上海交通大学学报（医学版）

上海交通大学学报（医学版）

• 论著（预防医学） • 上一篇    下一篇

250例医务人员职业暴露成因分析

张 轶，黄 霞   

  1. 上海交通大学 医学院附属瑞金医院预防保健科， 上海 200025
  • 出版日期:2014-12-28 发布日期:2014-12-30
  • 作者简介:张 轶（1973—）， 女， 主管技师, 学士; 电子信箱: zy40336@rjh.com.cn。

Analysis of causes of occupational exposure of 250 medical staff

ZHANG Yi, HUANG Xia   

  1. Department of Prevention and Health Care， Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
  • Online:2014-12-28 Published:2014-12-30

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摘要：

目的 分析医务人员职业暴露的主要成因，针对性地提出预防策略，以减少职业暴露的发生。方法 收集瑞金医院2012年1月—2013年12月发生职业暴露后上报的250个案例，分析其职业暴露的主要成因。根据具体情况，采取相应的预防性治疗，并进行跟踪调查和随访分析。结果 250例职业暴露情况分析结果显示：在暴露职业中，护士占58.80%，医师占32.00%。暴露方式以针刺伤为主，占94.00%，常见于拔针及手术缝合时被刺伤。暴露源不明占34.00%，暴露源为阴性或事后追查为阴性占32.40%，乙型肝炎病毒阳性占23.20%。大多数暴露者均及时进行局部处理和消毒，并迅速上报，采取相应预防性干预措施，经追踪检测无因此发生血源性感染者。结论 医务人员的职业暴露成因分析有助于确定职业安全防护教育的重点目标人群，针对性预防并减少其职业暴露风险。

关键词: 职业暴露, 针刺伤, 职业安全

Abstract:

Objective To analyze main causes of occupational exposure of medical staff and to propose preventive measures for decreasing the occurrence of occupational exposure. Methods The data of 250 reported cases of occupational exposure in Ruijin Hospital from January 2012 to December 2013 were collected and main causes of occupational exposure were analyzed. Preventive treatments were conducted according to their actual situations and tracking survey and follow-up analysis were performed. Results The results of analysis of 250 reported cases of occupational exposure showed that top two exposure rates were observed among nurses (58.80%) and doctors (32.00%). Needle stick injuries (NSIs) were the most common cause (94.00%), which occurred frequently during needlewithdrawing and suturing. Unknown causes, negative causes or causes confirmed to be negative afterwards, and hepatitis B virus accounted for 34.00%, 32.40% and 23.20% respectively. Most cases underwent local treatments and disinfection properly and were reported immediately. Relevant preventive measures were taken and no blood borne infections were found by detections conducted afterwards. Conclusion Analysis of causes of occupational exposure of medical staff facilitates identifying the key target group of occupational safety education, taking relevant preventive measures, and decreasing the risk of occupational exposure.

Key words: occupational exposure, needle stick injuries, occupational safety