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中华实验和临床感染病杂志(电子版) ›› 2016, Vol. 10 ›› Issue (02) : 184 -187. doi: 10.3877/cma.j.issn.1674-1358.2016.02.011

临床论著

HIV感染者骨科手术中医务人员职业暴露和防护
孙胜1, 张强1,(), 赵昌松1, 李鑫1, 赵汝岗1, 张耀1, 刘琨2, 王晶晶3, 陈宗峰2, 蔡娟1   
  1. 1. 100015 北京,首都医科大学附属地坛医院骨科
    2. 271000 泰安市,泰山医学院
    3. 261042 潍坊市,潍坊医学院
  • 收稿日期:2015-10-13 出版日期:2016-04-15
  • 通信作者: 张强
  • 基金资助:
    首都临床特色应用研究项目(No. Z131107002213063); 首都卫生发展科研专项项目(No.首发2011-2017-01); 北京市卫生和计划生育委员会卫生科技成果和适宜技术推广项目(No. TG-2015-05)

Occupation exposure and prevention in human immunodeficiency virus infected patients for orthopedic disorders

Sheng Sun1, Qiang Zhang1,(), Changsong Zhao1, Xin Li1, Rugang Zhao1, Yao Zhang1, Kun Liu2, Jingjing Wang3, Zongfeng Chen2, Juan Cai1   

  1. 1. Department of Orthopedics, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China
    2. Taishan Medical University, Taian 271000, China
    3. Weifang Medical University, Weifang 261000, China
  • Received:2015-10-13 Published:2016-04-15
  • Corresponding author: Qiang Zhang
引用本文:

孙胜, 张强, 赵昌松, 李鑫, 赵汝岗, 张耀, 刘琨, 王晶晶, 陈宗峰, 蔡娟. HIV感染者骨科手术中医务人员职业暴露和防护[J/OL]. 中华实验和临床感染病杂志(电子版), 2016, 10(02): 184-187.

Sheng Sun, Qiang Zhang, Changsong Zhao, Xin Li, Rugang Zhao, Yao Zhang, Kun Liu, Jingjing Wang, Zongfeng Chen, Juan Cai. Occupation exposure and prevention in human immunodeficiency virus infected patients for orthopedic disorders[J/OL]. Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition), 2016, 10(02): 184-187.

目的

探讨骨科人类免疫缺陷病毒(HIV)感染者围手术期应用预防职业暴露相关防护规范化流程对医务人员减少职业暴露的作用。

方法

回顾性分析2010年1月至2015年2月首都医科大学附属北京地坛医院收治的需行骨科手术治疗的HIV感染者共66例,其中给予切开复位钢板螺钉内固定术42例,脊柱椎间融合内固定术11例,关节置换术9例,带锁髓内钉固定术4例。术中精细操作、规范手术操作流程;严格执行预防职业暴露相关防护规范化流程。监测2010至2015年骨科手术医务人员发生职业暴露38例/次。

结果

医务人员发生一级暴露24例,二级暴露9例,三级暴露5例。经严格按照职业暴露后预防处理原则,无1例医务人员发生HIV感染。

结论

围手术期严格执行职业暴露相关防护规范化流程可以有效避免医务人员职业暴露后的感染。

Objective

To investigate the prevention of occupation exposure for medical staff in HIV infected patients who underwent implant surgery.

Methods

From January 2010 to February 2015, 66 cases of HIV infection were admitted to Beijing Ditan Hospital, Capital Medical University for orthopaedic surgery. Among whom, 42 cases were treated with open reduction and plate screw fixation, 11 cases were treated with spinal interbody fusion and pedicle screw internal fixation, 9 cases were treated with hip arthroplasty, 4 cases were treated with interlocking intramedullary nail fixation. Standardized operation process and meticulous operative manipulation were applied during operation. The prevention of occupational exposure protection standardization process was strictly enforced. Total of 38 exposure occupation were observed.

Results

There were 24 cases with primary occupational exposure; 9 cases of two-level occupational exposure; 5 cases of three-level occupational exposure. According to the principle of prevention and treatment after occupational exposure, no case of HIV infection occurred in medical staff.

Conclusions

Strict implementation of intra-operative related protective standardization process could reduce occupational exposure in medical staff.

表1 38例职业暴露者一般情况及构成比
表2 职业暴露后预防治疗方案
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