built by CABR, from the testing results, analysis and summarization are done for typical experimental items; lastly, using of numerical theory and CFD, numerical simulation have been completed according to 1:1 entity model, representative streamline of the patient contamination 、 representative streamline from inlets to outlets、 dimensionless concentration distributing drawing of patient contamination for all design conditions have gotten, from the simulation results,
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