北京市血液透析单位重症急性呼吸综合征发病及预防情况的调查

The incidence and prevention of severe acute respiratory syndrome in 81 hemodialysis units in Beijing

目的 了解 2 0 0 3年 3～ 6月北京市血液透析中心重症急性呼吸综合征 (SARS)发病及预防情况。方法 采用统一的调查表对北京市 83家透析中心 (军队医院透析中心除外 )SARS发病及其预防措施进行调查。结果 (1)即时返回调查表的有 81家 (三级医院 36家 ,二级医院 37家 ,一级医院 8家 ) ,共有透析患者 2 885例 ,工作人员 6 73名。临床诊断SARS 7例 (7/2 885 ,0 2 4 % ) ,痊愈 3例 ,死亡 4例 ,所有工作人员无SARS或疑似病例 ,无透析中心内部传播者。 (2 )所有透析中心均采取了额外的消毒措施。 98 8% (80 /81)的透析中心使用一次性透析器。 98 8% (80 /81)的透析中心对患者开展了SARS预防知识教育。 90 %以上的透析中心的患者透析前测体温、更换拖鞋和病号服。所有透析中心的医务人员在透析治疗过程中戴口罩、戴帽子 ,93 7% (74 /79)的透析中心医务人员戴手套 ,2 2 8%(18/79)的透析中心医务人员戴护目镜。结论 参加本次调查的各透析中心均无SARS内部传播。加强环境消毒、医务人员的自身防护、对患者卫生习惯的教育 ,有助于预防SARS在透析中心内的传播。

Objective To study the situation of severe acute respiratory syndrome (SARS) infection in the hemodialysis units in Beijing. Methods Eighty-one hemodialysis units were investigated on the incidence and preventive measures for SARS from March to July 2003 by a standardized investigation form. Results (1) Seven hemodialysis patients were diagnosed as SARS clinically and account for 0.24% of total 2885 hemodialysis patients in these units in Beijing. Among the 7 SARS patients,3 recovered from SARS and 4 died. No case was infected within the hemodialysis units.No SARS case or suspected case was found in the health care workers in hemodialysis units.(2)Additional disinfected measures were carried out in all the hemodialysis units. 98.8%(80/81) of them did not reuse the dialyzer. (3)98.8%(80/81) of the hemodialysis units developed education about proventing SARS among hemodialysis patients. Before dialysis treatment patients must take temperature,change specific clothes and shoes in over 90% of the hemodialysis units.(4)All health care workers in the hemodialysis units wore hats and gauze masks and 93.7%(74/79) of them wore gloves. Eye shield was worn in 22.8%(18/79) of the dialysis units centers. Conclusions No ARS case was infected within the hemodialysis units in Beijing. Intensified disinfection of surroundings,self-protection for health care workers and education for patients in personal hygiene habit may be helpful to prevention of SARS in hemodialysis units.