目的 探讨产妇产前经血传播疾病检测对助产士职业暴露在医院感染控制中的意义.方法 对2007年10月至2009年10月间的产妇进行乙型肝炎表面抗原(HBsAg)、丙型肝炎抗体(抗HCV)、艾滋病抗体(抗HIV)、甲苯胺红不加热血清试验(TRUST)检测,并对助产士在这两年间所发生的职业暴露进行统计分析.结果 检出HBsAg阳性521例,阳性率16.35%抗-HCV阳性4例,阳性率0.13%;抗-HIV阳性1例,阳性率0.03%;TRUST阳性12例,阳性率0.38%;助产士发生职业暴露5例,暴露率7.9%;经过随防一年,未发生医院院内感染.结论 产前检测经血传播性疾病可事先知晓产妇经血传播疾病的感染情况,使助产士更严格遵循安全的操作流程,规范操作,自觉加强防护,对助产士职业暴露防治、对医院感染控制、对提高职业防护的依从性和执行率有着重要意义,大大降低助产士职业暴露的风险.%Objective To investigate the significance of disease spread via blood testing to avoid occupational exposure among midwife and prevent the nosocomial infection. Methods From September 2007 to October 2009,serum hepatitis B virus surface antigen ( HBsAg ), antibody against hepatitis C virus (anti-HCV), antibody against human immunodeficiency virus (anti-HIV)and toluidine red unheated serum test(TRUST) of 3186 parturients were performed; the incidence of occupational exposure among midwife was statistically analyzed. Results The number and percentage of positive reaction for HBsAg,anti-HCV, anti-HIV and TRUST were 521, 6.35%; 4, 0.13%; 1, 0.03% and 12, 0.38%. The incidence of occupational exposure among midwife was 5 cases(7.90%) and no nosocomial infection occurred during one-year-follow-up. Conclusion The disease spread via blood testing should inform puerperal the infection of the parturients in advance, let the midwife strictly follow the safety operation procedures,standardize the operations and strengthen the protection. It has important significance to pre vent the midwife occupational exposure, control nosocomial infection and improve the compliance of occupational protection,and it can greatly reduce the risk of midwife occupational exposure.
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