医疗机构细胞毒性药物职业暴露风险防控指南  

Guidelines for Prevention and Control of Occupational Exposure Risks to Cytotoxic Drugs in Medical Institution

作　　者：四川省医学科学院·四川省人民医院 个体化药物治疗四川省重点实验室 电子科技大学医学院 闫峻峰[2] 邹林珂 刘慧 吕子彦 

机构地区：[1]不详 [2]四川省医学科学院·四川省人民医院 [3]四川省人民医院 [4]电子科技大学医学院

出　　处：《医药导报》2023年第7期941-952,共12页Herald of Medicine

基　　金：个体化药物治疗四川省重点实验室开放课题(2021YB10)。

摘　　要：目的为医疗机构提供细胞毒性药物职业暴露风险防控策略,提高医务人员防护意识,降低医务人员发生潜在的职业暴露风险。方法采用世界卫生组织(WHO)指南制定手册进行细胞毒性药物职业暴露风险分级管控防护指南的研究设计。通过系统检索,指南编写组广泛收集细胞毒性药物进入医院后调配、使用等各环节存在的暴露风险问题,采用德尔菲法调研专家并确定临床问题,采用文献调研、专家经验法整理形成相关证据体后,按照推荐分级的评价、制定与评估(GRADE)方法进行质量评价,并再次通过德尔菲法对推荐意见及证据级别达成共识,最终形成《医疗机构细胞毒性药物职业暴露风险防护指南》。结果通过对143位专家进行网络调查问卷调研,采用德尔菲法对指南达成共识,将工程控制、行政控制和个人防护设备3个不同等级相结合,通过分级管控方式,最终确定37个临床问题,共形成36条推荐意见。结论该指南内容涵盖运输、接收、储存、脱包、调剂、成品使用、废物处理等7个环节,可为医疗机构制定细胞毒性药物相关防控措施提供参考与补充降低医务人员发生细胞毒性药物职业暴露的可能性,保护医务人员安全。Objective To provide medical institutions with occupational exposure risk prevention and control strategies for cytotoxic drugs.Enhance the protective awareness of medical personnel and reduce potential occupational exposure risks.Methods The World Health Organization(WHO)guideline formulation manual was used to study and design the guidelines for the hierarchical control and protection of occupational exposure to cytotoxic drugs.Guide writing group collect exposure risk problems in various links such as the allocation and use of cytotoxic drugs after entering the hospital retrieval through systematic retrieval.The Delphi method was used to construct identify clinical issues,and evidence-based research methods were used to develop relevant evidences.The Delphi method was used to survey experts and identify clinical issues.Literature research and expert experience methods were utilized to compile relevant evidences.Quality evaluation was conducted using the GRADE method,and consensus was reached on the recommendation opinions and evidence levels through Delphi method.Ultimately,the“Guidelines for Prevention and Control of Occupational Exposure Risks to Cytotoxic Drugs in Medical Institution”was formulated.Results Through the online questionnaire survey of 143 experts,the Delphi method was used to reach a consensus on the guidelines.By combining engineering control,administrative control and personal protective equipment at different levels,a graded control approach was established.A total of 37 clinical issues were finally determined through hierarchical management and control,resulting 36 recommendations.Conclusion The guidelines covers seven steps after cytotoxic drugs enter the hospital,including transportation,reception,storage,unpacking,dispensing,finished product use,and waste treatment,which provide reference for medical institutions to develop cytotoxic drugs related prevention and control measures.Therefore,the possibility of occupational exposure to cytotoxic drugs could be reduced and the safety of

关 键 词：细胞毒性药物 职业暴露 风险防控 指南 

分 类 号：R95[医药卫生—药学]