手术相关人员血源性传染病职业暴露危险因素及防范措施分析

Analysis on Risk Factors and Preventive Measures of Occupational Exposure to Blood-borne Infectious Diseases in Operation Related Personnel

目的:探讨手术相关人员发生血源性传染病职业暴露的危险因素,并提出相关防范措施。方法:选取2018年3月-2020年3月北京京煤集团总医院发生职业暴露的75名手术相关医护人员为研究对象。统计75名手术相关人员发生血源性传染病职业暴露的例数,并发放调查问卷,同时记录工种、工龄、文化程度及血源性传染病职业暴露感染源、暴露部位、暴露环节。统计手术相关人员发生血源性传染病职业暴露情况,根据调查结果分析手术相关人员发生血源性传染病职业暴露相关的危险因素,分析血源性传染病职业暴露感染源构成比、暴露部位、暴露环节,并提出相应防范措施。结果:75名手术相关人员发生血源性传染病职业暴露15例,发生率为20.00%。暴露感染源主要为乙型肝炎,构成比为40.00%。暴露部位中,手指占有较高的比例,构成比为46.67%,其次为手掌,构成比为33.33%。暴露环节中,缝合时构成比最高,为33.33%,其次为传递器械时。工龄≤5年、本科及以下学历、未对患传染性疾病主动了解、受到医源性伤害、未佩戴防护眼罩及静脉穿刺未佩戴手套均是手术相关人员发生血源性传染病职业暴露的危险因素(P<0.05)。结论:导致手术相关人员发生血源性传染病职业暴露的危险因素较多,在临床工作中应注重对低年资手术相关人员血源性传染病职业暴露知识的培训,提高自身的重视程度,加强职业防护,缓解手术人员的压力,减少医源性伤害等措施降低职业暴露的发生率。

Objective:To explore the risk factors of occupational exposure to blood-borne infectious diseases in operation related personnel,and put forward relevant preventive measures.Method:Seventy-five medical staff related operation with occupational exposure in Beijing Jingmei Group General Hospital from March 2018 to March 2020 were selected as the research objects.The cases of occupational exposure of blood-borne infectious diseases in 75 operation related personnels were counted,and questionnaires were issued.Meanwhile,the types of work,length of service,education level,infection source,exposure site and exposure link of occupational exposure of blood-borne infectious diseases were recorded.The condition of occupational exposure to blood-borne infectious diseases of operation related personnels was counted,the risk factors related to occupational exposure to blood-borne infectious diseases of operation related personnel were analyzed according to the investigation results,the infection source composition ratio,exposure site and exposure link of occupational exposure to blood-borne infectious diseases were analyzed,and the corresponding preventive measures were put forward.Result:There were 15 cases of occupational exposure to blood-borne infectious diseases among 75 operation related personnels,and the incidence rate was 20.00%.The main infection source of exposure was hepatitis B with a composition ratio of 40.00%.Among the exposed sites,fingers occupied a higher proportion,with a composition ratio of 46.67%,followed by palms,with a composition ratio of 33.33%.In the exposure link,the composition ratio of suture was the highest,which was 33.33%,followed by the transfer of instruments.The risk factors for occupational exposure to blood-borne infectious diseases were length of service less than or equal to 5 years,bachelor’s degree or below,no active understanding of infectious diseases,iatrogenic injury,not wearing protective eye mask and venipuncture without wearing gloves(P<0.05).Conclusion:There are many risk factors that lead to occupational exposure to blood-borne infectious diseases in operation related personnel.In clinical work,measures such as paying attention to the training of occupational exposure knowledge of blood-borne infectious diseases among low qualification operation related personnel,improving their own level of attention,strengthening occupational protection,relieving the pressure of operation personnel and reducing iatrogenic injuries should be taken to reduce the incidence of occupational exposure.