对医护学生乙型肝炎病毒感染的定群研究

在调查687名医护学生课堂学习阶段的HBV感染率后,选出HBV易感者,连续观察了在校期、临床实习期、工作后1～2年时HBV易感者的年感染情况的变化,以比较医院内HBV感染的严重性。发现在参加工作1～2年后,人年HBV感染率和HBsAg阳转率均显著高于在校阶段和临床实习阶段,也显著高于做教师一年的师范学生(对照组)。医护学生在医院内的HBV感染与医院损伤次数有关,并与医院消毒管理的好坏有关。

A COHORT STUDY OF HEPATITIS B VIRUS INFECTION AMONG MEDICAL AND NURSING STUDENTS

687 medical and nursing students in classroom study stage and 191 pedagogical students were screened for HBV markers, including HBsAg, anti-HBs and anti-HBc, and the susceptibles were followed-up for four years. During this period of observation time,the students passed through the clinical practice stage to one or two years as working staff members in hospitals or teachers in schools.The HBV infection rates for susceptible medical and nursing students one and two years after their graduation were 13.9% and 11.2% per person-year, respectively, 2.7 and 2.0 times higher than those during their student stage(3.7%). And among the HBV markers, the seroconversion rate for HBsAg was 4.0% per person-year,4.7 times higher than their student stage (0.7%). Compared to the pepagogical students who had been teachers in schools for one year,the HBV infection rate and HBsAg seroconversion rate were 4.2 and 1.2 times higher respectively. Since the susceptible medical and nursing students had become clinical doctors and nurses in hospitals, HBsAg seroconversion rate for those who had experienced medical injuries was higher than others, and was related to the number of times of injury. Among the medical injuries, syringe-pricks accounted for the most important part ( 39.2%),followed by liquid transfusion ( 7.8% ), acupuncture and tooth-extraction (3.9%). No HBV infection was found following surgical operations.The susceptible medical and nursing students working in Baoding Area had 2.3 times higher chance to become infected than those working in Qin- huangdao Area, which was in consistence with the medical appliance sterilization state in these two areas. The results suggest that hospital administrations had to put high priority to the sterilization of medical appliance in order to reduce the medical source of HBV transmission, which would benefit both doctors and patients.