一起医务人员HIV职业暴露的追踪调查与反思

Investigation and thinking on an event of HIV occupational exposure in health care workers

目的了解某院医务人员人免疫缺陷病毒（HIV）职业暴露情况，发现存在的问题，进行针对性管理，以提高职业防护能力。方法对2007年3月发生的一起医务人员HIV职业暴露事件进行回顾性调查和血清学追踪监测。结果此次事件中共36名医务人员发生H1V职业暴露，经完整皮肤暴露率为72．22％（26人），损伤性暴露率25．00％（9人），黏膜暴露率2．78％（1人）。发生职业暴露后，严格按规范要求实施急救处理者仅1人（2．78％）。所有职业暴露人员经临床追踪12个月，全部HIV血清学监测阴性。结论医务人员是HOV职业暴露的高危人群，该院职业防护管理工作存在重大隐患，必须加强培训和教育。

Objective To evaluate HIV occupational exposure in health care workers（HCWs） in a hospital, and find the existing problems and aim directly at improving the management of occupational protection. Methods An event of HIV occupational exposure in HCWs occurred on March, 2007 was investigated retrospectively and the serological follow-up monitor was performed. Results Thirty-six HCWs were involved in this occupational exposure event. Exposure rate to the intact skin, injury site and mucous membrane was 72. 22% （26 persons）, 25.00% （9 persons） and 2. 78% （1 person） respectively. Only one person （2. 78%） received emergent treatment. 12 months follow-up observation of HCWs showed that all the serological tests of HIV were negative. Conclusion Health care workers are high risk population of HIV occupational exposure, there are potential problems in the occupational protection in this hospital, the education and training must be strengthened.