陕西省农村基层安全注射现状调查分析

为了解陕西省基层安全注射现状,采用分层多阶段随机抽样法,对陕西省6个地区(市)所辖6个县(区,市)30个乡(镇)180个村的乡村医生调查,发现陕西省乡村级预防接种和临床治疗中以玻璃注射器和一次性注射器混合使用为主(分别占54.8%和59.0%);预防接种和临床治疗采用多人一管注射的分别占44.3%和9.1%;在玻璃注射器灭菌中,水冲洗或浸泡、酒精棉擦拭方式分别占16.9%和42.7%;在一次性注射器处理中,重复使用和丢弃分别占1.3%和18.9%;有36.4%～74.0%的乡村医生不清楚计划免疫针对传染病和常见传染病传播途径及其危害性;认为多人一管不会有问题的占26.7%,接种人数多或缺少注射器时,可进行只换针头方式注射的占33.9%～61.7%.提示在陕西省基层预防接种和临床治疗中都应注意玻璃注射器和一次性注射器的安全注射问题;多人一管注射方式,水冲洗或浸泡、酒精棉擦拭灭菌玻璃注射器,反复使用和丢弃一次性注射器等是非安全注射的主要因素;乡村医生安全注射知识水平及责任心,特别是对不安全注射引起传染病及危害性后果的认识亟待进一步培训提高;对一次性注射器使用后统一回收或在包装上注明"严禁重复使用"是防止不安全注射的方法之一.

Analysis on Present Status of Safe Injection in Shaanxi Province

After we had carried out the questionnaires for 180 township/village doctors of 30 townships in 6 counties of 6 cities selected by stratified multistage random cluster sampling method,the results showed that glass injectors and the disposable injectors were mainly used during EPI vaccination and clinical therapy at village level,acounting for 54.8% and 59.0% respectively.One syringe for many children in vaccination and clinical therapy accounted for 44.3% and 9.1% respectively.Disinfection of glass injectors with water-washing or dipping-in-water or with alcohol tampon were 16.9% and 42.7% respectively.Repeated using or discarding of disposable injectors were 1.3% and 18.9% respectively.36.4% to 74.0% of village doctors didn't know EPI-related knowledge,such as transmitting routes of common communicable diseases and its risks.There were 26.7% of the township/village doctors who answered that"using one syringe for many persons is right."33.9% to 61.7% of the village doctors only changed needles for one syringe when vaccinating more children or lacking of injectors.The findings suggest that we should pay close attention to the safety of using glass or disposable injectors during vaccination and clinical therapy.The risk factors of unsafe injection were mainly water-washing or dipping-in-water,or alcohol-tampon-cleaning of glass injectors and repeated use or discarding of disposable injectors.The knowledge of safe injection and responsibility of doctors need to be further improved,especially for the knowledge of communicable diseases and its harmfulness.Recovery and no repeated use of disposable injectors are also the effective way.