口腔医院医务人员针刺及锐器伤分析

Needlestick and sharps injuries among health care workers in a stomatology hospital

摘要:

目的 分析口腔医务人员针刺和锐器伤(NSIs)的发生情况及危险因素。方法 收集华西口腔医院2020—2023年报告的NSIs病例,并分析NSIs的相关因素。结果 共报告391例NSIs。仅有1例为无菌器械所致的损伤,其余390例均由污染器械所致。2020年85例,2021年107例,2022年113例,2023年86例。以实习医生为主(235例,60.1%)。294例(75.2%)NSIs发生在临床经验不足3年的医务人员。235例实习医生NSIs在不同月份的分布显示,NSIs在4—6月、7—9月占比较高,差异有统计学意义(P＜0.05)。左手拇指腹侧是最常见的NSIs部位(53例,13.6%),其次是右手食指腹侧(45例,11.5%)、左手食指腹侧(44例,11.3%)等;NSIs最常涉及的器械是各类注射器针头(84例,21.5%),其次是各类车针(76例,19.4%)和缝合针(49例,12.5%);发生阶段主要为治疗过程中(212例,54.2%);最常发生在牙体牙髓科(86例,22.0%)。追踪未发现NSIs引起的职业性血源感染病例。结论 NSIs主要发生在经验不足的口腔实习医生中,引起NSIs的器械与治疗操作阶段有关。

Abstract:

Objective To analyze the occurrence and risk factors of needlestick and sharps injuries (NSIs) among oral health care workers (HCWs). Methods NSIs reported by West China Hospital of Stomatology from 2020 to 2023 were collected, and factors relevant to NSIs were analyzed. Results A total of 391 cases of NSIs were reported. Only one case of injury was caused by a sterile device, while the remaining 390 cases were caused by contaminated devices. There were 85, 107, 113, and 86 cases in 2020, 2021, 2022, and 2023, respectively. Most NSIs occurred among interns (n=235, 60.1%). 294 cases (75.2%) of NSIs occurred among HCWs who had less than 3 years of clinical experience. The distribution of NSIs among 235 interns in different months showed that NSIs accounted for a relatively high proportion from April to June and July to September, and the difference was statistically significant (P<0.05). The ventral side of the left thumb was the most common site of NSIs (n=53, 13.6%), followed by the ventral side of the right index finger (n=45, 11.5%) and the ventral side of the left index finger (n=44, 11.3%). The most common devices involved in NSIs were various types of syringe needles (n=84, 21.5%), followed by various types of dental burs (n=76, 19.4%) and suture needles (n=49, 12.5%). Injuries mainly occurred during the treatment process (n=212, 54.2%) and in the department of endodontics (n=86, 22.0%). This study didn’t find any occupational bloodborne infection case caused by NSIs. Conclusion NSIs mainly occur among inexperienced oral interns, and devices causing NSIs are related to the treatment process.