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<section data-role="paragraph" data-color="rgb(182, 228, 253)" data-custom="rgb(182, 228, 253)"><section><section><section><section powered-by="gulangu"><section><section><section><section powered-by="gulangu"><section><section><section><section powered-by="gulangu"><section><section><section><section powered-by="gulangu"><section><section><section><section><p><p><img src="image/20201014/86b79d371e9862b01189f0252a03b2cd_1.png" /></p></p></section><section><section><span><strong></strong></span></section><p><span>医疗器械媒体报道先锋</span></p><p><span>分享专业医疗器械知识</span></p></section><section><section><section><span>关注</span></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section><p><br /></p><section powered-by="gulangu"><section><section powered-by="gulangu"><section><p><span>日前，筑医台资讯记者从首都医科大学附属北京儿童医院（以下简称“北京儿童医院”）获悉，医院成功引入一台方舱CT，放置在发热门诊外。发热患者在发热门诊外即可接受CT检查。方舱CT的适时引入，在提高检查效率，改善医疗体验的同时，还有效避免了院内交叉感染。</span></p></section></section></section></section><section powered-by="gulangu"><p><br /></p><p><strong><span>医院口中的方舱CT究竟是什么？</span></strong><br /></p><p><br /></p><section><section powered-by="gulangu"><section><section powered-by="gulangu"><section><section powered-by="gulangu"><section><p><span>方舱CT与方舱医院的概念一脉相承，是一个可独立放置于放射科或影像科之外的CT扫描及诊断单元，虽然面积较一般医院建设的机房小一些，但是配备并无两样，CT接电即可使用。<br /></span></p><p><br /></p><p><span>方舱标配一个扫描间（病人接受扫描的房间）和操作间（医生操作的房间）。扫描间配有电动平移门，方便病人有序进出，室内装修、照明、空调一应俱全。考虑到疫情期间，每个房间配备紫外线杀菌灯，保障机房内空气不被污染，防止检查期间交叉感染。房间布局根据不同设备、不同型号略有偏差，大概面积为30平方米，其中扫描间20-24平方米，操作间4-6平方米，满足设备运行和医生操作需要。</span></p><p><br /></p><p><span>现在市面上的方舱CT分为两类，一类是实际应称为“车载CT”的“方舱CT”。</span></p><p><span><br /></span></p></section></section><section powered-by="gulangu"><section><section powered-by="gulangu"><section><section powered-by="gulangu"><section><p><img src="image/20201014/cb52db04e467df841a570727132669f9_2.jpg" /></p></section><section><br /></section><section><span>还有一类就是我们近期最常见的放置在医院发热门诊门前的，也叫“方舱CT”。</span></section><section><br /></section></section></section></section></section><section><section powered-by="gulangu"><section><section powered-by="gulangu"><section><p><img src="image/20201014/2ff061dbb5834273de9081a0abfa5615_3.jpg" /></p></section><section><br /></section></section></section></section></section></section><section powered-by="gulangu"><section><p><span>随着新冠肺炎的爆发，全国有很多的疑似病例急需确诊，应尽早收治，尽快切断传染源。CT虽然不是诊断新冠肺炎的金标准，在国家卫生健康委员会印发的《新型冠状病毒肺炎诊疗方案》第一至第六版中，也逐渐明确了影像学检查在新冠肺炎疑似病例和临床诊断病例诊断中的重要作用。<br /></span></p><p><br /></p><p><span>新建临时性医院、原来设置了发热门诊但没有专用CT的定点医院，如何在最短的时间建立起一间CT检查室，是摆在眼前的现实问题。这时，对方舱CT的需求应运而生。</span></p></section></section></section></section></section></section></section><p><br /></p><p><span>记者通过电话连线了北京儿童医院方舱CT的辐射防护施工厂家——山东大华医特，了解到，他们是在2月6日接到上海联影CT生产厂家的电话需求，紧急定制一套CT的方舱。</span></p><p><br /></p><p><span>方舱CT这一事物可以说是顺应时代需求产生的，在这之前没有任何的国家标准、行业标准或者其他的执行标准。然而事态紧张，时间就是生命。大华医特立即成立线上研发小组，经过一天的技术交流，当晚这个直接实施人员达到16人的团队便连夜开始了第一台方舱的制作。</span></p><section powered-by="gulangu"><p><br /></p></section></section><section powered-by="gulangu"><section><p><img src="image/20201014/0afd7977febfbaede59d304614b9e9c1_4.jpg" /></p></section></section><section powered-by="gulangu"><p><br /></p></section><section powered-by="gulangu"><p><span>经过7个日夜不停歇的工作，这套名为“昆仑”（寓意这套方舱可以犹如神灵一般，降妖除魔，庇佑祖国）的第一套方舱终于踏上了前往北京之路。</span></p><p><br /></p><p><span>截止到目前，大华医特公司已经制作并安装完成CT应急方舱30套，先后发往北京等多地。实际上，疫情发生后，像大华医特一样的很多辐射防护屏蔽施工厂家，他们在疫情发生的第一时间便与影像设备厂商联合做出积极响应，快速行动，推出了方舱CT，并将其迅速投入战“疫”一线。</span></p></section><section powered-by="gulangu"><p><br /></p></section><section powered-by="gulangu"><section><section powered-by="gulangu"><section><p><span><strong><span>方舱CT的建设要点</span></strong></span></p></section></section></section></section><section powered-by="gulangu"><section><br /></section></section><section powered-by="gulangu"><p><span>近日，医学影像工程与技术分会联合多家单位编写了《方舱CT应用和防护专家建议（第一版）》，其中对方舱CT的结构、布局和防护屏蔽需求等做出了详尽的建议。</span></p></section><section powered-by="gulangu"><section><section><section powered-by="gulangu"><section><section powered-by="gulangu"><p><span><br /></span></p></section></section></section></section><section><section powered-by="gulangu"><section><section><section powered-by="gulangu"><section><p><strong><span>一、方舱CT的结构</span></strong><span></span></p></section></section></section><section><section powered-by="gulangu"><section><section><section powered-by="gulangu"><section><section powered-by="gulangu"><section><p><br /></p></section></section></section></section></section></section></section></section></section></section></section></section></section><section powered-by="gulangu"><section><p><img src="image/20201014/7d8f9c341ca2e715772d50a331db9055_5.png" /></p></section></section><section powered-by="gulangu"><section><p><span>▲ 方舱CT场地平面布局图</span></p><p><span>（房间布局根据不同设备、不同型号略有偏差）</span></p></section></section><section powered-by="gulangu"><p><br /></p></section><section powered-by="gulangu"><section><p><img src="image/20201014/928c831dd26ec022b3a58fe9c018bdd4_6.jpg" /></p></section></section><section powered-by="gulangu"><section><p><span>▲ 方舱CT内景透视图</span></p></section></section><section powered-by="gulangu"><p><br /></p></section><section powered-by="gulangu"><section><section><section powered-by="gulangu"><section><section powered-by="gulangu"><p><strong><span>二、</span><span>方舱CT主要部件及功能</span></strong></p></section></section></section></section></section></section><section powered-by="gulangu"><p><br /></p></section><section powered-by="gulangu"><p><span>方舱CT主要由配电系统、操作间、机房、CT系统、照明设施、智能紫外线杀毒设施、恒温恒湿系统、监控装置、网络通信部件构成。他们的功能如下：</span></p></section><section powered-by="gulangu"><p><br /></p></section><section powered-by="gulangu"><section><section><p><strong><span>1.</span><span>配电系统</span></strong></p></section></section></section><section powered-by="gulangu"><p><br /></p></section><section powered-by="gulangu"><p><span>方舱CT的配电系统主要包括供电线缆，总配电柜、插座、开关等组成。配电系统输入要求为三相380V交流电，功率要求80kW，采用三相五线制。</span></p><p><br /></p><p><span>系统通过总配电柜对方舱CT进行电源分配，总配电柜由2个空气开关和若干熔断开关组成，其中一个空气开关用于给CT系统提供380V交流电；另一个空气开关用于给方舱内部的照明、空调、监控、紫外线杀毒、插座等提供电源。</span></p></section><section powered-by="gulangu"><p><br /></p></section><section powered-by="gulangu"><section><section><p><strong><span>2.</span><span>操作间</span></strong></p></section></section></section><section powered-by="gulangu"><p><br /></p></section><section powered-by="gulangu"><p><span>方舱CT的操作间主要用于进行扫描操作，操作间配套照明、空调、排风扇及紫外线杀毒装置。CT机主要部件操作台也位于操作室，由Console系统、2个显示器、操作键盘POD等组成，可以方便快捷进行各类扫描操作。</span></p></section><section powered-by="gulangu"><p><br /></p></section><section powered-by="gulangu"><section><section><p><strong><span>3.</span><span>机房</span></strong></p></section></section></section><section powered-by="gulangu"><p><br /></p></section><section powered-by="gulangu"><p><span>方舱CT的机房用于病人扫描，机房配套照明、空调、排风扇及紫外线杀毒装置。CT系统的主机即CT机架、诊断床和电源分配单元（PDU）都位于机房内部。机房采用铅屏蔽，达到与医院机房一致的辐射防护要求。同时，机房配备电动移门，用于病人进出。</span></p></section><section powered-by="gulangu"><p><br /></p></section><section powered-by="gulangu"><section><section><section><p><strong><span>4.</span><span>CT系统</span></strong></p></section></section></section></section><section powered-by="gulangu"><p><br /></p></section><section powered-by="gulangu"><p><span>方舱CT的CT系统主要包括CT机架、诊断床、电源分配单元（PDU）和操作台。CT系统为16排32层CT，最高转速0.5s/r，±30°数字倾斜，搭载5.3MHU球管。</span></p><p><br /></p><p><span>CT系统拥有imA智能毫安技术、NDI微剂量迭代、MAS金属伪影抑制算法、线束硬化伪影校正软件、智能胸部反向扫描和智能穿刺定位等高端功能。</span></p></section><section powered-by="gulangu"><p><br /></p></section><section powered-by="gulangu"><section><section><p><strong><span>5.</span><span>照明设施</span></strong></p></section></section></section><section powered-by="gulangu"><p><br /></p></section><section powered-by="gulangu"><p><span>方舱CT的机房和操作间内部安装LED照明灯，提供柔和明亮的光线。</span></p></section><section powered-by="gulangu"><p><br /></p></section><section powered-by="gulangu"><section><section><p><strong><span>6.</span><span>智能紫外线杀毒系统</span></strong></p></section></section></section><section powered-by="gulangu"><p><br /></p></section><section powered-by="gulangu"><p><span>方舱CT的机房和操作间安装有紫外线杀毒系统，能够进行全面消毒不留死角，能够做到一患一消毒。</span></p><p><br /></p><p><span>同时，配套智能控制系统，系统自动识别机房内是否有人，在无人的情况下自动开启紫外线杀毒，当监测到有人进入机房时则自动关闭紫外线系统。有效保护病患和操作者免受紫外线照射的同时，最大限度的提高紫外线杀毒系统的利用率。</span></p></section><section powered-by="gulangu"><p><br /></p></section><section powered-by="gulangu"><section><section><p><strong><span>7.</span><span>恒温恒湿系统</span></strong><span></span></p></section></section></section><section powered-by="gulangu"><p><br /></p></section><section powered-by="gulangu"><p><span>恒温恒湿系统主要由空调和排风扇构成，方舱CT的机房和操作间内都配套有恒温恒湿系统，能够保证方舱CT内部各环境保持在恒定的温度和湿度，保持方舱内外空气的流通顺畅，给操作者和病人提供较为舒适的环境。</span></p></section><section powered-by="gulangu"><p><br /></p></section><section powered-by="gulangu"><section><section><p><strong><span>8.</span><span>监控装置</span></strong><span></span></p></section></section></section><section powered-by="gulangu"><p><br /></p></section><section powered-by="gulangu"><p><span>方舱CT系统的机房配套两个监控探头，实现360°无死角监测机房内设备与病人的实时状态，能够有效的应对突发情况。</span></p></section><section powered-by="gulangu"><p><br /></p></section><section powered-by="gulangu"><section><section><p><strong><span>9.</span><span>网络通信</span></strong><span></span></p></section></section></section><section powered-by="gulangu"><p><br /></p></section><section powered-by="gulangu"><p><span>方舱CT配套5G高速网络通信，支持智能前瞻式远程维护系统，可以动态、实时远程监测设备的运行状况，使售后维保更便捷，更高效。网络端口可集成至医院网络，实现与HIS、RIS、PACS等系统的对接。</span></p></section><section powered-by="gulangu"><p><br /></p></section><section powered-by="gulangu"><section><section><section powered-by="gulangu"><section><section powered-by="gulangu"><p><strong><span>三、</span><span></span><span>方舱CT的辐射防护</span></strong></p></section></section></section></section><section><section powered-by="gulangu"><section><section><section powered-by="gulangu"><section><section><section powered-by="gulangu"><section><section powered-by="gulangu"><section><p><br /></p></section></section></section></section></section></section></section></section></section></section></section></section></section><section powered-by="gulangu"><p><span>辐射安全：方舱CT机房采用铅板防护，配套铅玻璃机房防护门。主防护（球管正上方及左右两侧范围）为5mm/pb铅当量，其余位置4mm/pb铅当量防护要求。</span></p><p><br /></p><p><span>方舱CT(移动式CT机房)应通过第三方检测机构依据《医用X射线诊断防护要求》（GBZ 130-2013），《X射线计算机断层摄影放射防护要求》（GBZ 165-2012）以及《电离辐射防护与辐射安全基本标准》（GB 18871-2002）进行检测并通过。</span></p></section><section powered-by="gulangu"><p><br /></p></section><section powered-by="gulangu"><p><span>安全性及有效性：方舱CT所搭载的CT子系统应取得医疗器械注册证。</span></p></section><section powered-by="gulangu"><p><br /></p></section><section powered-by="gulangu"><section><section><section powered-by="gulangu"><section><section powered-by="gulangu"><p><strong><span>四、</span><span>方舱CT运输安装</span></strong></p></section></section></section></section></section></section><section powered-by="gulangu"><p><br /></p></section><section powered-by="gulangu"><section><p><img src="image/20201014/f0fd441ff5360e889ae558ac24de1c2a_7.png" /></p></section></section><section powered-by="gulangu"><p><br /></p></section><section powered-by="gulangu"><section><section powered-by="gulangu"><section><section><section powered-by="gulangu"><section><p><span>1.</span><span>方舱CT运输前，需要将CT转子与机架进行锁定，避免车辆行驶过程中CT主轴承的旋转及振动冲击。</span></p><p><span><br /></span></p></section></section></section></section></section><section powered-by="gulangu"><section><section><section powered-by="gulangu"><section><p><span>2.</span><span>方舱CT运输前，需要对扫描床的水平以及垂直运动进行锁定，防止车辆在行驶过程中，出现的床板窜动以及额外的冲击载荷。</span></p><p><span><br /></span></p></section></section></section></section></section><section powered-by="gulangu"><section><section><section powered-by="gulangu"><section><p><span>3.</span><span>操作室内的显示器、键盘、椅子等所有部件也需要进行必要的固定。</span></p><p><span><br /></span></p></section></section></section></section></section><section powered-by="gulangu"><section><section><section powered-by="gulangu"><section><p><span>4.</span><span>现场吊装时，起吊机、吊索、吊钩等工具均需要满足13T的承载能力。</span></p><p><span><br /></span></p></section></section></section></section></section><section powered-by="gulangu"><section><section><section powered-by="gulangu"><section><p><span>5.</span><span>方舱落地时根据安装规程进行舱体调平，安装完成后需要检验扫描床的水平。</span></p><p><span><br /></span></p></section></section></section></section></section><section powered-by="gulangu"><section><section><section powered-by="gulangu"><section><p><span>6.</span><span>上电前务必解除CT转子以及扫描床的所有锁定。</span></p><p><span><br /></span></p></section></section></section></section></section><section powered-by="gulangu"><section><section><section powered-by="gulangu"><section><p><span>7.</span><span>方舱CT内部自带电源分配系统，由内部总配电柜进行电源的统一分配。</span><span>方舱CT系统的总输入功率为80kW，输入采用三相五线制；</span><span>方舱内部所有的供电和布线都在出厂前安装固定完成，方舱CT到达现场后无需对内部供电做任何作业。</span></p><p><span><br /></span></p></section></section></section></section></section><section powered-by="gulangu"><section><section><section powered-by="gulangu"><section><p><span>8.</span><span>方舱CT发机前，将外围输入的3根火线、1根零线和1根地线拆除，将线缆盘卷后放入方舱后端底部的箱体即可。</span></p><p><span><br /></span></p></section></section></section></section></section><section powered-by="gulangu"><section><section><section powered-by="gulangu"><section><p><span>9.</span><span>当方舱CT达到指定场所后，只需将3根火线、1根零线和1根地线拉出并按相应顺序连接至外部供电系统，整个方舱CT即可上电运行。</span></p><p><span><br /></span></p></section></section></section></section></section><section powered-by="gulangu"><section><section><section powered-by="gulangu"><section><p><span>10.</span><span>如果运输路途路况较差，或者是运往山区和高原地带，需要在方舱底座和车辆承载面之间添加一层减震材料，通常硬质泡沫是一个比较好的选择。</span><span>对于这种运输路况，需联系厂家决定减震方案。</span></p></section></section></section></section></section></section></section><section powered-by="gulangu"><p><br /></p></section><section powered-by="gulangu"><section><section><section powered-by="gulangu"><section><section powered-by="gulangu"><p><strong><span>五、</span><span>方舱CT设备维护保养</span></strong><span></span></p></section></section></section></section><section><section powered-by="gulangu"><section><section><section powered-by="gulangu"><section><section><section powered-by="gulangu"><section><section powered-by="gulangu"><section><p><br /></p></section></section></section></section></section></section></section></section></section></section></section></section></section><section powered-by="gulangu"><p><span>为了加强CT大型医用设备的使用管理，提高和确保机器设备正常运转，延长其寿命，杜绝人为因素所造成机器故障、损坏，对设备的维护有以下要求：</span></p></section><section powered-by="gulangu"><p><br /></p></section><section powered-by="gulangu"><section><section><p><strong><span>1.</span><span>场地要求</span></strong><span></span></p></section></section></section><section powered-by="gulangu"><p><br /></p></section><section powered-by="gulangu"><p><span>方舱CT选址需尽量避免潮湿、低洼、大型广告牌和各类铁塔底下等不安全区域。设备长期处于潮湿和低洼环境极易引发设备表面防锈漆（油）失效而造成表面锈化现象，长期置于大型广告牌和各类铁塔底下在雷暴天易雷击和损坏。因此在选址时尽量避免太过潮湿低洼等危险环境放置CT。</span></p><p><br /></p><p><span>方舱CT是应对疫情而研发的方舱式应急专用CT，在选址时需考虑疫情对周边环境及居民的污染，阻止疫情的传播。尽量避免在上风口、水源地、人口密集等场所放置CT。</span></p><p><br /></p><p><span>在使用方舱CT时也需考虑到病人与医务人员进入方舱CT通道的硬隔离，搭建隔离墙将方舱CT外的工作人员通道与病人通道隔离开，避免病人误闯入操作室及医患之间的交叉感染。</span></p></section><section powered-by="gulangu"><p><br /></p></section><section powered-by="gulangu"><section><section><p><strong><span>2.</span><span>电源及地线</span></strong><span></span></p></section></section></section><section powered-by="gulangu"><p><br /></p></section><section powered-by="gulangu"><section><section powered-by="gulangu"><section><section powered-by="gulangu"><section><p><span>1.</span><span>电源要求</span></p></section></section></section></section></section></section><section powered-by="gulangu"><p><br /></p></section><section powered-by="gulangu"><p><span>CT设备所用电源要求是独立的专用铜芯电缆、不与其他设备共用，确定医院变压器到方舱CT的距离。电源规格和容量：三相五线制AC380V/80kVA，相间平衡；空气开关规格250A。电源负载变化率5%以下，如果超过必须配稳压器。为了保证CT的正常使用和图像质量，避免由于电压不稳而导致的设备故障，请用户尽量配备稳压器。</span></p></section><section powered-by="gulangu"><p><br /></p></section><section powered-by="gulangu"><section><section powered-by="gulangu"><section><section powered-by="gulangu"><section><p><span>2.</span><span>地线要求</span></p></section></section></section></section></section></section><section powered-by="gulangu"><p><br /></p></section><section powered-by="gulangu"><p><span>方舱CT设备需独立接地，不得与其他设备共用地线，独立接地的接地阻抗值应小于4?。特别在野外及其他特殊环境下需注意需要制作地线，接地处常用水淋湿。连接地线有利于漏电安全保护及防止电磁干扰。</span></p></section><section powered-by="gulangu"><p><br /></p></section><section powered-by="gulangu"><section><section><p><span>3.</span><span>场地环境</span></p></section></section></section><section powered-by="gulangu"><p><br /></p></section><section powered-by="gulangu"><section><section><section powered-by="gulangu"><section><section><section powered-by="gulangu"><section><p><span>1）</span><span>温度要求机房温度:24±3°C。</span><span>昼夜温度需保持，建议晚间不要关闭空调，若开机扫描间温度不在要求范围内，设备上电后需等待机房温度保持在要求范围内做空气校准再扫描病人。</span></p></section></section></section><section><section powered-by="gulangu"><p><br /></p></section></section></section></section><section powered-by="gulangu"><section><section><section powered-by="gulangu"><section><p><span>2）</span><span>湿度要求机房相对湿度保持在30﹪～70﹪（无凝露）。</span><span>在外界湿度较大的情况，即便不使用设备也应该将除湿机打开，开机前如果湿度过大，建议先开除湿机，在湿度允许的范围内半小时以上再开机扫描。</span><span>如果相对湿度低于30%，建议使用室内蓄水池蓄水（或者加湿器），使扫描间湿度达到要求再开机扫描。</span><span>（注：</span><span>若温湿度不符合要求，可能导致图像质量下降或图像伪影，甚至可能设备元器件损坏。</span><span>）</span></p></section></section></section></section></section></section></section></section><section powered-by="gulangu"><p><br /></p></section><section powered-by="gulangu"><section><section powered-by="gulangu"><section><p><span><strong><span>未来应用展望</span></strong></span></p></section></section></section></section><section powered-by="gulangu"><section><br /></section></section><section powered-by="gulangu"><p><span>方舱CT作为疫情防控重点保障物资，应急结束后CT部分可以安装于医院影像科室继续发挥作用，或安装在平板车上成为车载CT。反之在疫情防控、灾害急救需要时又可以随时组合为方舱CT。方舱CT作为疫情防控或紧急医疗保障的储备物资，具有非常高的灵活性、经济性和实用性。</span></p></section><section><br /></section><section data-role="outer" label="Powered by gulangu"><section data-role="paragraph" 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发表于 2020-10-14 12:41:15