医务人员血源性职业暴露监测分析与防护对策

Analysis and Preventive Strategy of Occupational Exposure to Blood Source Among Medical Staffs

目的了解血源性职业暴露状况,建立医务人员血源性职业暴露报告流程和监测管理系统,为制定职业暴露防护对策提供科学依据。方法监测了2005年11月-2008年11月,95名血源性职业暴露的医务人员,对其职业、高危因素、致锐器伤操作环节、暴露后的风险评估以及预防用药等进行了分析。结果血源性职业暴露护士发生率最高(75.79%),其次是医师(16.84%);职业暴露类型主要是锐器伤造成,锐器类型以输液器针头占首位;致锐器伤操作环节以输液结束拔针与回套或徒手拔针帽时发生率最高;经风险评估,3名HIV职业暴露者,给予预防用药,无1名因职业暴露而发生血源性病原体感染。结论加强医务人员培训教育,规范操作流程,实施标准预防,建立监测系统、完善报告流程及暴露后正确有效处理和干预,是降低职业暴露风险的关键。

OBJECTIVE To monitor the risk of occupational exposure among medical staffs and give the preventive measures. METHODS The profession high risk factor, element of sharp instrument injury , the risk of evaluation after exposure and preventive medication in 95 blood-borne among medical staffs from Nov. 2005 to 2008 were analyzed. RESULTS Among the occupational exposure degree to blood source among medical staffs, the first was nurses （75.79%）,the second doctors （16.84%）. The sharp instrument injury was the most common type of the occupational exposure to blood source, and common appeared in the pinhead of infusion apparatus, and most appeared at the withdrawal of needles after transfusion completed or bare-handed. No staff got the infection brcause of occupational exposure to three HIV patients. CONCLUSIONS It is the key to cut down the risk of occupational exposure by enhancing the training of medical staffs, specification of procedure, enforcing standard precautions, establishment monitoring system, strengthening the report and effective treatment after exposure.