综合性医院参与艾滋病临床综合医疗服务的研究

Challenges and responses in general hospitals participating in the clinical service to people living with HIV /AIDS in China—Evidence-based health policy research

目的探讨综合性医院参与艾滋病临床医疗服务的挑战与对策。方法收集四川省人民医院城东病区自开诊以来参与艾滋病临床治疗以及职业暴露情况的资料,结合相关领域政策法规,使用META-LAB高性能计算平台(HCP)对数据进行分析。结果 2009年11月至2012年12月合计报告感染者42例(门诊报告4例、住院报告38例),除1例因需抗逆转录病毒治疗(ART)治疗转入定点医院外,其余均在本院接受治疗,其中手术治疗6例。各年份合计职业暴露共计49例次,总体职业暴露发生率为0.05%,HIV相关职业暴露4例次。所有HIV相关职业暴露者后续HIV抗体检测均为阴性。结论随着艾滋病疫情的蔓延,综合性医院参与艾滋病防治工作已成必然。在管理制度、安全意识培训等方面进行调整和适当投入,职业暴露发生率可以控制在很低水平,医务人员因为医疗操作而感染HIV的风险可以得到有效控制。综合性大医院完全可以承担艾滋病感染者的普通医疗服务。

Objective To explore the challenges and responses in general hospitals participating in the clinical service to peo -ple living with HIV/AIDS（PLWHAs）.Methods The data from clinical services to PLWHAs and the condition of occupational expo -sure at the East Branch of Sichuan Provincial People＆#39;s Hospital had been cumulated since its opening in November 2009 .All the data was processed by SPSS 17.0 on META-LAB HCP.Results According to our data ,the number of PLWHAs and other ordinary patients had both been rising every year since the ward＆#39;s opening.The reported number of PLWHAs of three years was 42,including 4 outpa-tients and 38 inpatients,only one of which was transferred to a designated hospital .In totally,there were 49 occupational exposure e-vents,which represented an exposure rate of 0.05%,including 4 HIV/AIDS exposures.After timely intervention,no one was infected HIV from the exposures .Conclusion AIDS has largely become a chronic disease requiring life-long care .With the spread of HIV/AIDS,the participation of general hospitals in the clinical service to PLWHAs is now inevitable .Appropriate input and adjustment in management and prevention awareness training are here demonstrated to result in low level of occupational exposure .Therefore ,the risk of infection for health care personnel can be effectively controlled .We believe that general hospitals have the responsibilities and the ca-pacity to participate in the ordinary medical care of PLWHAs .