【作者】 苏琛；

【导师】 徐新喜；

【作者基本信息】 中国人民解放军军事医学科学院 ， 卫生防护防疫技术与装备， 2011， 博士

【摘要】 舱室空气质量及振动环境是机动卫生装备舱室微环境的重要构成因素,直接关系到舱室内医护人员和伤病员的身体健康、工作效率以及生命安全。本文以提高机动卫生装备舱室微环境质量、实现舱室内人员“安全、高效、舒适”为目标,研究了常规和生化防护两种条件下舱室空气质量及振动环境与人体舒适性、工效性、安全性的关系。分析了常规条件下舱室空气质量与人体舒适性的影响因素,建立了评价指标体系,确定了舒适性各影响因素的等级标准,提出了舒适性评价的灰色关联度方法。以某急救车为例,研究了高温、高湿条件下开启制冷空调30min和60min时舱室内卧姿伤病员、坐姿伤病员和站姿医护人员的舒适性。结果表明:高温高湿初始条件下舱室内人体舒适性为“不舒适”等级;30min时卧姿伤病员、坐姿伤病员、站姿医护人员的舒适性等级达到“最舒适”和“舒适”等级;60min时舒适性进一步提高;卧姿伤病员的舒适性优于坐姿伤病员和站姿医护人员的舒适性。分析了常规和生化防护条件下舱室空气质量与人体工效性的影响因素,分别建立了评价指标体系,确定了工效性各影响因素的等级标准,提出了工效性评价的模糊综合方法。以某急救车和手术方舱为例,分别研究了常规条件下高温、高湿环境开启制冷空调30min和60min时舱室内站姿医护人员的工效性和舱室升、降温过程中医护人员的工效性以及生化防护条件下医护人员的工效性。结果表明:高温高湿初始条件下舱室内站姿医护人员处于“工效性一般”等级,开启空调30min时达到“工效性优”等级、60min时工效性进一步提高;外界环境-41时,开启加热系统30min,舱室达到“工效性一般”等级,40min时达到“工效性良”等级;外界环境46时,开启制冷空调12min,舱室达到“工效性一般”等级,28min时达到“工效性良”等级。急救车通过生物污染区域运送和急救伤病员时,在超压防护不开空调和超压防护开启空调两种工况下,舱室整体和医护人员在各采样时刻的工效值均大于4,属于“工效性优”等级,能确保舱室内医护人员工效性不受影响;急救车运送生物污染伤病员或烈性传染病员时,在负压防护不开空调和负压防护开启空调两种工况下,随着舱室内生物污染物的扩散,舱室整体和医护人员工效值急剧降低,5min时工效值降为1,属于“工效性差”等级,舱室内医护人员若无采取有效的个人防护措施,将丧失作业能力。当手术方舱舱室外维埃克斯(VX)气溶胶浓度为0.1mg/L时,除左半区医生1和麻醉师出现中毒症状,基本丧失作业能力外,其他人员工作效率未受到太大影响;舱室右半区医护人员工作效率未受影响。分析了生化防护条件下舱室空气质量与人体安全性的影响因素,建立了评价指标体系,确定了安全性各影响因素的等级标准,提出了安全性评价的污染损失率方法。以某急救车和手术方舱为例,分别研究了急救车运送生物污染伤病员或烈性传染病员时在负压防护条件下舱室内医护人员的安全性和手术方舱遭遇氢氰酸(HCN)袭击时在过滤净化超压防护条件下舱室内医护人员和伤病员的安全性。结果表明:急救车在负压防护不开空调和负压防护开启空调两种工况下,随着舱室内生物污染物的扩散,5min时舱室整体和站姿医护人员的安全性均属于“极危险”等级,舱室内医护人员若无采取有效的个人防护措施,生命安全将受到威胁;当手术方舱舱室外HCN浓度为5mg/L时,除左半区医生1安全性受到威胁外,其他人员安全状况良好;舱室外HCN浓度增加到20mg/L时,舱室内安全程度明显下降,左半区医生1和麻醉师生命安全受到威胁,其他人员作业能力受到影响;在两种情况中,舱室右半区安全性均明显优于左半区,人员安全性较好。分析了舱室振动环境中振动频率、振动加速度和振动暴露时间对伤病员舒适性的影响,依据相关标准确定了舱室振动环境对坐姿和卧姿伤病员舒适性影响的评价方法。选取采用橡胶阻尼减振器和三自由度零刚度减振器两级减振的某履带卫生急救车,通过各种工况条件下的行驶试验,研究了两级减振措施的减振效率以及坐姿和卧姿乘员的振动舒适性。结果表明:一级减振器起到了较好的减振效果,减振效率在56%～80%之间;二级减振器对卧姿乘员的减振效率优于坐姿乘员的减振效率,卧姿乘员舒适性优于坐姿乘员舒适性;两侧卧姿乘员舒适性评价等级处于“舒适”和“基本舒适”之间,且左侧卧姿舒适性总体优于右侧;左侧坐姿乘员舒适降低界限值为0.426h～1.348h,右侧坐姿乘员舒适降低界限值为0.175h～1.401h;左侧隔振型减振器减振效果优于右侧冲击型减振器减振效果。更多还原

【Abstract】 The air quality and vibration condition of compartment play an important role in microenvironment of mobile medical equipment compartment, which have a significant impact on physical health, work efficiency and safety protection of medical personnel and the wounded in compartment. In order to improve the microenvironment and ensure person’s safety, effectiveness, comfortableness , the relationship between human’s comfortableness, effectiveness, safety and air quality, vibration in Mobile Medical Equipment Compartment is studied in this paper, considering normal condition, biology and chemistry protection condition. The indicator system of evaluation is established by analyzing the influencing factors on comfortableness of air quality in compartment under normal condition.The grade standards of comfortableness are ascertained and the method of comfortableness evaluation with grey correlation grade is brought out. With the case of emergency ambulance, the comfortableness of the standing medical personnel and the recumbent and seating wounded is studied under high temperature and high humidity condition when air-condition has worked 30min and 60min. Results show that the comfortableness grade of human in compartment is uncomfortable at beginning. The comfortableness grade of human in compartment is best comfortable and comfortable at 30min. The comfortableness is improved at 60min. Besides, the comfortableness of the recumbent wounded is better than standing medical personnel and the seating wounded.The two indicator systems of evaluation are established by analyzing the influencing factors on effectiveness of air quality in compartment under normal condition, biology and chemistry protection condition. The grade standards of effectiveness are ascertained and the method of effectiveness evaluation with fuzzy comprehensive is brought out. With the case of emergency ambulance, the effectiveness of the standing medical personnel is studied under high temperature and high humidity condition when air-condition has worked for 30min and 60min, and the effectiveness in extreme condition is also studied when temperature is rising and falling. With the case of operation shelter, the effectiveness of the medical personnel is studied under biology and chemistry protection condition. Results show that the effectiveness grade of the standing medical personnel in compartment is generally effective at beginning under high temperature and high humidity condition. When the air-condition is on, the effectiveness grade of the standing medical personnel is best effective at 30min and the effectiveness is improved at 60min. When the outside temperature is -41 , the effectiveness grade of compartment is generally effective at 30min and better effective at 40min. When the outside temperature is 46 , the effectiveness grade of compartment is generally effective at 12min, better effective at 28min. When the emergency ambulance carry and rescue the wounded passing through the biological contamination zone. The effectiveness value of whole compartment and medical personnel are more than 4 under overpressure protection when air-condition is on and off at every sampling time. The effectiveness grade is best effective and the effectiveness of medical personnel in compartment is uninfluenced. When the wounded infected by biological contamination or the patients with strong infectious disease are carried by emergency ambulance, the effectiveness of whole compartment and medical personnel are falling under negative-pressure protection when air-condition is on and off. The effectiveness value is 1 belonging to best effective at 5min. The effectiveness of the medical personnel in compartment is losed if unadopt available protection. When the VX concentration is 0.1mg/L outside the operation shelter, the doctor1 and anaesthetist is poisoned and lose the working ability in left part compartment. The effectiveness of the medical personnel is uninfluenced in right part compartment.The indicator system of evaluation is established by analyzing the influencing factors on safety of compartment air quality under biology and chemistry protection condition. The grade standards of safety are ascertained and the method of safety evaluation with pollution loss rate is brought out. With the case of emergency ambulance, the safety of the medical personnel is studied when the wounded infected by biological contamination or the patients with strong infectious disease are carried. With the case of operation shelter, the safety of the wounded and medical personnel is also studied under filtration and decontamination protection when attacked by HCN. Results show that the safety grade of whole compartment and the medical personnel are most dangerous at 5min under negative-pressure protection when air-condition is on and off. The safety of medical personnel in compartment is most threatened if unadopt available protection. When the HCN concentration is 5mg/L outside the operation shelter, human is safy except the doctor1 in left part compartment. The safety of compartment is falling when the outside HCN concentration is 20mg/L. The safety of doctor1 and anaesthetist in left part compartment is threatened while others’working ability is influenced. Under the both condition, the safety of person in right part compartment is better than the person in left part compartment.The frequency, acceleration, exposure time of vibration are analysed. The method of comfortableness evaluation for the seating and recumbent wounded is confirmed by relevant standards under compartment vibration condition. The tracked emergency ambulance with two-level damping device (rubber damper and 3-dof zero stiffeness damper) is experimented through running test under various road and speed condition. The two-level damping efficiency and ride comfortableness (included recumbent comfortableness and seating comfortableness) is analysed. Results show that the first level damping device has performed good damping efficiency between 56% and 80%. Condidering the second level damping device, the damping efficiency of recumbent is better than seating position while the recumbent comfortableness is better than seating comfortableness. The evaluation grade of recumbent comfortableness on the two sides is comfortable and generally comfortable . The recumbent comfortableness on left is better than recumbent comfortableness on right. The value of reduced comfort boundary is 0.426h～1.348h ( left seating position) and 0.175h～1.401h (right seating position). The damping efficiency of isolation type damper on left is better than the damping efficiency of impact type damper on right.更多还原