医务人员发生血源性病原体职业暴露相关因素分析与预防

The Related Factors Analysis and Prevention of Occupational Exposure to Blood Borne Pathogens in Medical Personnel

目的:了解某院医务人员发生血源性病原体职业暴露的相关因素,为采取相应的防护措施提供科学的依据。方法:对2010年1月-2014年12月笔者所在医院5年发生血源性病原体职业暴露后上报的医务人员进行调查,统计分析发生血源性病原体职业暴露的职业类别、暴露方式、暴露源情况等方面,并进行回顾性调查。结果:5年共发生血源性病原体职业暴露46人次,其中医生8例,占17.39%,护士35例,占76.09%,工勤人员3例,占6.52%;发生职业暴露方式构成比,其中拔针8例,占17.39%,手术操作9例,占19.57%,针头回套25例,占54.35%,清理废物4例,占8.69%;暴露源病原体构成比,其中乙型肝炎居首位,30例,占65.22%,丙型肝炎6例,占13.04%,甲型肝炎2例,占4.35%,梅毒8例,占17.39%。结论:应加强医务人员职业暴露的安全防范教育培训,严格执行各项诊疗操作规程,采取标准预防措施,必要时进行免疫接种,发生职业暴露后按照职业暴露后处理流程正确处理,增加免疫力,以降低血源性病原体职业暴露感染的发生。

Objective：To understand the relative factors of occupational exposure to blood borne pathogens in medical staff in a hospital,in order to provide the scientific basis for the corresponding protection measures.Method：From January 2010 to December 2014,the medical staff who were reported after occupational exposure to blood borne pathogens from our hospital in 5 years were investigated.The occupational categories,exposure mode and exposure source of occupational exposure to blood borne pathogens were used for statistical analysis,and then reviewed retrospectively.Result：A total of occupation exposure to blood borne pathogens of 46 passengers in 5 years,among them there were 8 cases of doctors,accounting for 17.39%,35 cases of nurses,accounting for 76.09%,3 cases of handymen,accounting for 6.52%.The proportion of occupational exposure mode：there were 8 cases of pulling out needle,accounting for 17.39%,9 cases of surgical operation,accounting for 19.57%,25 cases of needle back to the set,accounting for 54.35%,4 cases of cleaning waste,accounting for 8.69%.Exposed to the source of pathogens,including hepatitis B in the first place,there were 30 cases,accounting for 65.22%,hepatitis C in 6 cases,accounting for 13.04%,2 cases of hepatitis A,accounting for 4.35%,8 cases of syphilis,accounting for 17.39%.Conclusion：Should strengthen the safety prevention education and training of occupational exposure in medical staff,strict implementation of the diagnosis and operation procedures and standard precautions are taken,when necessary for immunization,according to the occupational exposure treatment process to deal with correctly,increase immunity,in order to reduce the occurrence of occupational exposure to blood borne pathogens infection.