外科医生经手术感染乙型肝炎病毒的防护

Prevention Measures Against HBV Infection among Surgeons

目的 选择乙型肝炎病毒（HBV）经手术感染外科医生的防护方法。方法在比较东、西方国家现有HBV经手术传播防护方法的基础上,阐述以乙型肝炎e抗原（HBeAg）作为手术期间HBV传染源监控指标的特点。结果乙型肝炎表面抗原（HBsAg）、HBeAg阴性者和HBeAg阳性者的HBV浓度分别为（100-104）、（100-106）（、102-109）ID/ml;HBV经单层手套传播的感染阈值为105ID/ml,经双层手套传播的感染阈值为106ID/ml;HBsAg阴性者的病毒浓度均达不到手术感染阈值,83.88%HBeAg阳性者的病毒浓度达到手术感染阈值,有80.65%在乙型肝炎疫苗低度反应者的防护范围之内,其余3.23%超过了这种防护能力。结论以HBeAg作为手术期间HBV传染源监控指标的方法属零危险性防护标准,更适合我国现在的国情。

OBJECTIVE To explore the prevention measures against HBV infection among surgeons. METHODS On the basis of the comparison of the current prevention measures HBV infection during operation in the Eastern and Western countries, new prevention measures that HBeAg serves as a supervising and controlling index of HBV were studied. RESULTS The concentration HBV of HBsAg negative, HBeAg negative and HBeAg positive patients were （10^0-10^4 ）, （10^0 -10^6） and （10^2-10^9） ID/ml, respectively. HBV infective threshold value of single layer gloves was 105ID/ml, and that of double layer gloves was 106ID/ml. The viral concentration of all the HBsAg negative patients did not reach the infective threshold value of single layer gloves. 83. 88% HBeAg positive patients reached the threshold value, from them 80. 65% was protected by HBV vaccine and 3. 23% remainders exceeded the protection. CONCLUSIONS HBeAg serving as a supervising and controlling index of HBV infection can be an effective indicator which can reduce the risk of infection. It is more suitable for the current condition of our country.