目的总结HIV感染剖宫产术中职业暴露的特点,探讨职业暴露原因及防范措施。方法回顾柳州市妇幼保健院2002年4月-2013年12月开展的282例HIV感染剖宫产术中发生医务人员职业暴露情况;观察、比较自2008-2013年开展职业防护培训前后HIV感染剖宫产职业暴露的发生率、类型差异等。结果 282例HIV感染剖宫产术中有6例发生职业暴露,发生率2.13%。开展HIV感染剖宫产职业防护培训前(2008年以前)职业暴露发生率13.16%(5/38),明显高于职业防护培训后(2008年1月-2013年12月)0.41%(1/244),差异有统计学意义(P<0.05)。发生职业暴露的原因:4例为针刺伤引起、2例为无保护接触引起。结论本研究HIV感染剖宫产发生职业暴露更易在未经职业防护培训的早期发生,且以针刺伤为主。经职业防护培训后,通过规范手术操作、减慢手术速度、严格执行普遍性防护措施等可减少HIV感染剖宫产术中职业暴露发生。

Objective To summarize the characteristics of occupational exposure in HIV infection in cesarean section and to explore its cause and preventive measures.Methods Retrospectively analyzed the medical staff's occupation exposure when carry out282 cases of HIV infection in cesarean section,which were admitted to our hospital from April 2002 to December 2013.The incidents and types of occupational exposure before and after the occupational protection training were observed and compared.Results The investigation discovered there occurred 6 cases of occupation exposure among that 282 cases of HIV infection in cesarean section,the incidence was 2.13%.Before the training of occupational protection( before 2008),the rates of occupational exposure was 13.16%( 5 /38),which were significantly higher than 0.41%( 1 /244) after training( from January 2008 to December 2013).There was significant difference between two groups( P < 0.05).Responsible for occupational exposure:4 cases were caused by needle stick injuries and 2 cases were caused by unprotected exposure.Conclusion The occupational exposure of HIV infection in cesarean section is more likely to present before training and the categories is given priority to with needle stick injuries.After training,performing proper operation,slowing the speed of operation and strict enforcement of universality protection,all these procedures can effectively reduce occupational exposure in HIV infection in cesarean section.