医护人员血源性传播疾病暴露的现况分析

目的调查医护人员血源性传播疾病暴露的现况,并探讨预防措施。方法对第二军医大学附属长海医院2006年1月-2008年5月登记上报的117例医护人员血源性传播疾病暴露案例进行回顾性分析。结果发生职业暴露伤的117例患者中,护师(士)64例(包括实习护士15例),占54.7%;医师46例(包括实习医师25例),占39.3%。引起职业暴露损伤的均为血源性传播疾病。发生血源性传播疾病暴露伤的原因中,以针刺伤为主(98例),占83.8%。医师发生血源性传播疾病暴露的操作环节以手术为主,占65.2%;护师(士)发生血源性传播疾病暴露的操作环节以注射治疗为主,占54.7%。发生血源性传播疾病暴露后,伤口处理不正确39例,占33.3%;未按期随访检查或注射疫苗62例,占53.0%。结论增强对职业暴露的防范意识,强化职业防护培训,改善诊疗环境,降低诊疗操作过程中的风险,建立健全职业暴露安全管理体系,以降低职业暴露的发生率,保证医护人员的身心健康。

Exposure to blood-borne diseases among medical staffs: analysis of current status

Objective Investigate the exposure to blood-borne diseases among medical staffs and to discuss the preventive measures.Methods The data of 117 cases of exposures to blood-borne diseases(Jan.2006 to May 2008) among medical staffs in our hospital were retrospectively analyzed.Results All together 117 cases of exposures were identified during the period,including 64(54.7%) nurses and 46(39.3%) doctors.All the exposures were blood-borne diseases.The main cause of the exposure was needle-stick injury,accounting for 83.8% of the total.The exposures of doctors mainly occurred during operation,accounting for 65.2%;and for the nurses,the exposure was mainly during injection and infusion,accounting for 54.7%.The injuries of 39(33.3%) staffs were not correctly dealt with;62(53.0%) staffs did not have timely follow-up examination or vaccine inoculation.Conclusion To enhance the education on occupational exposure,intensify occupational disease prevention,improve the working environment,reduce the risks during medical management,and establish a sound management system for occupational exposure are the keys to decrease the incidence of occupation exposure and to maintain the physical/psychological health of the medical staffs.