国际口腔医学杂志

国际口腔医学杂志 ›› 2020, Vol. 47 ›› Issue (3): 366-372.doi: 10.7518/gjkq.2020057

• 综述 • 上一篇    

口腔医护人员传染病职业暴露危险因素及防护

潘剑1(),曹昊天2,刘济远1,王了1,刘显1,廖学娟1   

  1. 1.口腔疾病研究国家重点实验室 国家口腔疾病临床医学研究中心四川大学华西口腔医院口腔颌面外科 成都 610041;
    2.中山大学孙逸仙纪念医院口腔科 广州 510000
  • 收稿日期:2020-02-12 修回日期:2020-02-26 出版日期:2020-05-01 发布日期:2020-05-08
  • 通讯作者: 潘剑
  • 作者简介:潘剑,教授,博士,Email：jianpancn@163.com
  • 基金资助:
    四川大学华西口腔医院探索与研发项目(LCYJ2019-1)

Occupational exposure risk factors and protection for dental health care workers from contagion

Pan Jian1(),Cao Haotian2,Liu Jiyuan1,Wang Liao1,Liu Xian1,Liao Xuejuan1   

  1. 1.State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China;
    2.Dept. of Stomatology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510000, China
  • Received:2020-02-12 Revised:2020-02-26 Online:2020-05-01 Published:2020-05-08
  • Contact: Jian Pan
  • Supported by:
    Research and Develop Program of West China Hospital of Stomatology, Sichuan University(LCYJ2019-1)

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摘要：

口腔医护人员长期暴露在各种致病因素之中,其中对传染病病原体的暴露是威胁口腔医生身体健康的一个重要因素。病原微生物在口腔诊疗过程中传播的基本途径有：血源性传播、飞沫传播、接触传播以及气溶胶传播。通过这些途径,微生物群落如朊毒体、病毒、真菌、细菌等得以传播。2019年12月以来,随着由2019新型冠状病毒（2019-nCoV、SARS-CoV-2）引起的新型冠状病毒肺炎（COVID-19）在武汉爆发,口腔诊疗过程中产生的气溶胶带来的感染风险也迅速被人重视。本文总结目前人们对传染性疾病在口腔诊疗环境中传播和风险因素的相关研究,以便口腔临床医生参考,做好相关的防护,避免职业暴露的发生。

关键词: 新型冠状病毒肺炎, 职业暴露, 传染病, 气溶胶

Abstract:

Dentists are exposed to various pathogens, particularly to infectious disease pathogens that seriously threaten their health. The basic transmission ways of pathogenic microorganisms in dental operation include blood-borne, splatter, contact, and aerosol transmissions. Microbial colonies, such as prions, viruses, fungi, and bacteria, are transmitted through these pathways. With the outbreak of the novel coronavirus pneumonia (COVID-19) caused by 2019-nCoV (SARS-CoV-2) in Wuhan, Hubei Province, China since December 2019, the risk of infection caused by aerosols generated during dental operations has received increasing attention. This review summarizes current studies on the spread of infectious diseases in dental operations and the related risk factors to encourage oral physicians to prioritize protection and avoid occupational exposure.

Key words: novel coronavirus pneumonia, occupational exposure, contagion, aerosol transmission

中图分类号: 

  • R78

表 1

减少气溶胶传播的措施"

措施 优点 局限性
个人防护用品 阻断了大多数飞沫传播和气溶胶传播。 1）外科口罩仅阻断60%~95%气溶胶传播,边缘渗漏不能完全封闭;
2）N95或专业口腔防护口罩较昂贵;
3）摘下口罩后,对术后仍在空气中的气溶胶无法防控。
术前氯己定漱口 1）廉价、易推广; 1）在口腔及黏膜表面对游离细菌有较好的作用,对生物膜内细菌无效;
2）减少了口腔、唾液和空气中病原体的数量。 2）对咽部呼吸道病原体无效;
3）对新型冠状病毒无效。
强吸 减少术区绝大多数气溶胶对产生。 需要四手操作,依赖助手和操作技巧。
空气过滤器及有消 减少气溶胶中的微生物,阻断其远处传播以及 较为昂贵。
毒功能对通风设施 诊室间传播。
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