医务人员口腔诊疗中血源性职业暴露及防护现状调查  

Blood-borne occupation exposures in dental practice of medical staff:status and protection

作　　者：陈建伟[1] 王晶[2] 王爱芹[2] 张洁[1] 韩立海[3] Chen Jianwei;Wang Jing;Wang Aiqin;Zhang Jie;Han Lihai(Department of Nosocomial Infection,Binzhou Medical University Hospital,Binzhou 256603,China;Department of Somatology,Binzhou Medical University Hospital,Binzhou 256603,China;Radiologic Department,Binzhou Medical University Hospital,Binzhou 256603,China)

机构地区：[1]滨州医学院附属医院感染管理科,256603 [2]滨州医学院附属医院口腔科,256603 [3]滨州医学院附属医院影像科,256603

出　　处：《中华劳动卫生职业病杂志》2020年第1期29-32,共4页Chinese Journal of Industrial Hygiene and Occupational Diseases

基　　金：山东省滨州市软科学基金项目(2014BRK23);山东省高等学校科技计划项目(J13LL73)。

摘　　要：目的探讨医务人员口腔诊疗中血源性职业暴露和防护状况,为制定有效预防措施提供依据。方法于2019年4月1~15日,采用分层随机抽样方法以滨州市6所综合医院的221名口腔专业医务人员为调查对象,采用调查问卷方式收集其2018年度血源性职业暴露资料,并采用χ2检验分析护士、医生和实习研修人员等不同职业、级别医院职业暴露和防护状况。结果共有166名医务人员发生职业暴露269次,发生率为75.11%(166/221),上报率为37.55%(101/269)。其中,锐器伤占89.59%(241/269),致伤锐器主要为注射器/必兰麻针头(35.68%,86/241)、手术缝针(16.60%,40/241)、车针(16.18%,39/241);暴露操作环节主要为拆卸/处理针头或器械(37.17%,100/269)、手术缝合/协助缝合(22.30%,60/269)、注射麻药(17.84%,48/269)。不同职业人员暴露次数、上报率、致伤锐器类别、暴露操作环节以及乙肝疫苗接种年限等差异均有统计学意义(P<0.05)。不同级别医院在标准预防依从性、安全操作、暴露后上报和预防以及接受职业防护培训等方面部分差异有统计学意义(P<0.05)。结论口腔专业医务人员血源性职业暴露发生率高,上报率低,自我防护薄弱,应加强标准预防、安全使用及处理锐器、暴露后积极上报。Objective To understand the status of blood-borne occupational exposure and protection among health care workers(HCWs)in dental practice,and provide evidence for making effective prevention.Methods From April 1 to 15,2019,a stratified random sampling method was conducted to investigate the data of blood-borne occupational exposure among 221 dental HCWs in 2018,and Chi-squared Test was used to evaluate the differences of status on occupational exposure and protection among different professionals,such as nurses,doctors and trainees,and among different-grade hospitals.Results A total of 166 HCWs were exposed to occupational exposure 269 times,with the annual incidence of 75.11%(166/221),and 37.55%(101/269)of exposures were reported.However,all source patients of exposures had failed to be traced.89.59%(241/269)of exposures were sharp injuries.The top three instruments caused injuries were syringe/bilan needles,suture needles and vehicle needles,accounting for 35.68%(86/241)、16.60%(40/241)and 16.18%(39/241),respectively;and the top three exposure operations were removal/disposal of needles or instruments,suture/assisting suture and injection of anesthetic,accounting for 37.17%(100/269)、22.30%(60/269)and 17.84%(48/269),respectively.There were statistically significant differences among different professionals in occupational exposure frequency,reporting rate,the types of instruments caused injuries,exposure operations and hepatitis B vaccinated time(P<0.01).The compliance rate of standard precautions,safe operation,post-exposure reporting and prevention,and training on occupational protection were generally poor among HCWs,with significant differences in different-grade hospitals(P<0.01).Conclusion There is a high incidence,low reporting rate and poor self-protection of blood-borne occupational exposure among dental HCWs.Strongly suggesting that standard precautions,safe use and disposal of oral instruments,active post-exposure report and prevention must be improved for everyone.

关 键 词：口腔 血传病原体 医务人员 职业暴露 职业防护 

分 类 号：R197[医药卫生—卫生事业管理]