109例HIV职业暴露者的情况分析

发布时间：2018-11-19 11:39

【摘要】：目的分析北京佑安医院7年来接诊的艾滋病病毒(HIV)职业暴露病例的情况,为HIV职业暴露后预防措施的完善提供借鉴。方法 2007年1月至2014年7月,北京佑安医院性病艾滋病门诊共接诊了109例HIV职业暴露者。对这些病例进行回顾性研究,分析暴露人群的职业和暴露方式,评估暴露后的预防服药方案、服药疗程及效果。结果 109例HIV职业暴露者中,医务人员70例(64.2%),执法人员31例(28.4%);针刺暴露66例(60.6%)。有91例(83.5%)进行了紧急伤口处理。14例(12.8%)经风险评估后未给予HIV暴露后预防药物;95例(87.2%)接受了HIV暴露后预防性用药,其中29例(30.5%)接受暴露后预防基础方案,66例(69.5%)接受强化方案;有37例(38.9%)在暴露后2小时内开始服药,50例(52.6%)在2-72小时内开始服药,有8例(8.4%)在暴露72小时以后开始服药。不良反应以消化道反应为主,耐受性总体较好,有3例(3.2%)因不能耐受药物不良反应而未完成4周疗程。分别在就诊即刻、暴露后第4周、8周、12周、6个月随访,未发现HIV抗体转阳者。结论医务人员及执法人员应加强HIV职业暴露培训,职业暴露后通过规范的应急处理和预防性用药可有效预防HIV感染。
[Abstract]:Objective to analyze the HIV (HIV) occupational exposure cases in the past 7 years in Beijing Youan Hospital, and to provide reference for the improvement of prevention measures after HIV occupational exposure. Methods from January 2007 to July 2014, a total of 109 HIV workers were admitted to the STD clinic of Beijing Youan Hospital. A retrospective study of these cases was carried out to analyze the occupation and exposure patterns of the exposed population, and to evaluate the prophylaxis regimen, course of treatment and effect of the drug taken after exposure. Results among 109 cases of HIV occupational exposure, 70 cases (64.2%) were medical workers, 31 cases (28.4%) were law enforcement personnel, 66 cases (60.6%) were acupuncture exposures. Emergency wound management was performed in 91 cases (83.5%). 14 cases (12.8%) were not given preventive drugs after exposure to HIV after risk assessment. 95 cases (87.2%) received prophylactic therapy after exposure to HIV, 29 cases (30.5%) received basic prophylaxis regimen after exposure and 66 cases (69.5%) received intensive regimen. 37 cases (38.9%) began to take drugs within 2 hours after exposure, 50 cases (52.6%) began to take drugs within 2-72 hours, and 8 cases (8.4%) began to take drugs within 72 hours after exposure. The main adverse reactions were digestive tract reactions and the tolerance was good. 3 cases (3.2%) did not complete the 4-week treatment because of their intolerance to adverse drug reactions. No HIV antibody conversion was found at the time of visit, 4 weeks, 8 weeks, 12 weeks and 6 months after exposure. Conclusion Medical staff and law enforcement personnel should strengthen the training of occupational exposure to HIV. Standardized emergency treatment and prophylactic medication can effectively prevent HIV infection after occupational exposure.
【作者单位】：首都医科大学附属北京佑安医院;
【基金】：国家自然科学基金项目(81273136) 北京市医管局临床医学发展专项经费资助(ZY201401)~~
【分类号】：R512.91

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