医务人员血源性病原体职业暴露危险因素分析及对策

Risk factors and intervention of medical personnel's occupational exposure to bloodborne pathogens

摘要:

目的对血源性病原体职业暴露案例进行总结、分析，提出预防对策。方法回顾性分析某院2003—2008年48例职业暴露案例资料。结果48例血源性病原体职业暴露者中,人免疫缺陷病毒暴露19例，乙型肝炎病毒暴露18例，丙型肝炎病毒暴露6例，梅毒螺旋体暴露5例。手术科室医务人员发生职业暴露29例,非手术科室16例，其他科室3例。暴露途径以手术中各种锐器伤最多见，达16例。发生职业暴露最多者为医生24例（实习医生4例），其次为护理人员21例（实习护士8例），检验人员2例，助产人员1例。对职业暴露者均及时进行了预防性干预，经追踪随访，无一例发生感染。结论医务人员应增强职业防护意识，发生职业暴露后须及时进行干预以降低暴露后感染危险。

关键词:

血传病原体;职业暴露;医务人员;职业防护;危险因素;感染控制

Abstract:

ObjectiveTo summarize and analyze the incidence of occupational exposure to bloodborne pathogens among medical personnel, so as to provide strategies of prevention. MethodsA total of 48 cases of occupational exposure were analyzed retrospectively from 2003 to 2008.ResultsOf 48 occupational exposure cases, 19 were human immunodeficiency virus exposure, 18 were hepatitis B virus, 6 were hepatitis C virus, and 5 were Treponema pallidum exposure. Twentynine exposure were in medical personnel in operating room, 16 were in nonoperating room, 3 were in the other departments. Sharp injuries during operation were the most common route of exposure (16 cases). Most exposures were among doctors(24 cases, 4 of whom were interns), followed by nursing staff (21 cases, 8 of whom were probationer nurses), laboratorians(2 cases),and midwife (1 case). Intervention was carried out promptly among medical personnel after exposure , and no one was infected by these pathogens.ConclusionOccupational safety awareness should be emphasized，intervention should be taken promptly to reduce the risk of infection from postoccupational exposure.

Key words:

bloodborne pathogen; occupational exposure;medical personnel; occupational precaution; risk factors;infection control