手术相关人员血源性病原体职业暴露的调查分析  

Occupational exposure to blood-borne pathogens in operation-related health care workers

作　　者：韦志福[1] 覃金爱[1] 黄春芳[1] 黎昌宇[1] 赵劲民[1] 黄娟[1] 黄小红[1] 李绍英[1] 张云 郭世辉[1] 

机构地区：[1]广西医科大学第一附属医院

出　　处：《中国感染控制杂志》2009年第3期178-180,172,共4页Chinese Journal of Infection Control

基　　金：广西壮族自治区卫生厅项目(桂卫Z2004136)

摘　　要：目的 了解手术相关人员发生血源性病原体职业暴露情况，为制定相应的职业防护措施提供依据。方法建立血源性病原体职业暴露监测报告系统，调查手术相关人员发生职业暴露的情况。结果2005年1月1日-2008年12月31日共收到197名相关工作人员发生血源性病原体职业暴露的报告。其中，破损的皮肤或黏膜暴露41人，锐器伤156人。医生发生职业暴露的比率最高，达78．05％；工龄较短（0--10年）者发生职业暴露的比率占70．73％；眼睛的血液或体液溅污暴露达92．68％，92．68％的暴露物是血液；导致伤害的锐器中，缝合针占58．33％；暴露源为乙型肝炎表面抗原（HBsAg）阳性血液占60．91％。对发生职业暴露的人员及时进行相关干预，经追踪随访，无人因暴露而发生感染。结论应加强针对性培训，提高使用防护眼镜的自觉性，在手术室安装紧急洗眼装置，正确使用、传递和处理锐器，暴露后进行主动干预以降低暴露后感染的危险，保护广大医务人员健康。Objective To investigate the occupational exposure to blood-borne pathogens in operation-related health care workers （HCWs）, so as to provide evidence for the occupational preventive measures. Methods Surveillance reporting system for exposure to blood-borne pathogens was established, occupational exposure to bloodborne pathogens in operation-related HCWs was surveyed. Results From January 1, 2005 to December 31, 2008, 197 operation-related HCWs were reported to be exposed to blood-borne pathogens, 41 of whom had ruptured skin or mucosa exposure, 156 had sharp injuries. Doctors had the highest occupational exposure rate, which was up to 78. 05%; the rate of occupational exposure in HCWs with short length of service（0-10 years） was 70. 73%; the rate of blood or body fluid splash exposure was 92. 68%, 92. 68% of which was blood splash ; among sharp injuries, 58. 33% were caused by suture needles; 60. 91 %of blood-borne pathogen was HBsAg. Intervention in HCWs who had occupational exposure were taken, follow-up survey showed that no one were infected due to exposure. Conclusion Training on occupational exposure should be strengthened, awareness of use of goggles should be enhanced, eye-washing service should be provided in operating room, the use, delivery and handling of sharp objects should be correct, initiative intervention after exposure should be taken, so as to protect the safety of HCWs.

关 键 词：手术室 职业暴露 感染控制 血传播疾病 HBV HCV HIV 梅毒 

分 类 号：R136.4[医药卫生—劳动卫生]