医务人员职业暴露的危险因素分析与对策_林岩

·论　著·

医务人员职业暴露的危险因素分析与对策

林　岩,徐凤琴,陈丽容,肖秀红

(中山大学附属第二医院,广东广州510120)

摘要:目的　了解医务人员职业暴露的危险因素和预防措施。方法　对110名职业暴露的医务人员进行调查,对其职业、暴露过程、暴露物品、处理、追踪等进行分析。结果　职业暴露发生率从高到低依次为护士52.73%、医生35.45%、工人6.36%;发生针刺伤62.73%,各种液体污染20.00%,玻璃伤4.55%,手术刀割伤2.73%,其他器械4.55%;暴露原因为治疗护理时占40.00%,手术及配合时占31.82%,处理器械用物时占18.18%;所有职业暴露者均作妥善处理,暂未发现因职业暴露而感染血源性传播性疾病。结论　加强对医务人员职业暴露的知识培训,增强医务人员的个人防护意识,是减少医务人员职业暴露的关键。

关键词:医务人员;职业暴露;危险因素;分析;对策

中图分类号:R197.31 文献标识码:A 文章编号:1005-4529(2007)08-0985-03

Risk Factors of Professional Exposure among Medical Staff:

Analysis and Preventive Strategies

LIN Yan,XU Feng-qin,CH EN Li-ro ng,XIAO Xiu-hong

(The Second A f f iliated Hosp ital,S un Yat-sen U niversity,Guangzhou,Guangdong510120,China) Abstract:OBJEC TIVE To investig ate the risk factor s of pro fessio na l exposure among medical staff and ex plo re the preventiv e st rategie s.METHODS T he influence of factor s including professio n,ex po sure pr ocess,ex posed materials,treatment pro cess,and fo llow-up among110medical staff w ith professio nal exposure wa s analy zed.

RESULTS T he g ener al incidence of pr ofessional ex po sure was52.73%,35.45%and6.36%fo r clinica l docto rs, nures,and w or ke rs,respectively.Amo ng all ex po sure case s,w e fo und the incidence w as62.73%fo r pricking w ound,20%fo r v ario us liquid co ntamination,4.55%fo r glass injury,2.73%for scalpel cut ting,and4.55%fo r o ther instrument related damag e.T he rea so ns leading to ex posure w ere treatment and nursing ca re,surge ry assistance,a nd instrument and ma te rials manipulatio n,which accounted for40%,31.82%,a nd18.18%of to tal incidence,respectiv ely.A ll of the expo sure cases had been properly trea ted.N one of the inve stigated cases had bee n fo und illed with blo od de rived transmitted disea se caused by pro fessional e xposure.C ONC LUSIONS I t is critical to intensify the t raining of medical staff for the know ledge of professio nal ex po sur e and to impro ve their personal pr otective aw areness,so that the incidence of pro fe ssio nal expo sure could be reduced.

Key words:M edical staff;Pro fessional ex po sur e;Risk facto r;A naly sis;Str ateg y

为维护医务人员的职业安全,预防及减少职业暴露而发生血源性传播疾病,我们对2004年1月-2006年8月,共110名医务人员职业暴露进行登记,及时分析处理每一例职业暴露的情况,暂未发现有医务人员因职业暴露而感染血源性传播性疾病,现报道如下。

1　资料与方法

根据卫生部《医务人员艾滋病病毒职业暴露防护工作指导原则(试行)》要求,设计医务人员职业暴

收稿日期:2006-12-16;　修回日期:2007-03-15露个案登记表,对自2004年1月-2006年8月所登记上报的110名职业暴露情况进行统计分析。

2　结　果

2.1　暴露人员一般情况　发生职业暴露的110名医务人员中,护士58名(包括实习护士7名),占52.73%;医生39名(包括实习医生4名、进修医生1名),占35.45%;工人7名,占6.36%;技术员6名,占5.45%。男性19名,女性91名。

2.2　暴露的污染源　被患者血液、体液污染的职业暴露中,患者有血源性传播性疾病的共69例,占62.73%,其中梅毒检测阳性35例,占31.82%;

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中华医院感染学杂志2007年第17卷第8期