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目的 寻找院内感染SARS的危险因素 ,评估医院预防控制措施效果。方法 访谈了解医院防治SARS和医务人员发病的总体情况 ;现场考察相关病区的环境状况 ;问卷调查 78名参加SARS救治工作的医务人员卫生习惯、预防措施的执行情况 ,并用ELISA法检测其中 6 7人血清中的抗 SARS抗体。结果 该院共收治确诊和疑似SARS患者 2 81例 ,医务人员罹患率为 1% (4 / 395 )。隔离病区有 2名护工感染发病 ,ICU有 2名医生发病 ,1人死亡。医院采用通风良好的外廊式楼房做隔离病区 ,ICU收治重症患者。隔离病区采取一系列严格的消毒隔离措施。医务人员有良好的个人防护和卫生习惯 ,10 0 %戴口罩和洗手消毒 ,戴手套、穿隔离衣、穿鞋套、戴眼罩、漱口、粘膜保护等防护措施的采用率分别为 74 4 %、6 6 7%、4 6 2 %、9 0 %、2 4 4 %和 9 0 % ;医务人员预防服药率为 5 7 7%。 6 7份血清抗 SARS抗体全部阴性。结论 良好的卫生习惯和防护意识、对隔离防护制度的严格执行是防止SARS院内感染的关键环节 ,消毒、隔离、个人防护等主要干预措施是保护医务人员的重要防线
Objective To find the risk factors of nosocomial infection of SARS and evaluate the effect of hospital preventive control measures. Methods Interviews were conducted to find out the general situation of SARS and medical staff in the hospital. The environmental conditions of the relevant wards were investigated on site. The health habits of 78 medical staff participating in SARS and the implementation of preventive measures were investigated by questionnaire. Sixty-seven Anti-SARS antibodies in human serum. Results A total of 2 81 cases of confirmed and suspected SARS were admitted to the hospital. The medical staff rate was 1% (4/395). Two ward workers were infected in the isolation ward. Two doctors in the ICU were involved in the disease and one died. The hospital uses a well-ventilated corridor-type building isolation ward, ICU admitted to critically ill patients. Isolation ward to take a series of strict disinfection and isolation measures. Medical personnel have good personal protection and hygiene habits. The adoption rates of protective measures such as 100% wearing masks and hand-washing disinfectants, wearing gloves, separating gowns, wearing shoe covers, wearing goggles, gargling, and mucosal protection were 74 4% , 66.7%, 46.2%, 90.0%, 24.4% and 90% respectively. The preventive medication rate for medical staff was 57.7%. Sixty-seven serum anti-SARS antibodies were all negative. Conclusions Good hygienic habits and awareness of prevention and strict enforcement of isolation protection system are the key steps to prevent nosocomial infection in SARS. Major interventions such as disinfection, isolation and personal protection are important preventive measures to protect medical personnel