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603名医务人员血源性病原体职业暴露情况调查

[Investigation of 603 medical staff occupational exposure with blood-borne pathogens].

作者信息

Song X Z, Fang X, Ding J, Jin L, You J

机构信息

Department of Infection Control, The First People's Hospital of Yunnan Province, The NHC Key Laboratory of Drug Addiction Medicine and Department of Infectious Disease, Kunming 650032, China.

Department of Infection Control, The First People's Hospital of Yunnan Province, Kunming 650032, China.

出版信息

Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi. 2020 May 20;38(5):349-352. doi: 10.3760/cma.j.cn121094-20190510-00191.

Abstract

To investigate the occupational exposure with blood-borne pathogens of medical staff, and explore the protective strategy. Using cluster sampling method, 603 medical staff with occupational exposure with blood-borne pathogens were analyzed, from July 2014 to July 2018 in a tertiary hospital. In total of 603 occupational exposure incidents, 70.98% (428/603) were freshmen younger than 30 years old. 48.92% (295/603) nurses. The most cases of occupational exposure were in surgery (35.16%, 212/603) . Sharp injury was the major contact manner (86.90%, 524/603) . Hands were the main contact parts (90.38%, 545/603) . Ward (53.57%, 323/603) and the operating room (22.72%, 137/603) were the high-risk place. The most dangerous actions were needle injection (34.83%, 210/603) , surgery (20.89%, 126/603) and finishing/cleaning items (19.73%, 119/603) . The main items lead to injuries were scalp needles (34.73%, 182/524) . The most exposure source was hepatitis B virus (HBV) which occupied 39.30% (237/603) . Exposure source mainly comes from medical devices containing blood (81.92%, 494/603) . To compared the groups (χ(2)=19.940, <0.01) and titer (=-8.592, <0.01) of hepatitis B surface antibody (HBsAb) before and after used prophylactics, the differences were statistically significant. Comprehensive strategies of occupational exposure protection education, operation norms and monitoring management were effective methods to reduce the occupational exposure in the medical staff with blood-borne pathogens.

摘要

调查医务人员血源性病原体职业暴露情况,探索防护策略。采用整群抽样方法,对某三级医院2014年7月至2018年7月期间603例有血源性病原体职业暴露的医务人员进行分析。在603起职业暴露事件中,70.98%(428/603)为30岁以下的新人。护士占48.92%(295/603)。职业暴露最多发生在外科(35.16%,212/603)。锐器伤是主要接触方式(86.90%,524/603)。手部是主要接触部位(90.38%,545/603)。病房(53.57%,323/603)和手术室(22.72%,137/603)是高危场所。最危险的操作是针刺(34.83%,210/603)、手术(20.89%,126/603)和整理/清洁物品(19.73%,119/603)。导致受伤的主要物品是头皮针(34.73%,182/524)。最主要的暴露源是乙型肝炎病毒(HBV),占39.30%(237/603)。暴露源主要来自含有血液的医疗器械(81.92%,494/603)。比较使用预防药物前后乙肝表面抗体(HBsAb)的分组(χ²=19.940,P<0.01)和滴度(t=-8.592,P<0.01),差异有统计学意义。职业暴露防护教育、操作规范和监测管理等综合策略是减少医务人员血源性病原体职业暴露的有效方法。

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