手术中血源性职业暴露特点分析

Characteristics of occupational exposure to bloodborne pathogens during operation

目的分析手术中血源性职业暴露的特点,为制定预防和控制对策提供依据。方法调查某三甲医院2016年6月—2017年1月发生的手术中血源性职业暴露病例,调查内容包括医务人员一般资料、职业暴露方式、暴露源及锐器伤器械种类及操作环节等。结果手术中发生血源性职业暴露的医务人员共100名。主要为护士64名(64.00%),其次为医生30名(30.00%)。暴露方式主要为锐器伤88例(88.00%)、眼黏膜暴露10例(10.00%)。暴露源病种主要为乙型肝炎36例(36.00%)、梅毒11例(11.00%)。导致锐器伤的锐器主要为输液器针头(31例,35.23%),其次为注射器针头(24例,27.27%)、缝合针(14例,15.91%)等。锐器伤发生的操作环节主要为术中操作(31例,35.23%)。结论应加强医务人员的职业暴露培训,完善职业暴露的登记和报告流程;严格要求医务人员,尤其是护士在手术过程中应严格按照操作流程规范操作,从而减少手术中血源性职业暴露的发生。

ObjectiveTo analyze the characteristics of occupational exposure to bloodborne pathogens during operation, and provide reference for making the prevention and control measures. MethodsOccupational exposure to bloodborne pathogens during operation in a tertiary first class hospital between June 2016 and January 2017 were surveyed, the survey included general information about health care workers（HCWs）, modes of occupational exposure, exposure sources, types of sharp injuries, manipulation and so on. ResultsA total of 100 HCWs sustained occupational exposure to bloodborne pathogens during the operation, 64（64.00%）were nurses, followed by doctors（n=30, 30.00%）. The main mode of exposure were sharp injuries（n=88, 88.00%）and ocular mucosa exposure （n=10, 10.00%）. The main diseases of exposure source were hepatitis B（n=36, 36.00%） and syphilis（n=11, 11.00%）. The main sharp device that caused sharp injuries was transfusion system needle（n=31,35.23%）,followed by syringe needle （n=24, 27.27%） and suture needle（n=14,15.91%）. The main manipulation resulting of sharp injury was intraoperative manipulation （n=31,35.23%）. ConclusionTraining about occupational exposure should be strengthened among HCWs, it is necessary to improve the record and report process of occupational exposure, strictly require HCWs, especially nurses in accordance with the standard operating procedure during the operation process, so as to reduce the occurrence of occupational exposure to bloodborne pathogen during operation.