湘雅医院医务人员感染性职业暴露情况调查  

Infectious occupational exposure of medical staff in Xiangya Hospital

作　　者：汤紫媛 吴安华[1] 黄勋[1] 熊辛睿[1] 李春辉[1] 龚瑞娥[1] 曾烂漫[1] 周凤[1] 汪要望 曾翠[1] 周鹏程[1] TANG Zi-yuan;WU An-hua;HUANG Xun;XIONG Xin-rui;LI Chun-hui;GONG Rui-e;ZENG Lan-man;ZHOU Feng;WANG Yao-wang;ZENG Cui;ZHOU Peng-cheng(Xiangya Hospital of Central South University,Changsha,Hunan 410008,China)

机构地区：[1]中南大学湘雅医院感染控制中心,湖南长沙410008

出　　处：《中华医院感染学杂志》2020年第18期2864-2868,共5页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金资助项目(81800472);湖南省自然科学基金资助项目(2018JJ6062)。

摘　　要：目的了解湘雅医院医务人员职业暴露的发生情况及影响因素,为采取正确防控措施减少职业暴露提供依据。方法采用回顾性调查方法,对中南大学湘雅医院2015年11月1日-2018年10月31日发生的职业暴露事件进行分析。结果本院在上述期间共发生928例感染性职业暴露,其中护士619例占66.70%、医生248例占26.72%、医技28例占3.02%、工勤/医辅33例占3.56%;手术室是发生职业暴露最多的部门,共142例,其次是急诊61例,中心ICU 40例;处理废物(针头等)是医务人员最常见发生职业暴露的操作,共208例,其次是手术(含缝合)121例,拔针110例,回套针帽103例,采血79例;工作年限在2年以内的低年资医务人员是发生职业暴露的主要人群,共537例占57.87%;乙型肝炎病毒暴露是本院临床工作者血源性职业暴露最多的感染源,共237例次占24.71%;其次是梅毒螺旋体,89例次占9.28%。丙型肝炎病毒59例次占6.15%。人类免疫缺陷病毒共19例次占1.98%。结论护士、低年资、手术、处理医疗废物是发生感染性职业暴露的高危因素,应针对这些因素加强培训,规范操作,减少医务人员职业暴露的发生。OBJECTIVE To understand the occurrence and influencing factors of infectious occupational exposure of medical staff in Xiangya Hospital so as to provide evidence for taking correct prevention and control measures to reduce occupational exposure.METHODS The occupational exposure incidents that occurred in Xiangya Hospital from Nov 1,2015 to Oct 31,2018 were analyzed by using a retrospective survey method.RESULTS There were 928 cases of infectious occupational exposure during the period,including 619(66.70%)nurses,248(26.72%)doctors,28(3.02%)medical technicians,and 33(3.56%)medical assistants.The places with frequent infectious occupational exposure included operating rooms(142 cases),emergency department(61 cases)and central ICU(40 cases).The disposal of medical waste(needle head)was the most common operation that leaded to the occupational exposure(208 cases),followed by surgical procedures(suture)(121 cases),withdrawal of needles(110 cases),recapping of needles(103 cases)and blood collection(79 cases).The medical staff with the work experience less than 2 years(537 cases,57.87%)was the major population of the occupational exposure.The exposure to hepatitis B virus(237 cases,24.71%)was the most infection source for the bloodborne exposure to the clinical staff,followed by Treponema pallidum(89 cases),hepatitis C virus(59 case-times,6.15%)and human immunodeficiency virus(19 case-times,1.98%).CONCLUSION Nurses,short service life,surgical procedures and disposal of medical waste are the high risk factors for the infectious occupational exposure.It is necessary to strengthen the training,standardize the operation and reduce the incidence of occupational exposure of the medical staff.

关 键 词：职业暴露 医务人员 血源性病原体 

分 类 号：R192[医药卫生—卫生事业管理]