隨著醫(yī)療新技術(shù)和新的手術(shù)工具的不斷涌現(xiàn)，帶動了手術(shù)量的迅猛上升，而且手術(shù)室是醫(yī)學(xué)技術(shù)與工程技術(shù)結(jié)合的產(chǎn)物，下面來講講手術(shù)室建設(shè)要求以及手術(shù)室感染控制原則是怎樣的？

With the continuous emergence of new medical technologies and new surgical tools, the number of operations has increased rapidly. Moreover, the operating room is the product of the combination of medical technology and engineering technology. What are the requirements of the operating room and the principles of infection control in the operating room?

手術(shù)室的要求

Operating room requirements

手術(shù)室是醫(yī)院中無菌潔凈要求很嚴(yán)格的地方之一，手術(shù)室的建設(shè)、布局、工作流程和治理都是圍繞無菌要求設(shè)計的。

The operating room is one of the places in the hospital with strict aseptic and clean requirements. The construction, layout, work flow and management of the operating room are designed around the aseptic requirements.

手術(shù)室又是醫(yī)療設(shè)備密集的科室，除手術(shù)床、無影燈外，麻醉機(jī)、監(jiān)護(hù)、電刀以及自體血回收機(jī)、手術(shù)顯微鏡、影像系統(tǒng)等已成為手術(shù)常用設(shè)備。隨著技術(shù)的發(fā)展，新的手術(shù)工具不斷涌現(xiàn)，如各類軟硬內(nèi)窺鏡下手術(shù)、導(dǎo)航設(shè)備、立體定位系統(tǒng)、手術(shù)機(jī)器人等微創(chuàng)手術(shù)輔助設(shè)備等，如此眾多的設(shè)備擁擠在手術(shù)室內(nèi)，對設(shè)備布局、安裝、配電及用電安全提出了更高的要求。

The operating room is also a department with dense medical equipment. In addition to the operating table and shadowless lamp, anesthesia machine, monitoring, electric knife, autologous blood recovery machine, operating microscope and imaging system have become common equipment for surgery. With the development of technology, new surgical tools are constantly emerging, such as various soft and hard endoscopic surgery, navigation equipment, stereo positioning system, surgical robot and other minimally invasive surgical auxiliary equipment. So many equipment are crowded in the operating room, which puts forward higher requirements for equipment layout, installation, power distribution and power safety.

另外，現(xiàn)在各家醫(yī)院分散建設(shè)的導(dǎo)管室、膀胱鏡室等，有些也是參照手術(shù)室要求建立起來的準(zhǔn)手術(shù)室。尤其是開展參與治療的導(dǎo)管室，基本上是嚴(yán)格按照手術(shù)室的規(guī)范治理和使用，這些科室廣義上說也是擴(kuò)展的手術(shù)室。這些準(zhǔn)手術(shù)室在老醫(yī)院都是見縫插針式地建設(shè)，新建醫(yī)院應(yīng)該綜合考慮這些科室與常規(guī)手術(shù)室間的布局安排。

In addition, some of the catheter rooms and cystoscopy rooms scattered in various hospitals are also quasi operating rooms established according to the requirements of operating rooms. In particular, the catheter rooms involved in the treatment are basically managed and used in strict accordance with the specifications of the operating room. In a broad sense, these departments are also expanded operating rooms. These quasi operating rooms are built in the old hospital in a timely manner. The new hospital should comprehensively consider the layout between these departments and the conventional operating rooms.

手術(shù)室感染控制原則

Principles of infection control in operating room

防止和降低手術(shù)感染是手術(shù)室建設(shè)很基本的要求，感染控制的方法有：

Preventing and reducing surgical infection is a very basic requirement for the construction of the operating room. The methods of infection control include:

(1)通過術(shù)前備皮和術(shù)中對非手術(shù)區(qū)域的無菌覆蓋，減少患者自身感染；(2)對手術(shù)用具和物品的嚴(yán)格消毒或隔離，減少外源接觸感染；(3)降低空氣中的灰塵和微生物粒子，減少懸浮污染物的擴(kuò)散感染；(4)使用抗生素。這是一種補(bǔ)救措施，其靠藥物往控制已發(fā)生的感染。

(1) Through preoperative skin preparation and aseptic coverage of non-surgical areas during the operation, the patient's self infection can be reduced; (2) Strictly disinfect or isolate surgical instruments and articles to reduce external contact infection; (3) Reduce the dust and microbial particles in the air and reduce the diffusion and infection of suspended pollutants; (4) Use antibiotics. This is a remedial measure that relies on drugs to control the infection that has occurred.

我國目前普遍存在的題目是，只注重預(yù)防感染結(jié)果，而忽略了對感染的全過程控制。臨床表現(xiàn)是依靠大量抗生素來減少術(shù)后感染率，而對手術(shù)無菌過程缺乏嚴(yán)格控制。

At present, the common problem in our country is that we only pay attention to the prevention of infection results and neglect the whole process control of infection. The clinical manifestation is to rely on a large number of antibiotics to reduce the postoperative infection rate, while the aseptic process of the operation lacks strict control.

為減少抗生素的濫用，必須進(jìn)步手術(shù)室潔凈水平，嚴(yán)格無菌操縱和治理，加強(qiáng)對整個手術(shù)過程的控制，切斷所有可能的污染途徑(包括空氣)，阻止細(xì)菌接觸手術(shù)創(chuàng)口進(jìn)進(jìn)人體。

In order to reduce the abuse of antibiotics, it is necessary to improve the cleanliness level of the operating room, strictly control the aseptic operation and treatment, strengthen the control of the whole operation process, cut off all possible pollution channels (including air), and prevent bacteria from contacting the surgical wound and entering the human body.