某中医院医务人员血源性职业暴露与防护分析  

Blood-borne occupational exposure and protection in medical staff of a traditional Chinese medicine hospital

作　　者：张志刚[1] 魏秋霞[2] 杨致霈 魏巧妙 王小梅[2] 王小莉[2] 

机构地区：[1]陕西中医药大学,咸阳712046 [2]陕西中医药大学附属医院

出　　处：《中华劳动卫生职业病杂志》2017年第3期205-208,共4页Chinese Journal of Industrial Hygiene and Occupational Diseases

摘　　要：目的 了解某中医院医务人员血源性职业暴露与职业防护情况,为降低血源性职业暴露的风险和制定职业防护措施提供参考.方法 选择2015年1至12月发生血源性职业暴露的48名医务人员作为研究对象,分析其血源性职业暴露发生率、影响因素、发生环节、暴露源以及职业防护情况等.结果 该中医院2015年医务人员血源性职业暴露发生率为3.30％（48/1 455）,发生强度为0.04次/（人·年）.血源性职业暴露人群中护士、女性、年龄＜30岁、工龄＜5年以及初级职称医务人员较多;不同年龄和工龄血源性职业暴露发生率差异有统计学意义（x2=15.597、8.944,P＜0.05）.血源性职业暴露最主要的方式是锐器伤（96.08％）,主要环节是注射后回套针帽或分离针头、集中处置用过的锐器物.暴露部位以手为主（96.08％）,左手暴露部位主要为拇指和食指,右手暴露部位主要为中指和食指,两手暴露部位分布差异无统计学意义（P＞0.05）;暴露源病原体主要为乙型肝炎病毒（HBV,占68.96％）;血源性职业暴露发生后局部正确处理率为88.24％,接受预防用药处理占74.51％,最主要的方式为乙肝免疫球蛋白（HBIG）＋乙肝疫苗,其次为HBIG治疗;血源性职业暴露中未戴手套占62.74％.结论 低年资医务人员是血源性职业暴露的高危人群,应加强其血源性职业暴露和防护培训,降低血源性职业暴露和感染的风险.Objective To investigate blood-borne occupational exposure and related protection in the medical staff of a traditional Chinese medicine hospital,and to provide a reference for reducing the risk of blood-borne occupational exposure.Methods Forty-eight medical workers with blood-borne occupational exposure in 2015 were selected to analyze the incidence of blood-borne occupational exposure,influencing factors,operations that caused blood-borne occupational exposure,pathogens,and occupational protection.Results The incidence rate of blood-borne occupational exposure in the medical staff of the traditional Chinese medicine hospital in 2015 was 3.30% （48/1 455）,and the frequency was 0.04 time/person/year.The workers with blood-borne occupational exposure were mostly nurses,females,workers aged 〈30 years,workers with 〈5 working years,and workers with a junior professional title.There was a significant difference in the incidence rate of blood-borne occupational exposure between workers with different ages and working years.The main way of blood-borne occupational exposure was sharp injury （96.08%）.The main operations that caused blood-borne occupational exposure were covering or separating the syringe needle after injection and disposing used sharp instruments.The main exposure site was the hand （96.08%）,with the thumb and index finger for the left hand and the middle finger and index finger for the right hand;there was no significant difference in the exposure site distribution between the two hands （P〈0.05）.The main pathogen that caused blood-borne occupational exposure was hepatitis B virus （68.96%）.The rate of correct local treatment for blood-borne occupational exposure was 88.24%.The rate of prophylactic medication was 74.51%,and hepatitis B immunoglobulin （HBIG） plus hepatitis B vaccine was the main way,followed by HBIG.In all workers with blood-borne occupational exposure,62.74% did not wear gloves.Conclusion The medical workers with few working years have a high risk of blood-born

关 键 词：医务人员 血液 职业暴露 职业防护 

分 类 号：R192[医药卫生—卫生事业管理]