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題 名 | Detection and Treatment of Acute Hepatitis C by Needlestick Among Medical Personnel=醫療工作者因針扎事件感染C型肝炎之偵測與治療 |
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作 者 | 盧勝男; 何啟功; 余明隆; 王景弘; 莊萬龍; | 書刊名 | 中華民國消化系醫學雜誌 |
卷 期 | 15:2 1998.06[民87.06] |
頁 次 | 頁8-11 |
分類號 | 415.533 |
關鍵詞 | 針扎; C型肝炎; 職業病傷害; 干擾素治療; Needlestick; Hepatitis C; Occupational injury; Interferon therapy; |
語 文 | 英文(English) |
中文摘要 | 針扎意外是醫療工作者最常見的職業傷害,而 C 型肝炎是經體液傳染的慢性傳染 病, 可能因針扎意外而感染,為早期偵測與適當治療急性職業性 C 型肝炎,我們設計了針 扎意外後的追蹤準則。高雄醫學院附設醫院因針扎意外受傷者皆需向勞工安全衛生室報告。 受傷者及指標病例(感染源)在意外發生時皆需接受檢查,並定期追蹤至滿一年。對發生急 性職業性 C 型肝炎者,施行二十四週、每週三次、三百萬單位甲型干擾素( interferon-a )的治療。 自民國八十二年五月至八十五年二月止,在 191 次的意外報告中,僅一位受傷 者( 0.5 %)在受傷時已經為 C 型肝炎抗體陽性,而有 33 ( 17.3 %)位指標病例為 C 例肝炎抗體陽性, 其中有 14 例( 42 %)從病歷得知 anti-HCV 陽性,19 例( 58 %) 經由檢驗才發現為 C 型肝炎抗體陽性。 因這 33 位指標病例所受傷的醫療人員,有 23 例 追蹤六個月以上,只有一例( 4.4 %,95 %信賴區間為 0 %∼ 12.7 %)確定感染 C 型 肝炎。感染病例為 23 歲護理師,經甲型干擾素治療後,達到生化學、病毒學及組織學上痊 癒標準。 雖然經針扎事件而發生職業性急性 C 型肝炎的發生率不高,早期偵測與適當治療 是必要的。 |
英文摘要 | Needlestick is the most common occupational injuries among medical personnel. Hepatitis C is one of blood-borne diseases and may be transmitted through needlestick injury. To early detect and prompt treat acute occupational hepatitis C, we designed the protocol for needlestick accidents. All victims of needlestick accidents were registered in a medical center. From May 1993 to February 1996, a total of 191 events had been reported. In the event of accidents, all the victims and source patients were checked anti-HCV. The victims contaminated by anti-HCV-positive source patients were regularly followed for 12 months. Only one (0.5%) of 191 victims was anti-HCV-positive initially. A total of 33 (17.3%) source patients were identified as anti-HCV-positive. Fourteen of 33 cases (42%) were recognized from medical records and the other 19 cases (58%) were detected by postaccident screening. Twenty-three victims were followed for more than 6 months, and only one (4.4%, 95% confidence interval: 0% ∼ 12.7%) of them developed acute occupational hepatitis C. This infected case, 23 year-old nurse, was treated with interferon- α 3MU thrice a week for 24 weeks and achieved complete biochemistry, virological and pathological response. Although the incidence of acute occupational hepatitis hy needlestick injury is low, early detection and prompt treatment is recommended. |
本系統中英文摘要資訊取自各篇刊載內容。