传染病医院职业暴露的前瞻性调查与防护模式探讨  

Occupational Exposure and Preventive Model in Infectious Disease Hospital:A Prospective Investigation

作　　者：陈宝敏[1,2] 宋丽红[1,2] 陈利军[1,2] 张树琴[1,2] 

机构地区：[1]北京地坛医院医院感染管理科 [2]首都医科大学传染病研究所,北京100015

出　　处：《中华医院感染学杂志》2010年第14期2105-2107,共3页Chinese Journal of Nosocomiology

摘　　要：目的了解传染病院的职业暴露现状及高危因素,以寻求有效的防护模式。方法对2007年1月-2009年12月发生职业暴露的116名医护人员进行前瞻性监测,对职业暴露的人群、时间、地点分布、损伤部位,暴露源类别、暴露后应急处理及随访情况等进行统计分析。结果护士(75.00%)是职业暴露的高位人群;HBV、HCV、梅毒和HIV是主要的职业暴露源;锐器损伤(78.45%)是主要的损伤方式;左手食指及拇指是最多的损伤部位;暴露后及时进行局部处理、合理预防用药及坚持血清学追踪监测,会大大降低职业暴露的感染率;监测的116名职业暴露者无一名感染。结论加强对传染病医院不同层次的高危人群的职业防护培训及屏障保护措施、暴露后及时处理和合理预防用药等,可有效防范职业暴露及暴露后感染的发生。OBJECTIVE To study the occupational exposure status and its risk factors among the medical staff in the infectious diseases hospital,and to explore its corresponding preventive model.METHODS The 116 medical staff suffered from occupational exposure from Jan.2007 to Dec 2009 were prospectively monitored.The distribution of exposed occupation,time,locations,injury sites,exposure,post-exposure processing,chemoprophylaxis and follow-up monitoring were statistically analyzed.RESULTS Nurses（75.00%） were at the most high risk of occupational exposure.HBV,HCV,syphilis and HIV were the main causes of occupational exposure for blood-borne infectious diseases in the infectious disease hospital.Needle stick was the major way（78.45%）of injury,and the index finger and thumb of the left hand were the most frequently injurous during occupational exposure.Timely treatment of post-exposure for injurous part,reasonable chemoprophylaxis and the serological follow-up monitoring would significantly reduce the infection rate of occupational exposure.None of 116 exposed cases were infected.CONCLUSIONS Strengthening not only the vocational training for the high risk population on their self-protection awareness and the barrier of protection measures,but also a timely post-exposure treatment and prophylactic therapy for post exposure can minimize the risk of occupational exposure and essentially reduce the incidence of infection.

关 键 词：传染病 职业暴露 高危因素 职业防护 

分 类 号：R197.323[医药卫生—卫生事业管理]