CAJ | 학술논문

目的：探讨重症监护病房（ICU）内人类免疫缺陷病毒（HIV）职业暴露的原因和综合预防干预的疗效。方法选择2009年1月至2010年12月本院ICU发生HIV职业暴露的患者为对照组（25例），自2011年1月至2012年12月采用综合预防干预措施的患者作为干预组（53例）。对照组采用口罩、手套、隔离服等防护措施；综合干预组在对照组防护措施的基础上，采取AIDS患者进入ICU后常规在日间放置深静脉置管、动脉置管、密闭式吸痰管和防护面罩，由高年资、心理素质好的医护人员进行有创操作等综合预防措施。比较两组HIV职业暴露人数/收治获得性免疫缺陷综合征（AIDS）病例数比值的差异。结果4年间本院ICU共收治AIDS危重患者78例，发生HIV职业暴露共7例，采取综合干预措施使HIV职业暴露人数/收治AIDS病例数的比值由20%减低至4%（χ2=13.2，P＜0.05）。结论 ICU内收治AIDS患者发生HIV职业暴露的风险较高，采取综合干预措施能够降低ICU内HIV职业暴露的风险。
목적：탐토중증감호병방（ICU）내인류면역결함병독（HIV）직업폭로적원인화종합예방간예적료효。방법선택2009년1월지2010년12월본원ICU발생HIV직업폭로적환자위대조조（25례），자2011년1월지2012년12월채용종합예방간예조시적환자작위간예조（53례）。대조조채용구조、수투、격리복등방호조시；종합간예조재대조조방호조시적기출상，채취AIDS환자진입ICU후상규재일간방치심정맥치관、동맥치관、밀폐식흡담관화방호면조，유고년자、심리소질호적의호인원진행유창조작등종합예방조시。비교량조HIV직업폭로인수/수치획득성면역결함종합정（AIDS）병례수비치적차이。결과4년간본원ICU공수치AIDS위중환자78례，발생HIV직업폭로공7례，채취종합간예조시사HIV직업폭로인수/수치AIDS병례수적비치유20%감저지4%（χ2=13.2，P＜0.05）。결론 ICU내수치AIDS환자발생HIV직업폭로적풍험교고，채취종합간예조시능구강저ICU내HIV직업폭로적풍험。
Objective To investigate the factors of occupational exposure to human immunodeifciency virus (HIV) in Intensive Care Unit (ICU) and explore the effect of comprehensive protection strategy. Methods The occupational exposure cases to HIV in our ICU from January 2009 to December 2010 were collected as a control group (25 cases), using conventional protection mearements including masks, gloves and isolation clothing. The occupational exposure cases to HIV from January 2011 to December 2012 were collected as intervention group (53 cases), using a comprehensive prevention strategy including protective mask, isolating clothing, gloves and the closed suction pipe for patients, severe acquired immune deifciency syndrome (AIDS) patients conventionally receive deep venous and arterial catheter on daytime when they admit to ICU, and invasive operation by the seniority of nurses and doctors with good psychological quality and operative ability. The ratio of occupational exposure cases to HIV/AIDS cases in ICU were compared. Results There were 78 severe AIDS cases admitted to our ICU during the last four years, among those occupational exposure to HIV were 7 cases. The ratio of occupational exposure cases to HIV/AIDS cases signiifcantly reduced from 20%to 4%by comprehensive prevention strategy (χ2=13.2 ,P<0.05). Conclusions Risk of occupational exposure to HIV is higher of patients with AIDS in ICU. Comprehensive protection interventions strategy could reduce incidence of occupational exposure to HIV in ICU.