Hebra A, Adams D B, Holley H P
Department of Surgery, Medical University of South Carolina, Charleston 29425.
J S C Med Assoc. 1990 Sep;86(9):479-83.
To assess the exposure risks for surgeons and nurses treating HIV infected patients at the Medical University Hospital and the Charleston Memorial Hospital, a retrospective review of HIV positive patients who underwent surgical procedures from 1985-1988 was undertaken. During that period, 150 patients tested positive for HIV of which 30 (20%) underwent 19 surgical procedures. The prevalence of HIV infected patients at our institution has been increasing over the last two years. 5.3% of the patients tested were positive for the virus. Evidence of drug abuse was not a predictive factor of HIV infection but homosexuality was present in 57% of our patients. The mean age of the surgical group was 34 years. Seventy-three percent of the patients underwent minor operations and 27% had major surgical procedures. Almost half of the operations were performed to treat an AIDS-related complication or as a diagnostic aid in the workup of the AIDS patient. Major operations performed were for treatment of a co-morbid condition not related to the HIV infection. Only two patients had operations for trauma. Operative mortality was 10% but no death was directly related to surgical intervention. In addition to universal precautions in the pre and postoperative period, operating room personnel must follow established protocols in the conduct of the operation to ensure the safety of all staff.
为评估在医科大学医院和查尔斯顿纪念医院治疗艾滋病毒感染患者的外科医生和护士的暴露风险,对1985年至1988年接受外科手术的艾滋病毒阳性患者进行了回顾性研究。在此期间,150名患者艾滋病毒检测呈阳性,其中30名(20%)接受了19次外科手术。在过去两年中,我们机构艾滋病毒感染患者的患病率一直在上升。5.3%的检测患者病毒呈阳性。药物滥用证据不是艾滋病毒感染的预测因素,但57%的患者存在同性恋情况。手术组的平均年龄为34岁。73%的患者接受了小手术,27%的患者接受了大手术。几乎一半的手术是为了治疗与艾滋病相关的并发症或作为艾滋病患者检查的诊断辅助手段。进行的大手术是为了治疗与艾滋病毒感染无关的合并症。只有两名患者因外伤接受手术。手术死亡率为10%,但没有死亡与手术干预直接相关。除了在术前和术后采取普遍预防措施外,手术室工作人员在手术过程中必须遵循既定规程,以确保所有工作人员的安全。