居家患者腹膜透析产生的医疗废物处置现况调查与对策探讨

Current status of disposal of medical waste of home-based patients undergoing peritoneal dialysis and countermeasures

目的调查居家腹膜透析患者使用后的腹膜透析袋的处置现况,并提出安全、有效的对策,为腹膜透析袋的规范处理奠定基础。方法选择2017年1月-2018年1月在绍兴市人民医院做定期随访的居家腹膜透析患者作为研究对象,采用调查问卷的方式,对患者基本情况、使用腹膜透析袋情况、血源性传染指标检测情况、使用后腹膜透析袋的处置情况及未根据要求进行处置的原因进行调查分析,并根据现存问题提出针对性的整改措施。结果共调查162例患者,文化程度小学及以下占51.23%、职业类别中农民占53.70%、居住地以城市为主占68.52%、群居为主占97.53%;确诊患有乙型病毒性肝炎5例占3.09%、梅毒1例占0.62%;162例调查对象中未有患者对使用后腹膜透析袋按要求进行处置,主要影响因素为个人原因中的携带/出行不便占100.00%,主观认识不到位,对其危害性不了解占96.91%,宣传教育中的宣传形式简单,未能引起重视占75.31%。结论未按要求处置使用后腹膜透析袋的主要原因是宣教形式单一,造成主观认识不到位,最为重要的是患者处置不方便。

OBJECTIVE To investigate the status of disposal of peritoneal dialysis bags of the home-based patients undergoing peritoneal dialysis and put forward the safe and effective countermeasures so as to lay foundation for standardized disposal of the peritoneal dialysis bags.METHODS The home-based peritoneal dialysis patients for whom the regular follow-up was conducted by Shaoxing People′s Hospital from Jan 2014 to Jan 2018 were recruited as the study objects.By means of questionnaire survey,the baseline data,status of use of peritoneal dialysis bags,indexes of blood-borne infectious diseases,status of disposal of peritoneal dialysis bags and causes of failure to dispose according to requirement were investigated and analyzed,and the targeted rectification measures were put forward according to the exiting problems.RESULTS Of totally 162 patients who were enrolled in the study,51.23%had the degree of education of primary school or below,53.70%were peasants,68.52%lived in urban area,and 97.53%lived in group;5(3.70%)were diagnosed with hepatitis B,and 1(0.62%)had syphilis.None of the 162 study objects dispose the peritoneal dialysis bags according to the requirement;among the major influencing factors,100.00%were due to personal reasons of inconvenient carrying or emergence,96.91%were unaware of harmfulness of the bags,and 75.31%did not pay attention to propaganda and education.CONCLUSION The single form of propaganda and education is the leading cause of failure to dispose the peritoneal dialysis bags according to the requirements,and the inconvenient disposal is the most significant cause for the subjective unawareness.