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目的 寻找影响医务人员院内感染传染性非典型肺炎 (SARS)的环境和行为因素 ,为制定预防控制措施提供依据。方法 于 2 0 0 3年 3月选择收治病人较多的广州市有代表性的 9家医院 ,通过访谈了解医院收治病人、预防控制措施和医务人员发病等情况 ;现场考察收治科室的环境布局和通风情况 ;问卷调查其中 7家医院医务人员的暴露、卫生习惯、防护等行为因素和发病情况。通过单因素分析和非条件Logistic回归分析影响SARA发病的行为因素。结果 9家医院参与SARS病人诊治的医护人员罹患率为 0～ 2 4 6 % ,差异有显著性 (χ2 =1 4 1 73,P <0 0 1 )。 2 0 0 3年 1月 2 3日前收治病人的 4家医院的罹患率为 7%～ 2 4 6 % ,3家零感染的医院均为 1月 30日后收治SARS病人。零感染的医院都是分区合理、医患通道分开、医生办公室与病房分开及通风良好的医院。发生严重院内感染的医院都存在分区不合理、交叉污染、通风不良或方向错误等情况。单因素分析结果显示 :“参与抢救”、“常规进入病区”、“在病区吃饭、饮水、抽烟”、“戴口罩”、“戴 1 2层口罩”、“穿隔离衣”“戴眼罩”、“穿鞋套”、戴手套”、“洗手消毒”、“漱口液嗽口”、“鼻眼粘膜保护”、“服抗病毒药”、“回家前洗澡换衣”等行为因素与发病有?
Objective To find the environmental and behavioral factors influencing the hospital infection of SARS among medical staff and provide the basis for making prevention and control measures. Methods A total of 9 representative hospitals in Guangzhou were selected and treated in March 2003, and were interviewed to understand the hospitalized patients, prevention and control measures and the incidence of medical staff. The site layout of the department of treatment and treatment Ventilation; Questionnaire which seven hospital medical staff exposure, health habits, protection and other behavioral factors and incidence. Univariate analysis and non-conditional Logistic regression analysis of behavioral factors affecting the incidence of SARA. Results The incidence rate of medical staff involved in the diagnosis and treatment of SARS in 9 hospitals was 0-246%, with a significant difference (χ2 = 1 4 1 73, P 0 01). The attack rate was 7% ~ 246% in 4 hospitals admitted to the hospital on January 23, 2003. All three hospitals with zero infection were SARS patients after January 30. Zero-infection hospitals are well-partitioned, separate medical and patient access, and separate and well-ventilated hospitals with doctor’s offices and wards. Hospitals with severe nosocomial infections have subregions that are unreasonable, cross-contaminated, poorly ventilated, or in the wrong direction. The results of univariate analysis showed that “participating in the rescue”, “routine entering the ward,” “eating, drinking and smoking in the ward,” “wearing a mask,” “wearing a 1 layer mask,” “wearing a gown, ”,“ Wearing a shoe cover, ”wearing gloves,“ ”hand-washing and disinfecting,“ ”rinsing mouthwash,“ ”protecting the nasal mucosa,“ ”serving antiviral drugs,“ and ”bathing and changing clothes before going home." And the incidence of?