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目的探讨综合性医院参与艾滋病临床医疗服务的挑战与对策。方法收集四川省人民医院城东病区自开诊以来参与艾滋病临床治疗以及职业暴露情况的资料,结合相关领域政策法规,使用META-LAB高性能计算平台(HCP)对数据进行分析。结果 2009年11月至2012年12月合计报告感染者42例(门诊报告4例、住院报告38例),除1例因需抗逆转录病毒治疗(ART)治疗转入定点医院外,其余均在本院接受治疗,其中手术治疗6例。各年份合计职业暴露共计49例次,总体职业暴露发生率为0.05%,HIV相关职业暴露4例次。所有HIV相关职业暴露者后续HIV抗体检测均为阴性。结论随着艾滋病疫情的蔓延,综合性医院参与艾滋病防治工作已成必然。在管理制度、安全意识培训等方面进行调整和适当投入,职业暴露发生率可以控制在很低水平,医务人员因为医疗操作而感染HIV的风险可以得到有效控制。综合性大医院完全可以承担艾滋病感染者的普通医疗服务。
Objective To explore the challenges and countermeasures of comprehensive hospitals participating in AIDS clinical medical services. Methods The data collected from the clinical treatment and occupational exposure of AIDS patients in Chengdong Ward of Sichuan Provincial People’s Hospital since the first visit were collected and analyzed by using the META-LAB High Performance Computing Platform (HCP) in combination with the related field policies and regulations. Results From November 2009 to December 2012, a total of 42 cases were reported (outpatient report and inpatient report). All but one were transferred to designated hospitals due to antiretroviral therapy (ART) In our hospital for treatment, including surgical treatment in 6 cases. The total occupational exposure in each year totaled 49 cases, with a total occupational exposure rate of 0.05% and HIV-related occupational exposure in 4 cases. Follow-up HIV antibody testing was negative for all HIV-related occupational exposures. Conclusion With the spread of AIDS epidemic, comprehensive hospital participation in AIDS prevention and control work has become a necessity. In the management system, safety awareness training and other aspects of adjustment and proper investment, occupational exposure rate can be controlled at a very low level, medical staff because of medical risks of HIV infection can be effectively controlled. Comprehensive large hospitals can afford the general medical services of people living with HIV.