手术及输血前患者感染指标的检测及临床意义分析
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摘要
目的了解医院手术及输血前患者人类免疫缺陷病毒(human immunodeficiency virus,HIV)抗体、梅毒螺旋体(treponema pallidum,TP)抗体、丙型肝炎病毒(hepatitis C virus,HCV)抗体和乙型肝炎病毒表面抗原(hepatitis B surface antigen,HBsAg) 4项感染指标检测的结果,并探讨其临床意义。方法回顾性分析某医院2015-01/2017-01月12 655例输血及手术患者4项感染指标结果,并进行统计分析。结果 12 655例受检者阳性结果为1560例,总阳性率12.33%(1560/12 655),抗HIV、抗TP、抗HCV和HBsAg的阳性率依次为0.55%(70例次)、1.71%(216例次)、1.19%(150例次)和9.27%(1173例次)。其中男性抗HIV、抗HCV和HBsAg阳性率均高于女性(P<0.01或0.05)。4项感染指标均以≤20岁组阳性率最低。结论手术及输血前对患者进行感染4项指标的检测,可以了解患者的身体状况及是否具有血源性传染病,便于医生采取针对性的治疗和防范措施;同时能够为血源性医院感染提供依据,预防医院感染和职业暴露的发生,减少医疗纠纷。
Objective To explore the infection status and clinical significance of examination of human immunodeficiency virus(HIV) antibody,treponema pallidum(TP) antibody,antibody of hepatitis C virus(HCV),hepatitis B surface antigen(HBsAg) before blood transfusion and surgery. Methods A total of 12 655 patients with blood transfusion and surgery from January 2015 to January 2017 were retrospectively analyzed. Results The positive rate of 12 655 cases was 12.33%(1560/12 655),the positive rate of HIV antibody,TP antibody,antibody of HCV and HBsAg were 0.55%(70 cases),1.71%(216 cases),1.19%(150 cases) and 9.27%(1173 cases).The men′s positive results of HIV antibody,TP antibody,antibody of HCV and HBsAg were significantly higher than those of the female′s(P<0.01 or 0.05). The positive rate of all the four infection indicators was lowest in the group of 20-year old. Conclusion The four infection indicators of patients before surgery and blood transfusion can be detected to understand the physical condition and whether they have blood-borne infectious diseases, which is convenient for doctors to take targeted treatment and preventive measures. At the same time, it can provide evidence for blood-borne nosocomial infection,prevent nosocomial infection and occupational exposure, and reduce medical disputes.
Objective To explore the infection status and clinical significance of examination of human immunodeficiency virus(HIV) antibody,treponema pallidum(TP) antibody,antibody of hepatitis C virus(HCV),hepatitis B surface antigen(HBsAg) before blood transfusion and surgery. Methods A total of 12 655 patients with blood transfusion and surgery from January 2015 to January 2017 were retrospectively analyzed. Results The positive rate of 12 655 cases was 12.33%(1560/12 655),the positive rate of HIV antibody,TP antibody,antibody of HCV and HBsAg were 0.55%(70 cases),1.71%(216 cases),1.19%(150 cases) and 9.27%(1173 cases).The men′s positive results of HIV antibody,TP antibody,antibody of HCV and HBsAg were significantly higher than those of the female′s(P<0.01 or 0.05). The positive rate of all the four infection indicators was lowest in the group of 20-year old. Conclusion The four infection indicators of patients before surgery and blood transfusion can be detected to understand the physical condition and whether they have blood-borne infectious diseases, which is convenient for doctors to take targeted treatment and preventive measures. At the same time, it can provide evidence for blood-borne nosocomial infection,prevent nosocomial infection and occupational exposure, and reduce medical disputes.
引文
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[10] 吴琼,曾月嫦,李一鸣.输血前检测传染性指标对降低患者医院性感染的意义[J].中国卫生标准管理,2016,7(7):192-194
[11] 戴志澄,祁国明.中国病毒性肝炎血清流行病学调查(上卷)[M].北京:北京科学技术文献出版社,1997:60
[12] 孙晓玲,苏涛,李奇峰,等.医务人员锐器伤相关因素调查与防护对策[J].中华医院感染学杂志,2016,26(20):4752-4754
[13] CDC.Workbook for Designing,Implementing,and Evaluating a Sharps Injury Prevention Program[EB/OL].(2004-02-12) [2018-12-02].https://www.cdc.gov/Sharpssafety/appendixE.html
[14] 范崇梅,徐静,潘晓捷.孕产妇、手术和输血者4种传染病感染情况调查分析[J].国际检验医学杂志,2016,37(3):389-391
[15] Seck M,Dieye B,Gueye YB,et al.Evaluation of the efficacy of medical screening of blood donors on preventing blood transfusion-transmitted infectious agents[J].Transfus Clin Biol,2015,23(2):98-102
[2] 李洪兵,冉柏林,陈周,等.患者输血前感染性指标的临床检测价值分析[J].中华医院感染学杂志,2016,26(16):3777-3779
[3] 张凌云.术前及输血前患者传染性指标检测的临床价值[J].中国保健营养,2016,26(7):128
[4] 殷晋华.手术前输血前及孕妇产前4种传染病筛查的临床意义[J].山西医药杂志,2018,47(23):2879-2881
[5] 高世同,李晓恒,谢旭,等.输血感染恶性疟一例[J].中华传染病杂志,2016,34(6):183-188
[6] 齐伟亮,刘杰.2450例患者输血前感染性指标检测结果分析[J].标记免疫分析与临床,2017,24(8):852-855
[7] 郭小慧.输血前及手术前患者四项感染指标的检测及临床意义[J].中国感染控制杂志,2017,16(6):561-563
[8] 国务院防治艾滋病工作委员会办公室,联合国艾滋病中国专题组.中国艾滋病防治联合评估报告(2007)[R].北京:中华人民共和国卫生部,2007
[9] 王露楠,邓巍,李金明.梅毒螺旋体感染,不同血清学诊断方法的临床评价[J].中华检验医学杂志,2002,25(6):352-353
[10] 吴琼,曾月嫦,李一鸣.输血前检测传染性指标对降低患者医院性感染的意义[J].中国卫生标准管理,2016,7(7):192-194
[11] 戴志澄,祁国明.中国病毒性肝炎血清流行病学调查(上卷)[M].北京:北京科学技术文献出版社,1997:60
[12] 孙晓玲,苏涛,李奇峰,等.医务人员锐器伤相关因素调查与防护对策[J].中华医院感染学杂志,2016,26(20):4752-4754
[13] CDC.Workbook for Designing,Implementing,and Evaluating a Sharps Injury Prevention Program[EB/OL].(2004-02-12) [2018-12-02].https://www.cdc.gov/Sharpssafety/appendixE.html
[14] 范崇梅,徐静,潘晓捷.孕产妇、手术和输血者4种传染病感染情况调查分析[J].国际检验医学杂志,2016,37(3):389-391
[15] Seck M,Dieye B,Gueye YB,et al.Evaluation of the efficacy of medical screening of blood donors on preventing blood transfusion-transmitted infectious agents[J].Transfus Clin Biol,2015,23(2):98-102