血源性病原体职业暴露特点及防控费用研究

摘要

目的 研究血源性病原体职业暴露发生特点及防控费用,为医疗机构政策的制定提供依据.方法 采用前瞻性研究方法,通过医院职业暴露上报系统,收集某院 2016 年 6 月 1 日—2017 年 5 月 30 日发生职业暴露的医务人员上报及随访的数据.结果 共发生95 例次血源性职业暴露.职业暴露发生月份主要集中于 6、7、1 1 月,中午 12点为高发时刻.职业暴露医务人员的职业类别分布主要为护士(41.05%)、医生(28.42%)和实习护士(15.79%).科室分别主要为中心手术室(21.05%)、急诊(1 1.58%)、介入放射科(6.32%).95 例次职业暴露后防控费用合计 33 235.20 元,平均每例 349.84 元.人类免疫缺陷病毒(HIV)暴露后平均每例费用最高,为2 787.50元;梅毒暴露后平均每例费用最低,为58.88元.结论 应加强对血源性病原体职业暴露高危时间、高危人群和高危科室的培训教育,尤其应重视 HIV等防控费用较高职业暴露的预防.%Objective To study the characteristics of occupational exposure to blood-borne pathogens and the cost of prevention and control,and provide evidence for policy making in medical institutions.Methods A prospective study was conducted to collect the data and follow-up data about occupational exposure of health care workers(HC-Ws)from the occupational exposure reporting system of a hospital between June 1,2016 and May 30,2017.Results There were 95 cases of occupational exposure to blood-borne pathogens.Occupational exposure occurred mainly in June,July,and November,peak time for occurrence was 12∶00 at noon.The main occupations of HCWs who sustained occupational exposure were nurses (41.05%),doctors (28.42%),and practice nurses (15.79%).The main departments of occupational exposure were central operating room (21.05%), emergency department (1 1.58%),and interventional radiology department (6.32%).The total cost of prevention and control for 95 times of occupational exposures were 33 235.20 Yuan,with an average of 349.84 Yuan per case.The average cost per case after human immunodeficiency virus (HIV)exposure was the highest (2 787.50 Yuan);and cost of syphilis exposure was the lowest (58.88 Yuan).Conclusion It is necessary to strengthen the training and education of high-risk time,high-risk population,and high-risk departments of occupational exposure to blood-borne pathogens,pre-vention of occupational exposure with high cost of prevention and control such as HIV should be especially paid attention.