牙科手机传播乙型肝炎病毒的可能性探讨

The possibility of hepatitis B virus transmission through dental handpieces

目的探讨牙科手机(简称手机)传播乙型肝炎病毒(HBV)的可能性。方法2001至2004年在同一城市中随机抽取具有口腔门诊的三级医院、二级医院、一级医院各10所,调查使用后手机消毒与灭菌处理方式、消毒与灭菌处理前后HBsAg污染情况。利用血清斑点杂交方法观察鸭乙型肝炎病毒(DHBV)污染手机后,在洗脱液中DHBV检测阴性的情况下,能否排除其对动物的感染性。结果2001至2004年,抽检的医院中压力蒸汽灭菌处理手机的比例显著上升,从2001年的27.06%上升至2004年的84.51%;化学消毒剂浸泡、擦拭及其他方法处理手机的比例显著下降,从2001年的60%以上,下降到2004年的10%左右。使用后手机HBsAg抗原性检测阳性率为1.65%。用血清斑点杂交方法检测,在手机洗脱液中DHBV检测阴性的情况下,转染动物后仍可引起动物DHBV感染,证明未灭菌手机HBsAg抗原性检测阴性并不能排除手机仍存在传播HBV的可能性。结论手机传播HBV的可能性存在。压力蒸汽灭菌可杀灭手机上污染的HBV。

Objective To discuss the possibility of hepatitis B virus (HBV) transmission through dental handpieces.Methods Investigation was carried on methods for disinfecting and sterilizing dental handpieces and the condition of HBsAg contamination on dental handpieces before and after disinfection and sterilization by randomly sampling all special stomatological hospitals and dental clinics in a same city and 10 dental departments from the third, second and first class hospitals.The possibility of HBV transmission through dental handpieces was probed by investigating whether ducks can be infected by bath liquid of dental handpieces contaminated by DHBV,while in such bath liquid,DHBV can not be detected by serum dot hybridization.Results From 2001 to 2004, in methods to disposing dental handpieces ,the use of autoclave was remarkably increased while of the disinfectant wipe, immersion and other methods was remarkably decreased. The positive rate of HBsAg from dental handpieces in practice was 1.65%. It was evident that the bath liquid of dental handpieces contaminated by DHBV can conduce infection in vivo test of duck,while DHBV can not be detected in such bath liquid by serum dot hybridization,it is proved that the negative result of HBsAg in non-sterilized dental handpieces can not eliminate the possibility of HBV transmission through dental handpieces.Conclusion There might exist the possibility of HBV transmission through dental handpieces however,the autoclaves might kill the virus contaminating on dental handpieces.