医护人员在普外科手术中对HIV的防护

Protection of medical personnel in general surgery for HIV

目的总结为人类免疫缺陷病毒(HIV)感染者和获得性免疫缺陷综合征(AIDS)病人施行手术过程中避免职业暴露的经验,并提出相应的防范措施。方法对25例HIV感染者和5例AIDS病人施行手术时,医护人员采取了一系列的职业防护措施,并对手术经过进行回顾性分析。结果比较安全地完成了30例普外科手术。其中胆囊切除术12例、腹内金属异物取除术8例、阑尾切除术3例、胃穿孔修补术1例、肠切除吻合术1例、盆腔非霍奇金病淋巴瘤切除术1例、腹股沟非霍奇金病淋巴瘤切除术1例、肛周脓肿切开引流术1例、腹股沟斜疝修补术1例、肘部非霍奇金病淋巴瘤切除术1例。结论戴防护面罩或眼罩保护眼睛、戴双层乳胶手套护手;注意力高度集中;不直接传递器械;取放器械时眼随手动;不用手直接接针;尽量不用手触摸探查腹腔内金属异物;血液或分泌物喷溅时迅速用纱块遮挡等措施对减少医护人员的职业暴露具有实际的意义。

Objective To summarize the experience of occupational exposure in HIV-infected people and AIDS patients during surgery and propose preventive measures.Methods Twenty-five cases of HIV infection and 5 cases of AIDS patients during surgery,medical personnel were adopted a series of occupational protective measures,and after surgery were retrospectively analyzed.Results Thirty cases surgery were completed relatively safely,of which 12 cases of laparoscopic cholecystectomy,8 cases of intra-abdominal surgery removing metal foreign body,3 cases of appendectomy,1 case of gastric perforation repair,1 case of intestinal resection and anastomosis,1 case of pelvic non-Hodgkin＇s lymphoma excision,1 case of inguinal non-Hodgkin＇s lymphoma,1 case of perianal abscess incision and drainage operation,1 case of indirect inguinal hernia repair,1 case of non-Hodgkin＇s lymphoma elbow surgery.Conclusion To wear protective masks or goggles to protect eyes,wear double latex gloves,high concentration of attention,not to transfer equipment directly,pick-and-place equipment readily when the eyes move,not to receive needle directly,not to touch metal detecting intra-abdominal foreign body,blood or secretions of rapid yarn splash block shelter and other measures to reduce occupational exposure of health care has practical significance.