賴全裕LAI, CHANE-YU林書鳴LIN, SHU-MINGSHU-MINGLIN職業安全衛生學系碩士班2026-10-052031-02-1120262026-01-31https://handle.ncl.edu.tw/11296/hd8nzyhttps://scholars.csmu.edu.tw/handle/123456789/20546本研究以可控制之模擬手術環境，系統性探討電刀操作參數對手術煙霧氣膠粒徑分佈與細菌存活情形之影響，並評估不同電極型式、功率設定及操作模式所造成之氣膠生成特性差異。為避免生物組織固有差異所造成之不確定性，本研究以胰蛋白大豆瓊脂接種枯草桿菌與大腸桿菌，作為具可重製性之標準化切割介質，並於密閉壓克力腔室中進行模擬切割；同時以六階撞擊式採樣器收集具活性的氣膠，並以攜帶型光學分析儀量測氣膠總濃度與粒徑分佈，以建立可同時呈現「總氣膠」與「可培養氣膠」兩類訊號之完整量測架構。結果顯示，電刀操作模式、電極幾何與功率設定對氣膠生成具明顯影響。在 Blend 60W與針狀電極條件下，氣膠濃度顯著提升，且可培養氣膠粒徑多集中於數微米之範圍；此一粒徑屬於可呼吸性區段，顯示針狀電極所造成之局部高能量密度易形成含菌之較大煙霧。相較之下，球形電極因熱量分散，氣膠總量與可培養濃度皆顯著較低。至於模式差異，Standard coagulation 於相同功率下產生高變異之氣膠濃度，反映電弧放電與灼乾所造成之不穩定噴濺行為；Pure cut 為連續輸出，易形成細小氣膠，使可培養氣膠比例下降。功率提升則使總氣膠濃度上升，而可培養濃度與存活率反而下降，此現象可由熱分解增加與粒徑往細小區段偏移所共同造成，亦顯示總氣膠量與具活性之氣膠並非線性關聯。綜整本研究結果，不同電極型式、操作模式與功率設定皆會影響氣膠粒徑分佈、數濃度與細菌存活能力，而以針狀電極與 Standard coagula-tion 模式所生成之氣膠具較高生物性風險。研究亦證實提升功率會促使氣膠粒徑偏向較細小區段，使可培養氣膠比例下降，顯示僅以氣膠總量評估暴露風險可能導致高估或低估具感染性之實際暴露。本研究所建立之標準化程序與存活率計算方式，能作為後續手術煙霧防護策略、工程控制設計及職業衛生評估之重要基礎，並提供臨床在電刀操作參數選擇上之量化參考。This study systematically investigated the effects of electrosurgical pa-rameters on the particle‑size distribution and bacterial viability of aerosols generated during simulated electrosurgery. To eliminate the variability inherent in biological tissues, tryptic soy agar inoculated with B.subtilis or E.coli was used as a standardized cutting substrate. Simulated electrosurgical procedures were conducted inside a sealed acrylic chamber, and viable bioaerosols were collected using a six‑stage Andersen cascade impactor, while total aerosol concentration and particle‑size profiles were continuously monitored with a portable optical spectrometer. This dual‑measurement framework enabled simultaneous characterization of both total aerosol output and viable bioaero-sol emissions under controlled experimental conditions.Results demonstrated that electrosurgical mode, electrode geometry, and power settings substantially influenced aerosol generation. Under the Blend 60W condition with a needle electrode, aerosol concentrations were markedly elevated, and viable bioaerosols predominantly appeared within the microme-ter‑scale range, corresponding to respirable particle sizes. This indicates that the high energy density at the needle tip promotes the formation of bacte-ria‑containing droplet‑type aerosols. In contrast, the ball electrode, due to its more dispersed heat distribution, produced lower aerosol output and reduced viable bioaerosol recovery. Mode‑related differences were also evident: Stand-ard coagulation generated highly variable aerosol concentrations associated with arc discharge and surface charring, whereas Pure cut, characterized by continuous output, produced finer aerosols and lower viability. Increasing power resulted in higher total aerosol concentration but reduced viability, a trend attributed to enhanced thermal decomposition and shifts toward smaller particle sizes, demonstrating that total aerosol burden does not reliably reflect viable bioaerosol exposure.Overall, different combinations of electrode geometry, operating mode, and power level significantly altered aerosol characteristics and bacterial sur-vival. The needle electrode and Standard coagulation mode were associated with the greatest biological risk potential. The study also confirmed that higher power settings promote smaller particle sizes and reduce viable bioaerosol fractions, underscoring that exposure assessments based solely on total aero-sol concentration may lead to overestimation or underestimation of infectious risk. The standardized procedures and viability‑calculation framework devel-oped in this work provide a quantitative basis for future hazard assessments, engineering controls, and clinical decision‑making regarding electrosurgical smoke management.電刀手術煙霧生物氣膠聚四氟乙烯塗層電極手術室感染控制暴露評估ElectrosurgerySurgical smokeBioaerosolPTFE coated electrodeOperating roomInfection controlExposure assessmentthesis