目的 探讨口腔专科医院医务人员发生感染性职业暴露现状及原因。方法 选取某三甲口腔专科医院为研究地点,收集该院2019—2023年全院医务人员发生并上报的感染性职业暴露相关数据,从基本情况、暴露情况和暴露后紧急处理及上报情况三个方面进行比较和分析。结果 （1）2019—2023年该三甲口腔专科医院共发生感染性职业暴露84人,职业暴露率为2.23%;职业暴露率最高的为<30岁医护人员（3.32%）,不同职业类别医护人员中学生的职业暴露率最高（4.15%）,其次为医生（1.79%）。（2）职业暴露发生方式中,在终末处理收拾诊疗器械（50.00%）、食指（59.52%）、空心针刺伤（57.14%）、血液暴露（89.29%）、口腔颌面外科（38.10%）为发生职业暴露方式中的主要环节（P<0.05）。（3）80.95%的暴露人员在发生职业暴露后能及时上报,51.19%的医护人员发生职业暴露后对暴露处冲洗时间<5 min,其中<3 min的达30.95%（P<0.05）;85.71%的医务人员暴露后进行了消毒,暴露后未正确紧急处理的人数占47.62%。结论 口腔专科医院医务人员感染性职业暴露风险较高,<30岁的医务人员、学生是发生职业暴露重点人群,终末处理收拾污染器械、手指、空心针刺伤等是发生职业暴露关键环节,口腔颌面外科是发生职业暴露高危科室。应严格要求医务人员做好标准预防措施,加强其职业防护意识及操作技能,预防口腔专科医院医务人员发生职业暴露后感染。
Abstract
Objective To analyze the current situation and causes of infectious occupational exposure of medical staff in stomatological hospitals. Methods A tertiary first-class stomatological hospital was selected as the study site, and the occupational exposure data reported by all medical staff in the hospital from 2019 to 2023 were collected, and compared and analyzed from three aspects: basic situation, exposure situation, emergency treatment after exposure and reporting situation. Results (1) From 2019 to 2023, 84 medical staff had occupational exposure, and the occupational exposure rate was 2.23%; The highest occupational exposure rate was medical workers under 30 years old (3.32%) and students (4.15%), followed by doctors (1.79%). (2) There were statistically significant differences in occupational exposure composition among all groups (P<0.05). Among them, the main links of occupational exposure occurred in the final disposal of diagnostic instruments (50.00%), index finger (59.52%), hollow needle puncture wound (57.14%), blood exposure (89.29%) and oral and maxillofacial surgery (38.10%). (3) 80.95% of the exposed workers could report to the hospital infection-control department in time after occupational exposure, 51.19% of the exposed workers washed the exposed area for less than 5 minutes after occupational exposure, and 30.95% of them were less than 3 minutes (P<0.05).85.71% of medical workers were disinfected after exposure, and 47.62% were not treated properly after exposure. Conclusions Medical staff in specialized dental hospitals face a relatively high risk of infectious occupational exposure. Those under the age of 30, including students, constitute a key demographic of occupational exposure incidents. Critical moments for such exposure include the final handling and disposal of contaminated instruments, finger injuries, and hollow needle punctures. The Department of Oral and Maxillofacial Surgery is identified as a high-risk area for occupational exposure. It is imperative to enforce stringent standard precautionary measures among medical personnel, enhance their awareness of occupational protection, and improve their operational skills to prevent infections following occupational exposure in specialized dental hospitals.
关键词
职业暴露 /
医院感染 /
口腔科 /
医务人员 /
流行病学调查
Key words
occupational exposure /
hospital infection /
stomatology department /
medical worker /
epidemiological survey
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基金
2024年度校院联合基金项目 “口腔专科医院医务人员职业暴露情况及预防控制分析”（2024XYLH307）; 湖南省科技创新计划项目 “计算机虚拟设计3D打印技术辅助自体牙移植联合正畸治疗的临床研究”（2021SK53302）; 湖南省学位与研究生教学改革研究项目“医教研协同背景下研究生《临床流行病学》课程体系探索及效果评价研究”（2024JGYB101）
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