医务人员血源性病原体职业暴露危险因素分析及对策

Risk factors and intervention of medical personnels occupational exposure to bloodborne pathogens

目的对血源性病原体职业暴露案例进行总结、分析,提出预防对策。方法回顾性分析某院20032008年48例职业暴露案例资料。结果 48例血源性病原体职业暴露者中,人免疫缺陷病毒暴露19例,乙型肝炎病毒暴露18例,丙型肝炎病毒暴露6例,梅毒螺旋体暴露5例。手术科室医务人员发生职业暴露29例,非手术科室16例,其他科室3例。暴露途径以手术中各种锐器伤最多见,达16例。发生职业暴露最多者为医生24例(实习医生4例),其次为护理人员21例(实习护士8例),检验人员2例,助产人员1例。对职业暴露者均及时进行了预防性干预,经追踪随访,无一例发生感染。结论医务人员应增强职业防护意识,发生职业暴露后须及时进行干预以降低暴露后感染危险。

Objective To summarize and analyze the incidence of occupational exposure to bloodborne pathogens among medical personnel, so as to provide strategies of prevention. Methods A total of 48 cases of occupational ex posure were analyzed retrospectively from 2003 to 2008. Results Of 48 occupational exposure cases, 19 were human immunodeficiency virus exposure, 18 were hepatitis B virus, 6 were hepatitis C virus, and 5 were Treponema pallidum exposure. Twenty-nlne exposure were in medical personnel in operating room, 16 were in non-operating room, 3 were in the other departments. Sharp injuries during operation were the most common roule of exposure （ 16 cases）. Most exposures were among doctors（24 cases, 4 of whom were interns）, followed by nursing staff （21 cases, 8 of whom were probationer nurses）, laboratorians（2 cases）, and midwife （1 case）. Intervention was carried out promptly among medical personnel after exposure , and no one was infected by these pathogens. Conclusion Occupational safety awareness should be emphasized,intervention should be taken promptly to reduce the risk of infection from post occupational exposure.