怀远县人民医院医务人员锐器刺伤的调查与分析

目的了解医院医务人员被锐器刺伤情况,探讨预防对策。方法采用问卷调查医院医务人员被锐器刺伤有关情况。结果被调查178位医务人员中有159人发生过锐器伤,发生率89．32％;锐器伤发生以针头和玻璃伤为主,分别占58．37％、33．48％。刺伤后立即挤出血液并清洗消毒的有147人,占92．45％;定期做血清学检查的有29．56％;注射乙肝疫苗的22．64％。锐器刺伤率分别为：医生78．95％,护士95％。结论医务人员锐器刺伤较普遍,应提高医务人员安全防范意识,熟练规范操作,增加必要的设备,避免和尽量减少医疗锐器损伤。     

医务人员职业暴露调查与预防

随着医疗操作的增多,医务人员职业暴露风险日益增加,锐器伤已经成为医务人员发生血源性感染最重要的传播途径.目前职业暴露的原因与医务人员职业防护意识淡薄、技术操作不规范有直接关系[1],对医务人员的健康安全构成了一定的威胁.为了解我院医务人员职业暴露的发生情况,降低职业暴露后的感染风险,我院近期对医务人员锐器伤情况进行回顾性调查,现将结果报告如下.     

医务人员锐器伤的统计与分析

<正>医务人员锐器伤已经成为血源性病原体的主要传播途径,威胁医务人员的职业安全,是医务人员最常见的职业损害[1]。通过对179例发生锐器伤的医务人员的数据进行分析,了解锐器伤的危险因素、操作环节、病原体情况,为制定有效的防控措施提供依据。1对象与方法1.1调查对象:对2011年1月至2016年8月我院雕龙医院感染监测系统中监测统计的179例发生锐器伤的医务人员进行回顾性调查。     

医务人员锐器伤监测分析及防护对策

目的调查医务人员锐器伤发生情况,分析主要原因及探讨有效防护对策。方法根据本院医务人员锐器伤登记表,统计2007~2011年上报的39例锐器伤资料,对发生原因、受伤经过、受伤前后防护处理等情况进行分析。结果护理病区、手术室是锐器伤高发科室。病区发生锐器伤构成比占43.6%,手术室发生锐器伤构成比占28.2%。工龄11~20年、护士、低年资的医务人员是锐器伤的高危人群。结论加强重点科室、重点人群针刺伤的管理,制定相关的防范措施和制度,规范操作,标准预防,正确处理可以有效的减少医务人员锐器伤的发生,预防医务人员院内感染。     

医务人员锐器伤后乙型肝炎病毒感染调查

目的了解医务人员职业暴露认识情况及医疗锐器伤后感染HBV情况,探讨防控对策。方法自设知识问卷对焦作市821例医务人员进行调查,对其中154例锐器伤者进行监测。结果锐器伤发生率18.76%。锐器伤发生后,按意外刺伤流程处理者82.47%;接种乙肝疫苗者24.03%;注射乙肝免疫球蛋白者46.10%;HBV感染者12.34%。结论医务人员锐器伤后感染HBV的危险性较高,应加强职业防护教育及培训,严格执行正确处理流程。     

医务人员锐器伤发生情况调查与防护对策

目的了解医务人员锐器伤发生现状,为制定预防措施提供科学依据。方法 2016年4月20日—4月22日采用自行设计的《医务人员锐器伤情况调查表》对全院医务人员进行锐器伤现状问卷调查。结果参加调查的481名,医务人员中259名过去1个月曾经发生过锐器伤,发生率为53.85%。不同医务人员锐器伤的发生率不同,差异具有统计学意义(P=0.001),其中护士锐器伤发生率最高,发生率为59.83%。工作年限<2年的医务人员锐器伤发生率高于其他组别,但差异无统计学意义(P=0.707)。针头和玻璃为造成医务人员锐器伤的主要刺伤器具,分别占47.60%和40.12%。受伤原因排在前三位的分别是掰安瓿时、回套针头帽时和分离针头与注射器时。发生锐器伤后有55.69%的医务人员未上报,未上报原因最主要的是认为扎伤器具为清洁器具,不需要上报,占45.35%,发生锐器伤后95.63%的医务人员都能正确及时的处理伤口。结论医务人员锐器伤暴露普遍存在,亟须提高医务人员职业防护意识,制定实施针对性职业防护措施,建议加强重点人群、高危环节的培训,掌握锐器安全操作方法,避免和减少锐器伤发生。     

某院医护人员锐器伤及防护措施的调查分析

目的探讨我院医护人员在日常工作时锐器及相关的防护情况。方法利用自制的调查问卷,对我院126名医务人员进行调查,并对调查结果进行分析。结果此次共调查126名医护人员,107名医护人员发生锐器伤,发生率为84.9%,护士锐器伤发生率(64.28%)明显高于医师(20.63%)。拔针头和医护人员躁动是引起锐器伤的主要原因。结论我院医护人员锐器伤发生率较高,护士明显高于医师,加强管理和培训,减少锐器伤的发生,保障医护人员的安全。     

临床医务人员锐器伤预防与控制

<正>临床工作中锐器伤对医务人员健康的潜在威胁不可忽视。由锐器伤所造成的职业暴露而引发血源性感染的危险日趋严重,有报道称锐器伤已经成为医务人员发生血源性感染最重要的传播途径。我国的调查数据显示,工作3年以内的医院新职工(医生和护士)锐器伤发生率高达95.66%,而锐器伤后报告者仅占7.67%。没有报告将导致职业暴露后不能获得有效的专业指导和相应的医学处理,对锐器伤的预后产生不利影响。     

手术室护理人员锐器伤调查分析及防护措施探讨

目的了解手术室护理人员锐器伤发生情况,为制定职业防护措施提供依据。方法对30名手术室护理人员锐器伤发生情况进行回顾性调查。结果手术室护理人员锐器伤的发生率为86.7%,致伤的锐器主要为手术缝针、注射器针头、安瓿,以手术缝针刺伤最常见占66.7%,发生的环节是术中缝针的交接和传递。结论手术室人员锐器伤发生率高,应健全职业安全制度,采取防护措施促进医务人员执业安全。     

手术室医护人员锐器伤及防护情况分析

目的了解手术室医护人员锐器伤发生情况,探讨预防锐器伤的有效措施。方法对2009—2011年手术室护士、麻醉医生、手术医生锐器伤发生情况进行回顾调查。结果手术室医护人员锐器伤发生率为61.79%,其中手术室护士发生率80.48%,手术医生发生率59.72%,麻醉医生发生率70.37%。结论手术室医务人员面临锐器伤危险。提高职业防护意识,强化标准预防理念,规范操作行为,加强监控管理,是减少手术室医护人员锐器伤的重要措施。     

Hearing impairment among workers occupationally exposed to excessive levels of noise

Pure tone audiometry screening and ear examinations were conducted among 138 males working as machine and equipment operators occupationally exposed to intermittent noise of 85 to 105 dBA. Hearing loss up to 30 dB (preserved socially adequate hearing) was found in 25 workers. The hearing impairment was confirmed by distortion products of otoacoustic emissions measurements. A sharp increase in the frequency of cases can be found among the workers with service length over 10 years. While the frequency of the cases among workers with service length below 10 years is 5.45%, it is 26.5% among the subjects with service length over 10 years, with a gradual increase as a result of the increase in exposure duration. A positive correlation (p < 0.05) was found between the frequency of hearing impairment among the workers and the years of exposure to excessive noise levels. Some measures for preventing occupational noise-induced hearing loss were suggested.     

精神分裂症男女涉法行为对照研究

目的;对照研究精神分裂症男女犯罪行为特点。方法：抽取我院１９９５年～２０００年司法鉴定案例中精神分裂症男性１６０例,女性４３例,用自拟项目对精神分裂症男女犯罪行为进行统计分析比较。结果：精神分裂症男性违法者以凶杀、盗窃、伤害行为为主,女性则以凶杀、性受害、伤害或被伤害为主。盗窃比例男性高于女性;男性作案多选择在公共场所,女性多选择在自己家中;无责任能力的评定中男性比例高于女性;以上各项均有显著性差异。结论：精神分裂症男女涉法行为有各自不同的特点,需分别予以足够的重视。     

Responder safety and health: preparing for future disasters

This article reviews lessons learned about managing the safety and health of workers who were involved in disaster response, recovery, and cleanup after the 2001 World Trade Center (WTC) disaster. The first two sections review ongoing responder health burdens and the tragic toll of this disaster from a worker safety and health perspective. The remaining sections address changes in federal infrastructure, response planning, and resources for protection of response and recovery personnel. Proper preparation includes pre-event and "just-in-time" disaster-worker training on likely hazards, organizational assets for hazard monitoring, and hands-on instruction in the use of assigned protective equipment. Good planning includes predeployment medical review to ensure "fitness for duty" and considers the following: (1) personal risk factors, (2) hazards likely to be associated with particular field locations, and (3) risks involved with assigned tasks (eg, workload and pace, work/rest cycles, available resources, and team/supervisory dynamics). Planning also should address worker health surveillance, medical monitoring, and availability of medical care (including mental health services). Disaster safety managers should anticipate likely hazards within planning scenarios and prepare asset inventories to facilitate making timely safety decisions. Disaster safety management begins immediately and provides ongoing real-time guidance to incident leadership at all levels of government. Robust standards must be met to reliably protect workers/responders. An integrated and measurable multiagency safety management function must be built into the incident command system before an incident occurs. This function delineates roles and responsibilities for rapid exposure assessments, ensuring cross-agency consistency in data interpretation, and timely, effective communication of information and control strategies. The ability to perform this safety management function should be tested and evaluated in exercise simulations and drills at multiple levels. Joint planning and exercising of the safety management plan and its function are effective ways to build interagency relationships and to be more systemic in managing logistics for safety equipment and converging personnel. Planning must include mechanisms to enable safety decisions to be implemented-such as effective and rapid scene control (site access), personnel tracking, and safety enforcement. Worker safety and health preparedness and leadership are essential for protecting workers and promoting resiliency among personnel involved in disaster response, recovery, and cleanup.     

职业暴露抗肿瘤药和其他危险药物对医务人员的危害及防护

危险药物是指具有致癌性、致畸性、生殖毒性、遗传毒性及低剂量致器官毒性的药物,包括抗肿瘤药、抗病毒药、激素、免疫抑制剂等。大量研究表明,配制和使用危险药物的医务人员面临职业暴露风险。危险药物暴露可发生于呼吸道吸入、皮肤接触吸收、消化道摄入等。吸入和皮肤接触吸收可能是危险药物暴露的主要途径。职业暴露危险药物可导致机体免疫力降低、发生肿瘤的危险性增加和潜在的生殖损害,常见的不良反应有头晕、乏力、脱发、咳嗽、恶心、呕吐、月经异常及皮疹等,长期接触还可能引起慢性肝损害。为了减少危险药物暴露对医务人员的风险,应采取以下安全防护措施：制定安全操作规程;对可能接触危险药物的医务人员加强安全教育和培训;设置专用配药场所;使用生物安全柜;穿戴个人防护装备包括手套、隔离衣、护目镜、面罩和呼吸罩;加强对废弃物处理的管理;急性危险药物暴露应及时处理。     

Prospective study of patients with hand injury: Tikur Anbessa University Teaching Hospital, Addis Ababa

OBJECTIVES: To describe the nature of hand injuries among patients seen in a referral teaching hospital in Addis Ababa. PATIENTS AND METHODS: All six hundred and two patients with a total of 621 injured hands seen at the emergency out patient department of Tikur Anbessa University Hospital over a one- year period, May 1, 2003 - April 30, 2004 were evaluated and findings documented and analyzed. RESULTS: of the 602 patients, 511 (84.9%) were males and 91 (15.1%) females. The mean age was 28.3 years (males 28.8 years and females 25.4 years). The majority of the injuries 488 (81.1%) occurred either in a factory, on a street, at home or at a construction site. The commonest causes included machine accidents 195 (32.4%), followed by crushing 95 (15.8%), road traffic accidents 83 (13.8%) and injury from a sharp object 80 (13.4%). Fifty six percent of all the patients (336/602) had been injured at work, of whom 156 of 195 (80.0%) had been working with an unguarded machine. Fifteen of those injured 195 (7.7%) had suffered a previous machine injury. Work related hand injuries occurred more often among manual workers 77.7% (261/336). Three hundred and seven of the 621 injured hands had one or more fractures (49.4%), 233 a severe soft tissue injury (37.5%), 126 an amputation (20.3%), 40 a dislocation (6.4%), and 34 (5.5%) foreign bodies in the hands. Four hundred and sixty five (77.2%) arrived within eight hours of the injury, and this included the majority of those most severely injured. CONCLUSION: It is suggested that the provision of adequate safety guards on industrial machines, and their use, would significantly reduce the number of severe hand injuries occurring in Addis Ababa.     

华北地区部分基层部队食品卫生安全现状调查

目的 了解华北地区部分基层部队食品卫生安全现状,找出存在问题,提出解决方法.方法 采取现场查看、细菌学指标(大肠菌群)检测和问卷调查等方法,于2011年6-8月对华北地区部分基层部队119家餐饮单位进行食品卫生安全调查.结果 ①所有被调查单位在本年度中无食物中毒和其他食源性疾病发生,无"三无"和过期产品.对食品卫生安全现状综合评定为优秀、良好、一般、较差的单位分别为7、31、42、39家,合格单位占67.23%.②随机抽取餐饮用具及工作人员手样本952件,大肠菌群检测合格率为61.45%,其中熟食刀、板、盆及熟食间操作员手检测合格率低于60.00%.③餐饮人员食品卫生安全知识知晓率为57.67%.结论 华北地区部分基层部队食品卫生安全存在一定的问题,应加强食品卫生安全监督及食品卫生安全知识培训.     

某肝吸虫感染高发区餐饮人员肝吸虫病知信行调查

目的：了解餐饮业从业人员肝吸虫病防治知识、态度、行为的情况,为制定对策提供依据。方法对某肝吸虫感染高发区餐饮业从业人员进行问卷调查并统计分析。结果被调查者1643人,肝吸虫病相关知识知晓率为51.96%,男高于女（χ2=83.76, P〈0.01）,当地人高于本省非佛山籍高于外省籍从业人员（χ2=13.60, P〈0.01）,初中高于高中（或中专）高于小学及以下高于大学及以上（χ2=74.94, P〈0.01）;正确态度持有率及卫生行为形成率分别为84.3%、84.3%,不同性别、不同籍贯差异无统计学意义,但不同学历从业人员之间差异有统计学意义（P〈0.01）。结论应在肝吸虫感染高发区加强餐饮从业人员培训,并将肝吸虫病防治知识纳入各级学校健康教育内容。     

Health of farmers in southland: an overview.

AIM: To describe the health of farmers in Southland. METHODS: Coss-sectional study of a random sample of farmers in Southland. RESULTS: 586 individuals were interviewed from 286 farms with a response rate of 65.4%. The prevalence of at least one injury in the last twelve months which prevented normal farm work was 17.1%. Low back pain was common with 54.6% reporting such an episode in the last twelve months. Noise-induced hearing loss was prevalent among men with 28.7% of those 45 years and over being affected. Levels of asthma appeared low with a point prevalence of 6.8%, with 4.6% on medication.There were 19.3% of male farmers who were obese. The prevalence of alcohol use disorder among men aged 15-24 years was 57.4%, and 39.0% among farm workers. Similarly, 32.0% of men in this age-group smoked, with 35.6% of farm workers being smokers. CONCLUSIONS: Farmers experienced high levels of injury, low back pain and noise-induced hearing loss. Community intervention programmes to prevent injury remain a priority for farmers, although lifestyle factors should also be addressed, particularly among farm workers.     

不同方式下颌骨去骨后骨愈合情况的研究

目的 本实验旨在通过观察咬骨钳、高速涡轮机、种植机在不同条件下对大鼠下颌骨去骨后不同时期骨组织的病理结构变化,研究不同去骨方式对骨造成的损伤程度,为临床选择一种安全、可靠的去骨方式.方法 第1组使用种植机在3 000 r/min无冷却、第2组3 000 r/min有冷却、第3组30 000 r/min有冷却,第4组高速涡轮钻有冷却和第5组用咬骨钳对大鼠的下颌骨进行去骨,观察不同时期创面的变化.结果 第2组行骨磨除的组织愈合最快、最好,种植机在第3、4组愈合情况无明显差别,但第3、4组愈合情况均不如第2组,第5组与第1组差异无显著性,愈合情况最差.结论 在临床进行骨磨除时需要有冷却,在相同磨除时间下,低转速磨除对骨损伤最小,如去骨时间过长,需要进行间断磨除.     

2011年新疆塔河油田工人代谢综合征调查研究

目的 了解新疆塔河油田工人代谢综合征(metabolic syndrome,MS)的患病情况及流行特征,为高血压、高血糖、高血脂和高危人群健康教育以及做好心脑血管疾病的一级预防提供依据.方法 采用随机整群抽样的方法,于2010年3～4月对新疆塔河油田的4个基地工作1年以上的人群进行体格检查及相关代谢指标的测定.主要采用2005年国际糖尿病联盟(IDF)的MS诊断标准.结果 被调查人群MS的检出率为17.99％,随着年龄的增大,MS的检出率逐渐增高.MS患者的腰围、血压、三酰甘油、空腹血糖水平比非MS人群均有增高.结论 被调查人群MS检出率随年龄的增大而升高,在MS患者中以向心性肥胖最常见,应作为MS的重点监测人群,加强健康教育,采取相应防治措施,降低石油工人MS的患病率.