甘肃省11 358名医务人员锐器伤现状调查

目的对甘肃省不同层次医院的医务人员锐器伤（SI）现状进行调查，为提高临床医务人员的防护意识，规范操作行为以及制定职业防护措施提供指导。方法2012年1-12月，采用多阶段分层整群随机抽样的方法，对甘肃省6市州共38所医疗机构的医务人员进行现场问卷调查和访谈。结果共回收问卷11 358份，SI发生率为9.87%（1 121例），例次率为12.60%（1 431例次），发生密度为1.05次/(人·月)。不同性别、岗位、工作年限组医务人员SI发生率差异均有统计学意义（均P<0.05）；不同岗位人群，容易发生SI的地点不同；造成医务人员SI的主要医疗器具是注射器针头、静脉输液头皮针及手术缝针。已知暴露源的SI有1 099例次(76.80%)；发生污染SI 980例次(68.48%)，其中474例次（48.37%）为血源性疾病暴露，血源性疾病暴露率为33.12%。在调查的血源性暴露中，乙型肝炎病毒(HBV)占74.25%，梅毒螺旋体（TP）占13.10%，丙型肝炎病毒（HCV）占12.01%，人免疫缺陷病毒（HIV）占0.64%。 结论甘肃省医务人员锐器伤发生率处于较高水平，探索适合区域性医疗机构医务人员职业安全监控和管理体系，是一个亟待解决的社会问题。

Survey on the current status of sharp injury among 11 358 health care workers in Gansu Province

Objective To investigate the incidence of sharp injury（SI）among health care workers（HCWs）in different levels of hospitals in Gansu Province,so as to improve HCWs＇ precaution awareness,standardize behavior,and provide guide for making occupational precaution measures.Methods From January to December 2012,HCWs in 38 medical institutes in Gansu Province were selected with stratified random sampling,HCWs were surveyed through questionnaires and interview.Results A total of 11 358 questionnaires were received,the incidence of SI was9.87%（n=1 121）,case rate was 12.60%（n=1 431）,the frequency of SI was 1.05times/（person·month）.SI rates of different genders,positions and years of working were statistically different（all P〈0.05）.The main medical devices causing SI were syringe needle,venous transfusion scalp needle and surgical suture.SI caused by known sources were 1 099times（76.80%）;980times（68.48%）of SI were induced by contaminated sources,474（48.37%）of which were bloodborne diseases,bloodborne disease exposure accounted for 33.12%.Among bloodborne disease exposure,hepatitis B virus accounted for 74.25%,Treponema pallidun 13.10%,hepatitis C virus 12.01%,and human immunodeficiency virus0.64%.Conclusion There is a high incidence rate of SI among HCWs in Gansu Province,it is a very important public health problem which needs to be solved.