2015-2018年广安市广安区辖区内医院手术室医护人员HIV职业暴露现状调查分析  

Investigation and Analysis of HIV Occupational Exposure of Medical Staff in Operating Room of Hospitals in Guang’an District,Guang’an City From 2015 to 2018

作　　者：刘小林[1] 杨琼芳[1] 苏小兰[2] LIU Xiaolin;YANG Qiongfang;SU Xiaolan(Operating Room of Guang'an People's Hospital,Guang'an,Sichuan 638000,China;Department of Infectious Diseases,Guang'an People's Hospital,Guang'an,Sichuan 638000,China)

机构地区：[1]广安市人民医院手术室,四川广安638000 [2]广安市人民医院感染管理科,四川广安638000

出　　处：《预防医学情报杂志》2020年第1期54-57,61,共5页Journal of Preventive Medicine Information

基　　金：2018年四川省医学科研青年创新课题(项目编号:Q18040)

摘　　要：目的调查2015-2018年广安市广安区手术室医护人员HIV职业暴露现状,为制定针对性的防控策略、降低手术室医护人员HIV职业暴露提供参考依据。方法2019-01/03,根据广安市广安区现有的医院数量、性质,结合本项目资金预算,采用分层整群随机抽样的方式,随机抽取三级甲等、二级乙等和一级甲等医院各1家,以手术室的医护人员为调查对象,采用自制问卷收集调查对象的年龄、性别、职称、HIV职业暴露经过等资料,并对收集的数据进行统计分析。结果调查的3家医院手术室在2015-2018年间共发生职业暴露404例,其中发生HIV暴露34例(8.42%)。三级甲等医院发生HIV职业暴露18例(52.94%),二级乙等和一级甲等医院16例(47.06%)。手术室医生和护士发生HIV职业暴露分别为15例(44.12%)和19例(55.88%)。年龄<30岁、30~岁和≥40岁组医护人员发生HIV职业暴露分别为15例(44.12%)、11例(32.35%)和8例(23.53%)。初级、中级和高级职称的手术室医护人员发生HIV职业暴露分别为18例(52.94%)、6例(17.65%)和10例(29.41%)。HIV职业暴露环节中,锐器伤为主要暴露环节(88.24%)。暴露后,立即局部挤血+冲洗+消毒、立即局部挤血+消毒、立即局部挤血/冲洗、未立即处理的比例分别为73.53%、8.82%、11.76%和5.88%,且100%的手术室医护人员HIV暴露后均进行了血液检测和使用HIV用药程序预防治疗。暴露后未进行局部规范处理的原因主要为防护意识差、缺乏正规/严格的防护教育及工作繁忙。结论广安市广安区手术室医护人员存在一定比例的HIV职业暴露,需采取针对性措施,提高手术室医护人员个人防护意识、加强个人防护措施以减少手术室HIV职业暴露的发生。Objective To investigate the HIV occupational exposure status of medical staff in operating rooms from 2015 to 2018 in guang’an district,and provide reference basis for formulating specific prevention and control strategies and reducing occupational exposure to AIDS in hospital staff.Method From January 2019 to March 2019,according to the number and nature of existing hospitals in guang’an district,and in combination with the fund budget of this project,one each third-class A hospital,second-class B hospital and one class A hospital was randomly selected.The medical staff in the operating room were selected as the object.A self-made questionnaire was used to collect data such as age,sex,title and HIV occupational exposure,and statistical analysis was carried out.Results From 2015 to 2018,404 cases of occupational exposure occurred in the operating room of guang’an district,34 of whom were exposed to HIV,accounting for 8.42%.Occupational exposure to HIV was found in 18 cases(52.94%)in third-class A hospital and in 16 cases(47.06%)in the second-class B hospital and one class A hospital.15 cases(44.12%)and 19 cases(55.88%)of doctors and nurses had occupational exposure to HIV.Occupational exposure to HIV in primary,intermediate and senior titles was 18 cases(52.94%),6 cases(17.65%)and 10 cases(29.41%)respectively.Among the occupational exposure links of HIV,sharp injuries were the main exposure link,accounting for 88.24%.After exposure,73.53%,8.82%,11.76% and5.88% of medical staff in the operating room underwent blood test and treatment with HIV medication program after exposure to HIV,and the rates of immediate local blood squeezing+washing+disinfection,immediate local blood squeezing+disinfection,immediate local blood squeezing/washing and untreated were 73.53%,8.82%,11.76% and 5.88%,respectively.And 100% of the medical staff in the operating room had blood test and treatment with HIV medication program after exposure to HIV.The main reasons for non-standard treatment after exposure were poor awareness of pr

关 键 词：职业暴露 艾滋病 手术室 职业防护 

分 类 号：R512.91[医药卫生—内科学]