In the hospital system, the medical ICU operating room and medical laboratory are the most rigorous and important parts of the hospital construction. Cleanliness and safety issues are always the top priority of design and decoration. With the rapid development of interventional medicine, interventional therapy using digital subtraction angiography (DSA) equipment has become the trend of clinical medicine development in the 21st century. Because of the particularity of its computer room construction and equipment installation, it has also attracted more and more attention. A few hospitals have set up special intervention centers that can accommodate more than 1-3 DSAs, including a variety of models, and are managed with reference to the operating room. In most hospitals, DSA equipment is generally installed in the radiology department and managed by the radiology department.

This article will take the installation example of the Interventional Department of the First Affiliated Hospital of Zhengzhou University (abbreviation: Zheng Dayi) Weimai Medical Aurora Intelligent Seven-axis Flat Angiography Machine (abbreviation: Weimai Aurora), from layout planning, computer room decoration, equipment installation, The equipment acceptance uses 4 stages, and systematically elaborates the principles and key points of the decoration design and construction of the DSA interventional operating room.

I. DSA operating room decoration design principles regarding the construction of equipment room and catheter room

(1) Clarify the positioning of DSA equipment and catheterization laboratory

(2) Reasonable site selection, adapt measures to local conditions

(3) Scientific design process

(4) Strictly regulate the installation of equipment;

(5) Develop a complete operation and use system and strictly implement it;

(6) Pay attention to the expansion space for the use of new technologies in the future.

II. DSA operating room design regarding the planning and site selection of the equipment room

1. Clarify the expected positioning of the DSA equipment and the catheterization laboratory.

According to the size of the power, it is generally divided into three types: large C, medium C, and small C. According to the different needs of each hospital, DSA with power above medium C is generally used. In addition, according to the number of C-arms, it is divided into single-C-arm and double-C-arm. The double-C-arm has higher requirements for the machine room; the single-C-arm also has the difference between a suspension type and a floor-standing type, which have special effects on the roof and ground of the machine room. Claim. The hospital equipment department should select equipment in a targeted manner according to the needs of clinical departments.

Different patient types also have a great influence on planning. There are more emergency departments, which require higher patency of the entrance passage of the computer room; there are more severe patients and higher requirements for first aid facilities in the computer room; the utilization rate of equipment is high, and the efficiency of sterilization and disinfection in the computer room is high; there are many types of operations, so The machine room is required to have a larger area in order to place the auxiliary equipment required for different operations.

2. Reasonably select the site according to the plan and adjust measures to local conditions.

Reasonably arrange the various functional areas of the catheterization laboratory, according to the scientific design process of the existing house structure. Generally, the catheterization laboratory requires at least 3 functional areas: the main functions of the DSA operating room are the main functions of the DSA operating room, such as equipment racks and catheter beds, the operating room for surgery and other operations, and the control room for equipment control. Area; equipment rooms where main equipment such as high-voltage cabinets, image acquisition and reconstruction cabinets, and water-cooled cabinets are placed; surgical auxiliary areas such as surgical dressing, hand washing, dirty washing, and family talks. The three areas should be relatively independent and clearly marked. According to the requirements of the overall design of the hospital, entrances and exits for patients, staff, and filth should be set up respectively. The entire design should facilitate the inspection of the equipment and the development of treatment when it meets the specifications, and cater for the needs of medical, nursing, patient, engineering staff, equipment engineers and other aspects. Figure 2 is a design drawing of the DSA equipment room and its auxiliary rooms made according to the actual architectural layout.

The operating room area of DSA equipment recommended by the equipment manufacturer is 7,500 mm and 6,000 mm. In actual arrangements, the hospital expands the computer room as much as possible, leaving a square space to meet the equipment requirements; the control room is designed with two beveled edges of the trapezoid. And the equipment room; the design preparation room meets the requirements of the surgical buffer zone. There should be enough space in the dressing room, conversation room and surgical toilet to ensure the independence of the doctor-patient passage. It is particularly important to note that in order to save space, the practice of placing the equipment auxiliary cabinet in the operating room will cause problems such as overheating of the cabinet and affect the use of the equipment. Therefore, a separate room for the equipment cabinet and a dedicated air conditioner should be ensured.

To sum up, the planning and location of the DSA equipment room should be clearly defined in terms of functional partitions, ensuring the independence of the operating room area and the doctor-patient passage, and setting up surgical buffers to facilitate the use of DSA equipment.

3. The construction of the computer room should pay attention to standardization, convenience and scalability

(1) The decoration of the radiological equipment room should focus on radiological protection. According to GBZ 130-2013 "Radiation Protection Requirements for Medical X-ray Diagnosis" [7], the equivalent thickness of the shielding and protective lead of the interventional X-ray equipment room should not be less than 2 mm. In actual work, a lead equivalent with a thickness of 3 mm is generally used to ensure the radiation safety of the staff and the surrounding public. The operating room also has high requirements for the control of nosocomial infections. It is necessary to be equipped with a dynamic air sterilizer, while using independent air conditioners to ensure that the temperature and humidity of the operating room and the equipment room meet the requirements of the operation and equipment respectively.

(2) DSA equipment is high-power equipment and must strictly meet the power supply requirements of the equipment. Generally, a separate three-phase five-wire 380 V power supply is required. The power, wire diameter, circuit breaker, grounding, and power distribution cabinet have clear requirements and should be strictly followed. The self-weight of DSA equipment is very large, and the floor slab is generally required to bear more than 500 kg/m2. If it does not meet the requirements, it should be reinforced accordingly. Both the suspended C-arm and the monitor hanger need to be installed with hanging rails, and the hospital needs to prepare a channel steel fixing frame. The sliding of the C-arm requires a high level of the fixed frame. For example, GE requires that the vertical error between adjacent positioning holes is less than 1.5 mm, and Philips requires that the vertical error be less than 0.5 mm/m. Therefore, the welding installation of the fixed frame must be high. When the horizontal welder is finished, the site engineer should check the construction quality in real time, and rework in time if there is an excessive error. Floor-standing racks also require high ground levelness, requiring steel plates with a thickness of 25 mm or more as a reinforcement foundation. Figure 2 Design drawing of DSA equipment room and its auxiliary rooms (unit: mm)

(3) The convenience of using equipment should be fully considered when decorating the computer room. As much as possible to ensure the area of the operation room of the DSA equipment is to facilitate the use of equipment: cardiovascular interventional physiology instrument, intravascular ultrasound, blood flow reserve tester, radiofrequency ablation instrument and other equipment. Peripheral vascular intervention needs to be equipped with high-pressure syringes, General equipment such as ultrasound equipment, defibrillator, electrocardiograph, micropump, etc., are all placed in the operating room. In order to facilitate access, it is recommended that consumables such as commonly used catheter guide wires and emergency equipment such as temporary pacemakers should also be placed in the operation room for backup. Another aspect of convenience is reflected in the configuration of DSA and accessory equipment. For example, the monitor is recommended to be equipped with 2 invasive blood pressure; the equipment belt is recommended to be equipped with 2 sets of oxygen negative pressure ports on the head side and the surgeon side; taking into account the DSA equipment For the new development trend of surgery, it is recommended to have 2 sets of radial artery puncture arm rests; the surgical cart for cardiovascular intervention should be longer than that for radiological intervention; and so on. The above configuration is to ensure the safety and quality of the operation, and the medical safety and quality are often reflected in the details of the treatment.

(4) The scalability of the computer room is mainly reflected in the reservation of the interface. Considering the possibility of adding high-power devices in the future, some power margins need to be reserved; more strong and weak electrical interfaces are reserved on the walls and false ceilings to prepare for the installation of wireless devices and cameras.

4. DSA operating room equipment installation and acceptance specifications

The pros and cons of equipment installation can be directly reflected in the efficiency and service life of the equipment, and a good and standardized installation can better play the role of the equipment. Major manufacturers have always had a standardized process for the installation process. The hospital equipment department should be present throughout the process, urge the installation engineer to strictly follow the process for installation, and cooperate with the engineer for installation as needed. The main points that need to be paid attention to are: whether the level control of the suspension and placement of each component is accurate, whether the threading is orderly and tidy, whether the connection of various connectors is firm, and whether the cable trench of the surgeon's standing position uses a firm and inelastic plate Coverage, whether the software installation complies with the contract, etc. During acceptance, interventional radiologists, technicians, and cardiologists should jointly participate in the acceptance to ensure that the functions specified in the contract are complete. In particular, it should be noted that, in addition to the hardware configuration, the various functions of the DSA are demonstrated and confirmed by the equipment manufacturer's application engineers, operating technicians, and doctors. The acceptance of radiological equipment also involves the verification of radiation dose, which should be inspected on-site by a third-party inspection agency to ensure that the performance of the equipment and radiation protection and other indicators comply with the regulations of clinical and relevant departments.

Before the official start of use, operating technicians, doctors, and nurses should be trained accordingly, and relevant workers should also be trained on matters such as hospital infections and equipment cleaning. In summary, the principles of DSA equipment installation and catheterization laboratory construction and some specific issues that should be paid attention to in implementation. The catheter laboratory built according to the above principles must not only meet the requirements of the equipment environment, but also meet the requirements of different interventional surgery departments. It must also be convenient for doctors, technicians, and nurses to operate, so that the layout is reasonable, the facilities are complete and efficient, and the environment is clean and bright. Doctors and patients praised. DSA equipment has very strict requirements for installation. Good equipment room design and installation can prolong the service life of the equipment and improve the efficiency of the equipment. On the contrary, it will affect the normal use of the equipment. Kind of regulations.

To sum up, in the process of design and decoration, the design and construction unit should communicate with the hospital using the department, equipment manufacturer, and fully communicate, and take into account the quality of equipment installation and the convenience of use. CEIDI Xidi said that due to the rapid development of digital technology and medical industry, it is necessary to consider the needs of operating room and equipment renewal within 5-10 years at the beginning of the design. The construction materials should also be adapted to reality to avoid waste. . In the construction, we can refer to the concept of ergonomics to design a more humane and more comfortable operating room for doctors, nurses, and patients.