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目的探讨骨科人类免疫缺陷病毒(HIV)感染者围手术期应用预防职业暴露相关防护规范化流程对医务人员减少职业暴露的作用。方法回顾性分析2010年1月至2015年2月首都医科大学附属北京地坛医院收治的需行骨科手术治疗的HIV感染者共66例,其中给予切开复位钢板螺钉内固定术42例,脊柱椎间融合内固定术11例,关节置换术9例,带锁髓内钉固定术4例。术中精细操作、规范手术操作流程;严格执行预防职业暴露相关防护规范化流程。监测2010至2015年骨科手术医务人员发生职业暴露38例/次。结果医务人员发生一级暴露24例,二级暴露9例,三级暴露5例。经严格按照职业暴露后预防处理原则,无1例医务人员发生HIV感染。结论围手术期严格执行职业暴露相关防护规范化流程可以有效避免医务人员职业暴露后的感染。
Objective To investigate the effect of perioperative application of prevention and control of occupational exposure-related standardization on the reduction of occupational exposure to medical staff in patients with orthopedic human immunodeficiency virus (HIV) infection. Methods A total of 66 HIV-infected patients undergoing orthopedic surgery admitted to Beijing Ditan Hospital, Capital Medical University from January 2010 to February 2015 were retrospectively analyzed. Twenty-four patients underwent open reduction and internal fixation with screws, 11 cases of fusion between internal fixation, joint replacement in 9 cases, interlocking intramedullary nailing in 4 cases. Intraoperative fine operation, standardized surgical procedures; strict implementation of preventive measures to prevent occupational exposure standardization process. Monitoring occupational exposure to orthopedic surgeons from 2010 to 2015 38 cases / time. Results There were 24 cases of first grade exposure, 9 cases of secondary exposure and 5 cases of tertiary exposure. In strict accordance with the principles of occupational exposure prevention and treatment, no case of medical staff HIV infection. Conclusion Perioperative strict implementation of standardized procedures for occupational exposure-related protection can effectively prevent medical staff from occupationally exposed infection.