上海市中医诊疗相关感染预防控制现况调查

Current status of Chinese medicine treatment-related prevention and control in Shanghai

目的调查2017年上海市医院中医诊疗相关感染风险,为改进中医诊疗相关感染预防控制措施提出建议。方法采用自制问卷于2017年12月10日-12月31日对上海市96所二级以上医院中医医疗技术开展情况及其感染预防控制措施(针灸、拔罐、刮痧、推拿开展情况、类型及相关用具消毒与处置措施)进行调查。结果 96所医院有91.21%开展针灸诊疗,使用针灸类型最多的为毫针(26.12%),82.35%的医院针具均不复用,7.06%的医院在消毒供应中心集中消毒灭菌;85.71%的医院开展了拔罐诊疗,使用拔罐类型最多的为普通拔罐(53.85%),对于罐具的消毒,65.63%的医院采用浸泡,17.71%的医院采用自动清洗机,16.67%的医院采用擦拭;医院等级及门诊量与针、罐具处置方式之间差异无统计学意义;16.48%的医院开展刮痧诊疗,采用最多的刮痧器具材质为牛角(61.11%),对于刮痧器具的消毒,58.82%选择浸泡,41.18%选择擦拭。结论上海市医院中医诊疗过程中存在多个感染风险环节,二、三级医院都存在针、罐具处置不合理的现象,部分医院的中医诊疗器械消毒措施仍有待进一步改进。

OBJECTIVE To understand the related infection risk of Chinese medicine treatment in Shanghai in 2017,so as to provide suggestions for the improvement of prevention and control measures of Chinese medicine treatment-related prevention and control.METHODS By means of self-made questionnaire,the status of traditional Chinese medicine（TCM）technology and its infection prevention and control measures in 96 hospitals in Shanghai from Dec.10,2017 to Dec.31,2017 was investigated.The questionnaire included the types,equipment disinfection and disposal measures of the acupuncture,cupping,scraping and the massage.RESULTS Among the 96 hospitals with TCM,91.21% of them carried out acupuncture treatment.For the disposal of needles,the most commonly used type was the filiform needles（26.12%）,82.35% of the hospitals were not reused,while 7.06% of the hospitals were sterilized at the disinfection supply center.Totally 85.71% of hospitals conducted cupping treatment,and the most commonly used type was general cupping（53.85%）.For the disinfection of cupping cans,65.63% of hospitals used soaking,17.71% of hospitals used automatic cleaners,and 16.67% of hospitals used wipes.There was no difference between hospital grades,outpatients and disposal methods of needles or cupping cans.Totally16.48% of hospitals performed scraping,and the most used scraping device was made of horns（61.11%）.For the disinfection of scraping devices,58.82% of hospitals adopted the soak,and 41.18% adopted the wipe.CONCLUSIONThere are multiple risks of infections in the process of TCM treatment in Shanghai.The unreasonable disposal of needles and cupping cans exists widely in secondary and tertiary hospitals.Part of hospitals in Shanghai still need to further improve the disinfection measures of TCM treatment.