临床医护人员HIV职业暴露及其防护——附5例分析

Medical staff with occupational exposure to HIV and self - protection analysis of 5 cases

目的 对临床医护人员HIV职业暴露的原因、方式及危险程度进行评价,并探讨可能的防护方法。方法 对5位HIV职业暴露的临床医护人员的暴露原因、方式、危险程度及防护方法进行分析。结果（1）5位临床医护人员中,口腔医生1人（1/5）,护士4人（4/5）,其中艾滋病专业临床护士2人,外科护士1人,急诊科护士1人。（2）暴露方式及危险程度:4人为针刺伤并穿过皮肤,1人为长时间无保护接触病人血液。（3）暴露后处理及预防治疗:暴露后 5人均用清水冲洗,并挤压伤口,用碘酊及75％酒精消毒。4人在 24小时内接受 ZDV+3TC+IDV预防治疗两周,其中2人在2小时之内接受治疗,1人未接受治疗。（4）HIV抗体检测:5人在3～6个月后HIV抗体检测均阴性。结论 临床医护人员,尤其是临床护理人员,容易遭受HIV暴露。因此,应加强对医护人员HIV暴露的防护,防止医护人员感染HIV。

Objective To assess the condition, mode and risk of occupational exposure to HIV in medical staff and to provide realtively effective approaches to protect doctors and nurses from infection with HIV. Methods To analyze causes , modes, risk factors of occupational exposure of 5 medical workers to HIV and the ways of self- protection. Results (1)Of 5 doctors and nurses,dentist in 1(1/5) and nurses in 4(4/5), of whom 2 working in AIDS department, 1 in surgical department, and 1 in emergence department. (2)Mode and risk factor of exposure to HIV: Among the 5 persons,4 were due to percutaneous prick by injecting- needle,1 contacted the AIDS patient's blood without any protection for a long time. (3)Prophylaxis after exposure: Wound was washed by clean water and sterilized with 75% alcohol after exposure,4 were given ZDV + 3TC+ IDV for prophylactic treatment with in 24 hours for two weeks, but 1 did not receive any prophylactic treatment. (4)HIV antibody test:The results of all HIV tests were negative in 3-6 months after exposure. Conclusion Doctors and nurses would be easily exposed to HIV, especially clinical nurses. It is very important to itencify self - protection measures to avoid infection with HIV.