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| 医护人员血源性传播疾病职业暴露现况分析 |
| 张海燕1,王洁2,尚静3,卜欣欣1,侯兵1,马雨诗2,庄海花1,王文静1,倪海莱1* |
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(1. 海军军医大学(第二军医大学)长海医院保健科, 上海 200433;
2. 海军军医大学(第二军医大学)基础医学院, 上海 200433;
3. 海军军医大学(第二军医大学)护理学院, 上海 200433
*通信作者) |
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| 摘要: |
| 目的 探讨医护人员血源性传播疾病职业暴露的特征及危险因素，为其预防和干预提供有效依据。方法 回顾性分析海军军医大学（第二军医大学）长海医院2006年4月至2021年1月登记上报的746例医护人员血源性传播疾病职业暴露案例的资料，包括性别、年龄、职业、工作科室、职业暴露发生时间、暴露源、暴露途径、处理措施等。结果 从性别上看，发生血源性传播疾病职业暴露的女性（540例，72.39%）较男性（206例，27.61%）多；从职业来看，发生血源性传播疾病职业暴露的人员以护士（师）（305例，40.88%）、医师（171例，22.92%）和实习护士（111例，14.88%）为主；从科室分布看，发生血源性传播疾病职业暴露的医护人员所在科室主要为急诊科（105例，14.08%）、普通外科（73例，9.79%）、麻醉科（67例，8.98%）、消化科（55例，7.37%）、胸心外科（54例，7.24%）。暴露源以HBV为主，共有508例（68.10%）；暴露途径以皮肤锐器伤为主，共有666例（89.28%）。36例（4.83%）发生暴露后未进行任何紧急处理，但所有暴露者均接受了后续的预防性治疗及随访，且最终无一例发生职业暴露感染。结论 医护人员血源性传播疾病职业暴露不容忽视，应增强对血源性传播疾病的防范意识、强化职业防护培训、建立合理有效的防护制度、改善诊疗环境，以降低血源性传播疾病的发生率、保证医护人员的身心健康。 |
| 关键词: 医护人员 职业暴露 血源性传播疾病 预防措施 |
| DOI：10.16781/j.0258-879x.2021.11.1330 |
| 投稿时间：2021-08-24修订日期：2021-10-26 |
| 基金项目: |
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| Analysis of occupational exposure to blood-borne diseases among medical staff |
| ZHANG Hai-yan1,WANG Jie2,SHANG Jing3,BU Xin-xin1,HOU Bing1,MA Yu-shi2,ZHUANG Hai-hua1,WANG Wen-jing1,NI Hai-lai1* |
(1. Department of Health Care, Changhai Hospital, Naval Medical University (Second Military Medical University), Shanghai 200433, China;
2. College of Basic Medical Sciences, Naval Medical University (Second Military Medical University), Shanghai 200433, China;
3. School of Nursing, Naval Medical University (Second Military Medical University), Shanghai 200433, China
*Corresponding author) |
| Abstract: |
| Objective To explore the characteristics and risk factors of occupational exposure to blood-borne diseases among medical staff, so as to provide effective basis for prevention and intervention. Methods The data of 746 cases of occupational exposure to blood-borne diseases reported by Changhai Hospital, Naval Medical University (Second Military Medical University) from Apr. 2006 to Jan. 2021 were analyzed retrospectively, which including gender, age, occupation, working department, time of occupational exposure, source of exposure, route of exposure and treatment measures. Results In terms of gender, more females (540 cases, 72.39%) had occupational exposure to blood-borne diseases than males (206 cases, 27.61%); in terms of occupation, nurses (305 cases, 40.88%), doctors (171 cases, 22.92%) and student nurses (111 cases, 14.88%) were the main groups with occupational exposure to blood-borne diseases; in terms of department distribution, the top 5 departments were emergency department (105 cases, 14.08%), general surgery (73 cases, 9.79%), anesthesiology department (67 cases, 8.98%), gastroenterology department (55 cases, 7.37%) and cardiothoracic surgery (54 cases, 7.24%). The main source of exposure was hepatitis B virus (508 cases, 68.10%); the main route of exposure was sharp instrument injuries (666 cases, 89.28%). Thirty-six cases (4.83%) did not receive any emergency treatment after exposure to blood-borne diseases, while all exposed staff received preventive treatment and follow-up, and no occupational exposure infection occurred in the end. Conclusion To reduce the incidence of blood-borne diseases and ensure the physical and mental health of medical staff, we should strengthen the awareness to prevent blood-borne diseases, strengthen occupational protection training, establish reasonable and effective protection system, and improve the diagnosis and treatment. |
| Key words: medical staff occupational exposure blood-borne diseases preventive measures |
