临床医生发生血源性病原体职业暴露的调查分析

Occupational exposure to bloodborne pathogens among clinicians in a teaching hospital

目的了解临床医生发生血源性病原体暴露的情况,为制定预防对策提供依据。方法建立血源性病原体职业暴露监测报告系统,调查医生在工作中发生暴露的相关情况。结果共收到106名医生发生血源性病原体职业暴露的报告。其中,血液或体液溅污20人,锐器伤86人。最常见的暴露物为血液。外科医生发生锐器伤的比率最高,达67.44%,暴露多发生在医生使用缝合针、穿刺针或刀片进行手术时。暴露源以乙型肝炎表面抗原(HBsAg)阳性患者最多见(51.89%),其次是梅毒抗体阳性患者(16.98%),抗HIV阳性患者2例。对发生职业暴露的医生及时进行相关干预,经追踪随访,无人因暴露而发生感染。结论外科医生在进行手术相关操作时易发生血源性病原体暴露,应加强职业安全防护意识,规范操作规程,暴露后及时进行干预以降低暴露后感染的危险。

Objective To investigate the features of exposure to bloodborne pathogens among clinicans, so as to provide strategies of prevention. Methods Occupational exposure to bloodborne pathogens among clinicians were investigated by establishing a monitor-reporting system. Results One hundred and six incidents were reported by clinicians, 20 of them were cutaneous or mucosa membrane contamination of splash with blood or body fluids, and 86 clinicians were suffered from sharp injuries. Surgeons were affected in 58 cases（67.44%）. Most exposures occurred in operating room while clinicians were working with suture needles, puncture needles and knives during the operations. On exposure source analysis, 51.89% and 16. 98% were patients with positive HBsAg and antibody of treponema pallidum, 2 patients with positive anti- HIV. Interventions were carried out promptly among clinicians after exposure and no one was infected by these pathogens. Conclusion Bloodborne pathogens exposure can easily occur in operation-related procedures. Occupational safety awareness should be emphasized, standardized procedures should be followed and intervention should be taken promptly to reduce the risk of infection from post-occupational exposure.