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目的探讨凉山州第一人民医院医务人员锐器伤职业暴露的危险因素及应对措施。方法对医务人员在2011年8月1日-31日期间里的锐器伤发生情况进行问卷式和面对面提问式相结合的方式进行调查,共调查医务人员1 112名,包括医生288名,护士589名,医技人员180名,其他55名;采用《医务人员锐器伤调查问卷》进行筛查,筛查后与发生锐器伤的人员面对面交谈,并填写《医务人员锐器伤危险因素调查表》。用医务人员职业暴露监测系统(EPINeT)进行统计分析。结果发生锐器伤45例,发生率为4.05%,护士发生锐器伤的比例较高,达到了5.3%,医生为4.5%,医技人员较低为0.56%,其他人员发生锐器伤的可能性较小,经四格表的χ2检验,医生与护士锐器伤的发生率差异无统计学意义(χ2=0.010,P>0.05)。锐器伤发生的主要时机以抽血(占16%)、拔出动静脉针(占14%)、双手回套针帽(占14%)、手术缝针(占12%)以及将针头放入锐器盒(占10%)为主;发生的场所以普通病房(占60%)和手术室(占22%)为主;锐器伤发生的器械以一次性注射器(占32%)、静脉留置针(占18%)、真空采血针(占16%)和手术缝针(占14%)为主。结论医生和护士是锐器伤发生的高危人群,应采取一系列措施降低其发生职业暴露的风险,包括增加医护人员数量、加强职业培训、禁止双手回套针帽、采用安全留置针和使用皮肤粘合剂以及采用腹腔镜、阴道镜进行手术等措施,尽量降低医护人员的职业暴露风险。
Objective To investigate the risk factors and countermeasures of occupational exposure to sharp-weapon injuries among medical workers in First People’s Hospital of Liangshan Prefecture. Methods The questionnaires and face-to-face interviews were conducted between medical staffs in the period from August 1 to August 31, 2011. A total of 1 112 medical staffs were investigated, including 288 doctors and nurses 589, 180 medical technicians and 55 others. The medical staff was screened by the questionnaire of sharp injuries of medical staff. After screening, they were interviewed with the persons who had sharps injuries. The medical staff were also instructed the risk factors of sharp injuries Questionnaire". Statistical analysis was conducted using the Medical Professional Exposure Monitoring System (EPINeT). As a result, 45 cases of sharp wounds occurred, with a rate of 4.05%. The incidence of sharp injuries was higher in nurses (5.3%), doctors (4.5%), lower medical technicians (0.56%) and sharp injuries to other persons There was no significant difference in the incidence of sharp injuries between doctors and nurses (χ2 = 0.010, P> 0.05). The main occasion for the occurrence of sharp injuries was bleeding (16%), removal of arteriovenous needles (14%), hands with trocar caps (14%), surgical needles (12%) and needle placement (10%). In general, wards (60%) and operating theaters (22%) were the main places of occurrence; the disposable instruments (32% Venous indwelling needle (18%), vacuum lancet (16%) and surgical needle (14%) based. Conclusions Doctors and nurses are at high risk for sharps injuries. A series of measures should be taken to reduce the risk of occupational exposure. These include increasing the number of health care workers, strengthening vocational training, prohibiting the return of two-handed needle caps, using safety indwelling needles and using the skin Adhesives and laparoscopic, colposcopy surgery and other measures to minimize the occupational exposure of health care workers risk.