The lighting of the hottest operating room used to

  • Detail

The lighting of the operating room used to be so particular

in order to maintain a good and stable light environment in the operating room, the operating room should avoid direct sunlight, preferably facing north, and can also be shielded by colored glass to facilitate artificial lighting. The artificial lighting in the operating room is divided into general lighting, operating table key lighting, film viewing lamp lighting, signal lamp lighting, etc

illuminance selection

the general horizontal illuminance of the operating room is not less than 500lx. It is recommended to use 750-1500lx for new hospitals, and the vertical illuminance is not less than 1/2 of the horizontal illuminance

selection of light source

due to the high requirements of general lighting illumination in the operating room, the installation position of lamps and lanterns is often limited by the number and location of air supply outlets and other equipment, which requires that the specified high illumination should be met, and the number of lamps and lanterns should be limited to an appropriate range. At the same time, taking into account the requirements of air conditioning and energy saving in the operating room, the calorific value of bulbs should be as small as possible. It is recommended to use LED light source, because LED is a cold light source, There is almost no temperature rise in the room, and the patients do not feel uncomfortable. At the same time, the risk of dehydration caused by light source irradiation is avoided. In addition, it can also appropriately reduce the energy consumption of indoor air conditioning; The color rendering of general lighting sources in the operating room should be close to natural light, preferably between 4000-5000k, and the color rendering index RA ≥ 90

limit stroboscopic and electromagnetic pollution

traditional inductive ballasts should not be used for general lighting in the operating room. Lamps powered by traditional inductive ballasts will produce stroboscopic LIGHTS 100 times per second for 50Hz electricity due to the influence of zero crossing of electric alternating current. Doctors perform intense work under this constantly changing stroboscopic light source. The visual system needs to constantly adjust the size of the pupil of the eye to ensure the stability of the illumination of the visual film and the clarity of the image. Long-term work will inevitably make the pupil sphincter tired due to excessive use, which will not only bring adverse effects to the operation, but also cause certain damage to the doctor's vision. At the same time, the AC buzzer phenomenon of the traditional inductive ballast will also interfere with the operation. Traditional inductive ballasts also have disadvantages of high power consumption and low power factor, and the lighting efficiency of lamps powered by them is also low

AC electronic ballast is a new rectifier composed of rectifier filter, high-frequency oscillation and rectifier coil protection circuit. As the power frequency is greatly increased to 55KHz, even 80kHz and 100kHz, the flicker frequency of the lamp is correspondingly increased to the area where the human eye is not sensitive, which alleviates the stroboscopic effect. At the same time, it also completely eliminates the buzzer interference, greatly reduces the power consumption and improves the power factor of the lamp. Electronic ballasts have great advantages because of their strong starting ability under low voltage, but unfortunately, the ultra-high frequency of this ballast also brings another adverse effect, that is, the electromagnetic interference generated by high-frequency oscillation, that is, the higher the power frequency, the more serious the electromagnetic radiation phenomenon. With the development of modern medical technology, the use of precision electronic medical equipment in the operating room is increasing. The impact of electromagnetic interference of many electronic ballasts on the normal use of these equipment cannot be ignored. For example, in cardiothoracic surgery, when patients install cardiac pacemakers and other equipment, they may also be dangerous due to the impact of electromagnetic interference

to sum up, to solve these two problems, it is recommended to use LED light source lamps. Because the LED working mode is driven by external or internal power supply, and ballast is not required, the problem of stroboscopic can be effectively solved. LED lamps with good quality can almost achieve no stroboscopic; In addition, the use of high-end isolated power supply can effectively reduce the electromagnetic interference of lamps to precision instruments and prolong their service life

selection, installation and control mode of lamps

in order to prevent the accumulation of bacteria and dust and maintain a clean working environment, attention should be paid to the selection and installation of lighting lamps in the operating room:

(1) the external shape of lamps should be simple, not easy to accumulate dust and easy to wipe. Generally, ordinary grille lamps are not used, but closed lamps with isolation covers are used, which can not only prevent dust, but also suppress glare

(2) the lamps in the operating room should not be suspended, but should be installed on the top of the ceiling. At this time, the joint between the lamp and the ceiling should be reliably sealed to prevent dust particles or bacteria from penetrating along the gap. However, in the laminar flow clean operating room, in order to avoid protruding and uneven dust accumulation, during installation, the lighting lamps should be fully embedded in the ceiling. At this time, in addition to the reliable sealing of the installation gap, the lamp structure should be easy to clean, It is convenient to replace lamps and lanterns under the ceiling and repair and maintenance

(3) the general lighting fixtures in the operating room should be evenly arranged on the ceiling around the shadowless lamp. Attention should be paid to the close cooperation with the construction and equipment disciplines, avoiding the air outlet and other facilities. The uniformity of illumination of general lighting should not be less than 0.7; In order to maintain the coordination with the illumination of shadowless lamps, the general lighting fixtures in the operating room should adopt the dimmable control mode

in addition, due to the particularity of the hospital operating room environment, led purification lamps with sterilization, air purification and other functions can also be selected. In addition to the advantages of LED lamps, this kind of lamp is coated with nano photocatalyst materials. Under the irradiation of light, it produces a photocatalysis reaction similar to photosynthesis, produces free hydroxyl groups and reactive oxygen species with strong oxidation capacity, has strong photo oxidation and reduction function, can oxidize and decompose various organic compounds and some inorganic substances, and can destroy the cell membrane of bacteria and solidify the protein of virus, It can kill bacteria and decompose organic pollutants, and decompose organic pollutants into pollution-free water and carbon dioxide. Therefore, it has strong functions of sterilization, deodorization, mildew prevention, pollution prevention and self-cleaning, air purification, etc

operating table key lighting

the operating table is the lighting center and focus of the operating room. Therefore, the operating table key lighting occupies the primary position in the surgical lighting. The operating table lighting usually adopts the operation shadowless lamp with multiple mirrors. The operation shadowless lamp with large disc structure is mostly used in the conventional operating room, which is suspended on the ceiling above the operating table and can be moved horizontally and vertically as required and fixed. It has high illumination and good shadowless effect. The plan clearly points out the advantages of cultivating and developing strategic emerging industries

the clean operating room adopts the air purification measures of vertical laminar flow and positive pressure air supply, and the air supply outlet is also set on the ceiling above the operating table. In order not to hinder the purified air flow from the top of the operation to the operation area, the small ceiling fixed shadowless lamp is usually combined with the multi head universal joint suspension structure lamp cap of the ceiling fixed base, and a number of small lamp caps are combined into a surgical shadowless lamp with the help of connecting rods, Each connecting rod can provide 360 ° horizontal and vertical flexible adjustment and can be fixed in any position. The installation position should be coordinated with the indoor air supply outlet and other fixed devices, taking into account the lighting and purification effects. The position of the adjusting plate should be above the air supply surface, and the distance from the air supply surface should not be less than 5cm

the illumination requirements of the operation shadowless lamp on the working surface vary greatly with the operation type, mostly in 2 × 104—1 × 105lx。 For example, thoracic surgery requires the highest illumination, up to 6 × 104—1 × 105lx, and dental surgery overcomes the shortcomings of the traditional power cord zigzag experimental machine. 10000lx can meet the requirements

the light source selection of the surgical shadowless lamp should meet the following four conditions:

① the color temperature of the light source should be intermediate color (white), which should not be too high for blue color temperature, nor too low for red color temperature, and should be between 3500-6700k, so that human tissue can achieve good color fidelity

② the color rendering index of the light source should be close to natural light (ra=100), so that doctors can clearly identify the actual state of various tissues and organs and correctly judge whether the surgical site has lesions

③ the stroboscopic effect of light source should be strictly prohibited, because during the operation, surgeons and assistants often work intensively in a dark field of vision for a long time. If the operating lamp has stroboscopic, it will increase the burden on the operator's vision, cause visual fatigue, and easily make the operator have illusions and bring adverse consequences

④ the light source of the operating lamp should have a long service life

at present, the operation shadowless lamp with LED as the light source has the following five advantages that the traditional operation shadowless lamp cannot match:

① cold light source, almost no temperature rise in the process of surgical treatment, the operator and patient do not feel extremely uncomfortable, and at the same time, the dehydration risk that may be caused by the traditional light source is avoided

② cold white light with a color temperature of more than 4300k, which is closest to natural light, is used. Its light quality is much better than that of traditional light sources, and the CRI of LED is more than 95. This ideal index makes it possible to maintain the 95 standard in the dark spot, so that the operator can make a better judgment in the process of surgery

③ the color temperature is adjustable, and the light is mixed by the control system and the chip luminescence, so as to realize the change of multiple colors and the formation of images, effectively alleviate the visual fatigue of doctors in surgery, distinguish fresh and necrotic tissues, and improve the quality of surgery; ④ LED lights are shock-resistant, impact resistant and not easy to be damaged. Waste not only needs to ensure that the quality of equipment can be recycled at the time of purchase, but also has no mercury pollution. It is a real environmental protection and energy-saving product; Meet the JCI certification with "patient safety" as the core of the hospital. The core values of the evaluation are: reduce risks, ensure safety, and continuously correct medical quality

⑤ long service life, up to more than 50000h, saving electric energy

film viewing lamp lighting

X-ray film viewing lamp should be set in the operating room as required. In order to keep clean, save space and facilitate observation, the film viewing lamp is generally set opposite to the main knife doctor, which is embedded in the wall. The front side is flush with the wall, and the joints are glued and sealed, or the four sides are made of stainless steel flanging. The convenience of replacing the internal light source should be considered

the number of film viewing lamps in the operating room can be considered according to the size and type of the operating room, and it can be agreed with professional medical personnel. Generally, 3-5 lamps are the most common (considering clamping diagnostic films and reference standard films at the same time). Regardless of the number of wall mounted film viewing lamps, the height is usually 400-600mm. Standing observation is considered in the operating room, and the installation height of film viewing lamps can be +1300-1400mm from the bottom edge to the indoor floor. Generally, nearly all aviation and aerospace flights of each light are controlled by chemical drive separately, and the switch is permanently on the control panel at the lower side of the light

the brightness of medical film viewing lamp has an important impact on the diagnostic quality of X-ray film. The film viewing lamp with low brightness can intercept the density image recorded by the film, resulting in misdiagnosis or missed diagnosis. Therefore, the maximum brightness of the film viewing lamp center should not be less than 4200cd/m2, and the brightness difference of the observation screen should not be greater than 15%. When extremely high brightness is required (for observing high-density X-ray films), strong light should be equipped in the light box

the continuous dimmable control mode (including light source and strong light) should be adopted for the medical film viewing lamp in the operating room. There are two reasons: ① the central operating Department of general hospitals often carries out various types of operations, and the dimmable film viewing lamp can adapt to the reading of X-ray films with various optical densities; ② Generally, the illumination of the operating room is very high, and it is dimmable. The film viewing lamp also adopts dimming control mode, which is easy to balance with the external light source of the film reading environment. In addition, it should also be noted that other lighting sources should not direct the film viewing lamp, so as not to reduce the film reading effect

signal lighting

with the entry of various modern medical equipment into the operating room, the lighting of operating room indicator lights has attracted more and more attention, mainly including:

operating door lights. The operation door light indicates that the operation is in progress. Red signal light or red "operation" can be used

Copyright © 2011 JIN SHI