2004-2009年广西桂林市艾滋病病毒职业暴露流行病学特征分析

Epidemiology of occupational HIV exposure in Guilin city,Guangxi 2004-2009

目的了解艾滋病病毒(HIV)职业暴露情况,指导职业暴露的预防。方法收集桂林市2004年1月至2009年12月HIV职业暴露个案资料,对暴露者的职业、暴露方式及级别、暴露源级别、处理方式和转归等因素进行统计分析。结果共发生HIV职业暴露74例。职业分布以护士、公安干警和医生为主,分别占48.6%、24.3%和23.0%。HIV职业暴露事故有逐年增多的趋势,2009年发生的例数最多,占32.4%。主要暴露方式为针刺伤、黏膜污染、抓伤(刮伤)和伤口污染,分别占51.4%、16.2%、14.8%和10.8%;暴露级别和暴露源级别以1级和轻度为主,分别为86.5%和89.2%;31.1%(23/74)进行了正确的局部消毒处理,其中14例暴露程度较重者中,正确的局部处理率为78.6%;在应服药14例中,28.6%的暴露者进行了全程服药;经追踪检测74例暴露者无一例HIV抗体阳转。结论医务人员和警察较容易发生HIV职业暴露,职业暴露后及时正确的局部处理率较低,应加强对医护人员和公安干警预防职业暴露的宣传和培训,降低职业暴露发生,提高正确处理职业暴露的水平。

Objective To understand the status of occupational HIV exposure and provide evidence to develop prevention measures in Guilin. Methods The information of occupational HIV exposure from 2004 to 2009 were collected to conduct statistical analysis on exposure cases＇ occupation,exposure way and degree,exposure source degree,response method and outcome. Results Seventy four cases of occupational HIV exposure occurred during this period. Most cases were nurses （48.6%）,polices （24.3%） and doctors （23.0%）. The occupational HIV exposure cases increased by years,which was highest in 2009 and accounted for 32.4%. Most exposures were caused by needle puncture （51.4%）,mucosa contamination （16.2%）,scratch （14.8%） and wound contamination （10.8%）. Most cases＇ exposure degree and exposure source degree were grade 1 and mild,accounting 86.5% and 89.2% respectively. Of 74 cases,23 （31.1%） received correct local disinfection,the correct treatment rate among 14 severe exposure cases was 78.6%. Among the 14 cases for which preventive medicine should be taken,28.6% of them completed the full prevention course. The follow up for 74 cases indicated that no positive conversion of HIV antibody was found. Conclusion The medical workers and polices were the high risk groups of occupational HIV exposure. The rate of correct local disinfection was low among them. It is necessary to strengthen the education and training on prevention of occupational HIV exposure to reduce the exposure and increase the treatment level of the exposure.