广州市某综合医院锐器伤现状分析及防治对策

Current status and preventive strategies of sharp instrument injuries in a general hospital of Guangzhou City

目的通过了解医务人员锐器伤发生现状,为锐器伤的防护提出改良建议。方法对广州市某综合医院近8年登记上报的378例锐器伤个案进行回顾性调查分析。结果 378例锐器伤中,护理人员为高发人群,占76.2%;锐器伤大多发生在各种注射操作中(43.9%),其次是处理废物过程中(30.7%);90.5%锐器伤受伤部位在手,52.0%锐器伤人员未戴手套;明确暴露源病原学阳性者87例(乙型肝炎50例,梅毒25例,丙型肝炎12例);仅有25.3%(96/378)的医务人员在事后采取病原体监测或预防性治疗措施,不同职称以及受不同污染程度锐器刺伤的医务人员事后会采取相关防护措施的比例差异有统计学意义(P<0.05)。结论医院相关部门应加强锐器伤高发人员职业安全培训,规范操作技能,开展安全器具,完善职业暴露后的管理和处置。

[Objective]To understand the current status of sharp instrument injuries among heahhcare workers （HCWs）, propose effective guidance for protection of sharp injury. [Methods] A retrospective investigation was performed to analyze 378 cases of sharp injuries occurred in past 8 years in a general hospital of Guangzhou City. [Results] Nurses accounted for 76.2% of 378 cases of sharp injuries. The sharp injuries mainly caused by the injection operation （43.9%）, followed by waste disposal （30.7%）. 90.5% of the sharps injuries wounded in hand, and 52.0% of them did not wear the gloves. 87 cases were exposed to patients with known positive blood borne pathogens （50 cases were HBV, 25 were syphilis, and 12 were HCV）. Only 25.3% （96/378） HCWs received the pathogen monitoring or preventive treatment measures after exposure. There were statistically significant differences in proportion of taking the relevant protective measures after exposure among HCWs with different professional titles, as well as different pollution degree of sharp instrument. [ Conclusion ] The hospital authorities should strengthen the occupational safety training among high-risk group of sharp injury, standardized operation procedure, promote the safety injection, and improve the management and disposal after occupational exposure.