中国艾滋病患者骨科手术围术期预防

doi:10.3969/j.issn.1006-7795.2015.04.028

首都医科大学学报 ›› 2015, Vol. 36 ›› Issue (4): 654-658.doi: 10.3969/j.issn.1006-7795.2015.04.028

中国艾滋病患者骨科手术围术期预防

蔡娟¹, 张强¹, 肖江², 杨芳宇³, 李春梅⁴, 张红宇⁴

1. 首都医科大学附属北京地坛医院骨科, 北京 100015;
2. 首都医科大学附属北京地坛医院感染性疾病中心, 北京 100015;
3. 首都医科大学护理学院, 北京 100015;
4. 首都医科大学附属北京地坛医院护理部, 北京 100015

收稿日期:2013-12-30 出版日期:2015-08-21 发布日期:2015-07-17
通讯作者: 李春梅 E-mail:lisa_0515@163.com
基金资助:
首都卫生发展科研项目(2011-2017-01),首都临床特色应用研究项目(Z131107002213063)。

The perioperative protection in HIV/AIDS patients with fracture in China: a systematic review

Cai Juan¹, Zhang Qiang¹, Xiao Jiang², Yang Fangyu³, Li Chunmei⁴, Zhang Hongyu⁴

1. Department of Orthopedics, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China;
2. Center for Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China;
3. Department of Nursing, Capital Medical University, Beijing 100015, China;
4. Department of Nursing, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China

Received:2013-12-30 Online:2015-08-21 Published:2015-07-17
Supported by:
This study was supported by The Capital Health Research and Development Projects(2011-2017-01); Research on the Application of Capital, Clinical Characteristics(Z131107002213063).

摘要/Abstract

摘要：

本综述的目的是阐明艾滋病合并骨科手术患者围手术期防护措施,以减少暴露风险。在手术前,患者必须启动高效抗反转录病毒治疗以减少医务人员职业暴露的风险;在医疗活动中,医务人员要戴面罩和口罩;在术中,基于骨科手术常见的暴露风险,要求医务人员戴双层手套、眼罩,穿防护服,术中尽可能减少锐利器械和刀具的使用、尽可能进行无接触手术,以减少术中职业暴露的风险。如术中发生职业暴露,应尽早进行职业暴露后预防。基于艾滋病患者骨科手术职业暴露的风险的研究,建立了具有中国特色的围术期防护措施,这有助于减少骨科手术患者职业暴露的风险。

关键词: 艾滋病, 骨折, 围术期防护, 高效抗反转录病毒治疗

Abstract:

The objective for this review was to elucidate the perioperative protective measure in HIV/AIDS patients with fracture in China. In pre-operative period, high active antiretroviral therapy(HAART) must be initiated as an important measure to reduce the incidence of occupational exposure, and healthcare workers should wear face masks and gloves when performing medical practice. In operative period, based on the characteristics of occupational exposure in operations, we took some measures to reduce the risk of occupational exposure, including bilayer gloves, eye mask, disposable waterproof gown, and slippers with foot-strap, advised to minimize the use of sharp or electrical instruments and argon knifes, and advised contactless operation as far as possible to reduce opportunity of occupational exposure. Once occupational exposure occurred in surgical operation, post exposure prophylaxis must be taken immediately. We established perioperative protective measures with Chinese characteristics based on research on orthopedic surgery process in human immunodeficiency virus/acquired immune deficiency syndrome(HIV/AIDS) patients, which helped reduce the risk of occupational exposure in orthopedic surgery.

Key words: acquired immune deficiency syndrome, fracture, perioperative protection, high active antiretroviral therapy

中图分类号:

R512.91

蔡娟, 张强, 肖江, 杨芳宇, 李春梅, 张红宇. 中国艾滋病患者骨科手术围术期预防[J]. 首都医科大学学报, 2015, 36(4): 654-658.

Cai Juan, Zhang Qiang, Xiao Jiang, Yang Fangyu, Li Chunmei, Zhang Hongyu. The perioperative protection in HIV/AIDS patients with fracture in China: a systematic review[J]. Journal of Capital Medical University, 2015, 36(4): 654-658.

参考文献

[1] Zhang F J, Pan J, Yu L, et al. Current progress of China's free ART program[J]. Cell Res, 2005,15(11-12):877-882.
[2] Zhang F, Haberer J E, Wang Y, et al. The Chinese free antiretroviral treatment program: challenges and responses[J]. AIDS, 2007,21(Suppl 8):S143-S148.
[3] Brown T T, Qaqish R B. Antiretroviral therapy and the prevalence of osteopenia and osteoporosis: a meta-analytic review[J]. AIDS, 2006,20(17):2165-2174.
[4] Triant V A, Brown T T, Lee H, et al. Fracture prevalence among human immunodeficiency virus(HIV)-infected versus non-HIV-infected patients in a large U.S. healthcare system[J]. J Clin Endocrinol Metab, 2008,93(9):3499-3504.
[5] Young B, Dao C N, Buchacz K, et al. Investigators.Increased rates of bone fracture among HIV-infected persons in the HIV Outpatient Study(HOPS) compared with the US general population, 2000-2006[J]. Clin Infect Dis, 2011,52(8):1061-1068.
[6] Ofotokun I, McIntosh E, Weitzmann M N. HIV: inflammation and bone[J]. Curr HIV/AIDS Rep, 2012,9(1):16-25.
[7] Rojo Conejo P, Ramos Amador J T, García Piar L, et al. Decreased bone mineral density in HIV-infected children receiving highly active antiretroviral therapy[J]. An Pediatr(Barc), 2004,60(3):249-253.
[8] Duvivier C, Kolta S, Assoumou L, et al. ANRS 121 Hippocampe study group.Greater decrease in bone mineral density with protease inhibitor regimens compared with nonnucleoside reverse transcriptase inhibitor regimens in HIV-1 infected naive patients[J]. AIDS, 2009,23(7):817-824.
[9] Yin M T, Kendall M A, Wu X, et al. Fractures after antiretroviral initiation[J]. AIDS, 2012,26(17):2175-2184.
[10] Womack J A, Goulet J L, Gibert C, et al. Increased risk of fragility fractures among HIV infected compared to uninfected male veterans[J]. PLoS One, 2011,6(2):e17217.
[11] Haskelberg H, Hoy J F, Amin J, et al. Changes in bone turnover and bone loss in HIV-infected patients changing treatment to tenofovir-emtricitabine or abacavir-lamivudine[J]. PLoS One, 2012,7(6):e38377.
[12] Shiau S, Broun E C, Arpadi S M, et al. Incident fractures in HIV-infected individuals: a systematic review and meta-analysis[J]. AIDS, 2013,27(12):1949-1957.
[13] Peters B S, Perry M, Wierzbicki A S, et al. A cross-sectional randomised study of fracture risk in people with HIV infection in the probono 1 study[J]. PLoS One, 2013,8(10):e78048.
[14] Yoo J J, Chun S H, Kwon Y S, et al. Operations about hip in human immunodeficiency virus-positive patients[J]. Clin Orthop Surg, 2010,2(1):22-27.
[15] Kaplan J E, Benson C, Holmes K K, et al. Guidelines for prevention and treatment of opportunistic infections in HIV-infected adults and adolescents: recommendations from CDC, the National Institutes of Health, and the HIV Medicine Association of the Infectious Diseases Society of America[J]. MMWR Recomm Rep, 2009,58(RR-4):1-207.
[16] Sarrazin U, Brodt R, Sarrazin C, et al. Post-exposure prevention after occupational exposure to HBV, HCV and HIV[J]. Orthopade, 2004,33(2):231-244.
[17] Kuhar D T, Henderson D K, Struble K A, et al. Updated US Public Health Service guidelines for the management of occupational exposures to human immunodeficiency virus and recommendations for postexposure prophylaxis[J]. Infect Control Hosp Epidemiol, 2013,34(9):875-892.

中国艾滋病患者骨科手术围术期预防

The perioperative protection in HIV/AIDS patients with fracture in China: a systematic review

PDF

可视化

被引次数

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

本文评价

[1]	张进, 王东. 基于网络药理学和分子对接技术探讨续断促进骨折愈合的机制[J]. 首都医科大学学报, 2022, 43(2): 275-283.
[2]	岳睿, 李晓玉, 杨明辉, 张萍. 老年髋部骨折患者围手术期输血和危险因素[J]. 首都医科大学学报, 2021, 42(4): 629-634.
[3]	杨波, 王庆雷, 马建华, 梁智林, 唐杰, 赵小林, 高茂龙. 两种术式治疗老年骨质疏松性椎体压缩性骨折的效果及其术后继发相邻椎体骨折的危险因素分析[J]. 首都医科大学学报, 2021, 42(2): 293-298.
[4]	岳睿, 李晓玉, 杨明辉, 刘晓艳, 范斌, 张萍. 高龄老年髋部骨折患者术前下肢深静脉血栓形成的危险因素[J]. 首都医科大学学报, 2020, 41(3): 458-463.
[5]	董愉, 柳月红, 许雪静, 刘彬彬. 彩色照相联合间接检眼镜在艾滋病眼底病筛查中的临床价值[J]. 首都医科大学学报, 2017, 38(1): 82-84.
[6]	李瑞利, 米海峰, 李宏军, 任美吉, 赵晶, 员达, 王伟. 常规MRI表现正常的AIDS患者脑白质弥散张量成像TBSS分析[J]. 首都医科大学学报, 2016, 37(4): 454-459.
[7]	胡天丽, 刘晋新, 张烈光, 江松峰, 陈碧华, 官宛华. 艾滋病相关淋巴瘤的CT影像表现及病理结果[J]. 首都医科大学学报, 2016, 37(4): 472-476.
[8]	黄述婧, 陈铭, 代芳芳, 于艳华, 丁秀荣, 冯霞, 娄金丽, 李宏军. G试验对艾滋病合并肺孢子菌肺炎诊断价值的探讨[J]. 首都医科大学学报, 2016, 37(4): 504-508.
[9]	刘美玲. 2013年中国艾滋病疫情空间积聚性分析[J]. 首都医科大学学报, 2016, 37(3): 360-363.
[10]	武栋, 程斌, 高茂龙, 赵嘉训. 小剂量纳美芬在老年髋部骨折患者术后静脉自控镇痛中的应用[J]. 首都医科大学学报, 2016, 37(2): 241-244.
[11]	刘远志, 陈兵刚, 丁渭, 乔录新, 赵青霞, 吴昊, 陈德喜, 张玉林. 合并中枢神经系统机会性感染患者的中枢HIV-1载量和变异性增高[J]. 首都医科大学学报, 2014, 35(1): 81-86.
[12]	许元龙, 杨仙珊, 刘凯燕, 易银, 李群辉, 黄晓婕, 郭彩萍, 吴昊. 北京男男性接触人群性传播感染HIV/HBV现状及相关因素研究[J]. 首都医科大学学报, 2014, 35(1): 96-100.
[13]	丁渭;张玉林;乔录新;宋凤丽;徐树莹;陈德喜. 氧化损伤在HIV相关神经认知损害中的作用[J]. 首都医科大学学报, 2012, 33(5): 602-609.
[14]	沈峰;潘海涛;麻松;曾峥. 脑外伤合并骨折患者骨折愈合过程中血管内皮生长因子在血清和骨痂中的表达[J]. 首都医科大学学报, 2011, 32(5): 681-687.
[15]	石英△;孙玉△;张洪海;计云霞;乔录新;丁渭;张玉林;陈德喜. 感染HIV-1儿童经抗病毒治疗后乳酸浓度检测及其相关因素研究[J]. 首都医科大学学报, 2011, 32(3): 337-340.