中国医务人员HIV职业暴露情况的Meta分析

Occupational exposure to HIV among health care workers in China:a meta analysis

目的了解中国大陆医务人员人类免疫缺陷病毒(HIV)职业暴露的发生情况。方法以“医务人员”、“HIV”、“AIDS”、“人类免疫缺陷病毒”和“职业暴露”为检索词,检索中国生物医学文献数据库、维普中文生物医学期刊数据库、中国知网、万方数据知识服务平台和PubMed数据库建库至2020年12月1日发表的中国医务人员HIV职业暴露的相关文献。由2名研究人员独立筛选文献和提取相关数据。采用Stata 15.0软件进行Meta分析。结果最终纳入21篇文献,包含904例发生HIV职业暴露的医务人员。Meta分析结果显示,发生HIV职业暴露的医务人员中,暴露途径为针刺伤或切割伤的占66%(95%CI:62%~70%);暴露级别为Ⅱ~Ⅲ级的占60%(95%CI:55%~64%);发生针刺伤或切割伤后,在所有进行紧急处理的医务人员中,符合规范化处理程序的占75%(95%CI:68%~82%);所有HIV职业暴露医务人员中,预防性用药的占53%(95%CI:48%~59%)。结论中国医务人员发生HIV职业暴露时针刺伤或切割伤比例高,规范化处理比例低,Ⅱ~Ⅲ级暴露比例高,预防性用药比例低。应加强医护人员的HIV职业暴露的相关教育和培训工作,保护医务人员的职业健康。

OBJECTIVE To investigate the prevalence of occupational exposure to HIV among health care workers(HCWs)in China.METHODS HCWs,HIV,AIDS,human immunodeficiency virus and occupational exposure were used as key words for literature searching in Chinese BioMedical Literature(CBM),Vip Citation Databases(VIP),China National Knowledge Internet(CNKI),Wanfang,and PubMed databases,the literatures regarding the occupational exposure to HIV among Chinese HCWs were retrieved from its establishment to Dec 1,2020.Two investigators independently screened the literatures and extracted data of included studies,and the meta analysis was performed by using Stata 15.0software.RESULTS Totally 21literatures were finally included in the study,involving 904HCWs with occupational exposure to HIV.The result of meta analysis showed that among the HCWs with occupational exposure to HIV,66%(95%CI:62%~70%)were exposed through needlestick injury or cutting injury,60%(95%CI:55%~64%)had the exposure ranging between grade Ⅱ and grade Ⅲ.Among all the HCWs who carried out emergent treatment after the needlestick injury or cutting injury,75%(95%CI:68%~82%)carried out standardized treatment procedures.Among all the HCWs with occupational exposure to HIV,53%(95%CI:48%~59%)were treated with antibiotics prophylaxis.CONCLUSIONThe proportion of the HCWs who are exposed to HIV through needlestick injury or cutting injury is high,the proportion of the HCWs who carry out the standardized treatment is low,the HCWs with the exposure ranging between grade Ⅱ and grade Ⅲ is high,and the HCWs who are treated with antibiotic prophylaxis is low.It is necessary to strengthen relevant education and training for the HCWs so as to ensure the occupational health of the HCWs.