严重急性呼吸综合征的医学防护

实行科学防护 ,降低SARS对医务人员的感染。建立三区二线二带的建筑布局 ,做到三区隔离、三区之间的气流不对流。设立 1个清洁通道、3个污染通道 ,做到人流、物流不交叉。严格的区域性防护着装和流程。按烈性呼吸道传染病标准防护。防护重点是呼吸道和皮肤黏膜。按照右侧通行的流程 ,原则是污染区穿的防护用品禁止带入半污染区 ,半污染区的防护用品禁止带入清洁区。从而切断了病毒的各种传染途径 ,有效地保护了医务人员。建立由清洁区到污染区的正压气流走向。最好建有负压病房。加强医务人员宿舍区的隔离。结果显示 ,我院 3个月收治SARS患者 2 0 2人次 ,有 2 48名医务人员在SARS病房轮流工作过 ,均未感染SARS。小汤山“非典”定点医院收治 6 80例SARS患者 ,1384名医务人员也未发生SARS感染。提示只要我们坚持以上行之有效的科学防护 ,SARS对医务人员的感染是可防可控的。

PROTECTIVE MEASURES TO PREVENT HEALTH CARE WORKERS FROM CONTRACTING SEVERE ACUTE RESPIRATORY SYNDROME(SARS)

Our objective is to prevent doctors and nurses who worked on SARS ward from contracting this highly communicable disease through observing strict isolation strategies. The following measures have been taken in our hospitals. The wards for SARS patients were remodeled according to the isolation requirements for infectious diseases. They were separated into three quarters, namely clean area, semi-contamination area and contamination area. Two buffer zones were set up to separate the three quarters. Four specific passages were separately allotted to health care staffs, patients, soiled materials disposal and handling and dispatch of specimens, to avoid cross infection by contact. According to the criteria for isolation of serial A respiratory infectious diseases, every health care worker was strictly requested to wear and take off isolation garments properly when they entered and left the ward. Most importantly, specific garbs for different areas were essential for efficient isolation. Respiratory tract, skin and mucous surfaces should be effectively protected on the ward. In addition, doctors and nurses should wear special masks or helmets and waterproof suit during the performance of intubation, CPR or operation. Direction of air flow in SARS ward was diverted away from the clean area by using ventilator in order to prevent air-borne contamination. The air outlet of SARS ward was efficiently filtered to cut down pollution of the environment. Living quarters of medical staff working on SARS ward were isolated with a safe distance from the ward. Their health condition was closely monitored daily. After working in SARS ward for four weeks, they should enjoy a special vacation to assure their good health condition. In the past spring, 882 SARS patients were admitted to both the 309 hospital and Xiao Tanghan hospital. 1 632 health care workers worked for those SARS paitents by turns. To our satisfaction, none of our staffs was infected by SARS. Our experiences indicated that health care workers on the SARS ward could be effectively protected from contracting SARS infection by taking efficient and strictly observed protective measures.