Kurumatani N, Matsukura K, Boku C, Kitauchi S, Sakaguchi R, Kamiya K, Kataoka M, Motoyama M, Miyata H, Yoshioka N
Department of Public Health, Nara Medical University.
Nihon Koshu Eisei Zasshi. 1995 Aug;42(8):542-52.
A self-administered questionnaire was mailed to all midwives working in Nara Prefecture to investigate blood exposure events at delivery and to consider protective measures for the exposure. Out of the 203 midwives 193 responded to the questionnaire. The median number of deliveries in which the midwives had assisted within the past one year was 35 after excluding those who had not assisted in deliveries at all. The incidence of needle-stick injuries was estimated to be 86.2 per 100 persons within the past one year. The occurrence in the subgroup who had worked as midwife for less than 5 years was 2-3 times higher than that in those who worked for more than 5 years. Over 90% of the midwives had experiences of direct blood contact events to the skin while assisting in their 10 most recent deliveries. Blood contact events occurred in the finger-hand-arm area in 85% of the midwives, on the legs in 62%, in the face in 20% and in the eyes in 1%. Around 20% of the midwives had unintentionally sucked amniotic fluid when using a tracheal catheter on a newborn. The most common occasion where direct blood contact events occurred was while bathing an infant for removing blood and amniotic fluid. The midwives wore a disposal gown more often when assisting in labors of parturient women infected with blood-born infectious diseases than without the diseases, and similarly for wearing gloves when measuring blood loss and for usage of a mechanical device for sucking amniotic fluid in the tracheae of an infant. Based on the results obtained in this questionnaire study and our previous study about blood contact events observed in a delivery room, protective measures for midwives against exposure to blood at delivery are required and some ideas are presented.
我们向奈良县所有在职助产士邮寄了一份自填式问卷，以调查分娩时的血液暴露事件，并考虑针对此类暴露的防护措施。在203名助产士中，有193人回复了问卷。在排除完全没有助产经历的人员后，助产士在过去一年中协助分娩的中位数为35次。据估计，过去一年中针刺伤的发生率为每100人86.2例。从业不到5年的助产士亚组中的发生率比从业超过5年的助产士高出2至3倍。超过90%的助产士在最近10次协助分娩过程中有过皮肤直接接触血液的经历。85%的助产士血液接触事件发生在手指 - 手 - 手臂部位，62%发生在腿部，20%发生在面部，眼部为1%。约20%的助产士在给新生儿使用气管导管时无意中吸入了羊水。直接血液接触事件最常发生的场合是给婴儿洗澡以清除血液和羊水时。与未接触血源性传染病产妇的分娩协助相比，助产士在协助感染血源性传染病的产妇分娩时更常穿着一次性手术衣，在测量失血量时戴手套以及在给婴儿气管内吸羊水时使用机械装置的情况也是如此。基于本次问卷调查研究以及我们之前关于产房内血液接触事件的研究结果，需要为助产士在分娩时接触血液提供防护措施，并提出了一些想法。
