中医微创针刺类技术职业暴露调查及处置对策

Survey of occupational exposures to minimally invasive acupunctures of traditional Chinese medicine and treatment countermeasures

  • 摘要:
    目的 了解医院医务人员开展中医微创针刺类操作过程中发生针刺伤职业暴露的现状及原因,提出管理对策。
    方法 回顾性调查2020年1月-2024年12月广西中医药大学附属瑞康医院医院感染管理科处置的95例涉及中医微创针刺类操作针刺伤职业暴露的情况,并进行危险因素统计与分析。
    结果 中医微创针刺类操作针刺伤占该时段职业暴露总数的16.35%(95/581),暴露者主要为规培、进修、实习医生。其中针灸针刺伤(69例,72.63%),刺伤环节主要发生在针灸出针过程(34例,35.79%)。从不同年龄、职业类别、工作年限、分布科室、自身免疫水平、针刺伤类型、刺伤环节,以及采用急筛的方法处置职业暴露结果显示的数据比较,差异均具有统计学意义(均P<0.05)。
    结论 医务人员实施中医微创针刺类操作时针刺伤发生率较高,应予以重视并干预。通过规范、改良针具使用流程;使用便携式小锐器盒;强化培训低年资人员的安全操作技能;加强老师带教;关注自身免疫水平及时接种;以及职业暴露发生后有效处置,均对降低职业暴露的发生与感染风险有重要意义。

     

    Abstract:
    OBJECTIVE To investigate the current status and causes of occupational exposures to needlestick injuries among healthcare workers who perform minimally invasive acupunctures of traditional Chinese medicine (TCM) so as to propose treatment countermeasures.
    METHODS A total of 95 cases who were involved in the occupational exposures to needlestick injuries due to minimally invasive acupunctures and were treated in hospital infection management department of Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine from Jan. 2020 to Dec. 2024 were retrospectively investigated, and the risk factors for the occupational exposures were statistically analyzed.
    RESULTS The cases of operation-induced needlestick injuries accounted for 16.35% (95/581) among the total cases of occupational exposures due to the operation of minimally invasive acupunctures of TCM, standardized and advanced training doctors as well as interns were dominant among the occupational exposure cases. There were 69 (72.63%) cases of acupuncture needle injuries, 34 (35.79%) of whom had the needlestick injuries during the process of withdrawal of needles. The result of data analysis showed that there were significant differences in age, occupation, working years, distribution of departments, autoimmunity, type of needlestick injury, link of stick injuries and treatment of occupational exposure with emergent screening (all P < 0.05).
    CONCLUSIONS The incidence of needlestick injuries is high among the health care workers who perform the minimally invasive acupunctures of TCM, which should be attached great attention to. It is of great significance to standardize and modify the use procedure, use portable sharp boxes, intensify the safe operation skills for the health care workers with less experience, strengthen the teaching, focus on the autoimmunity, vaccinate in a timely manner, and effectively treat the occupational exposures so as to reduce the incidence of occupational exposures and the risk of infections.

     

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