摘要
目的探讨HBsAg阳性患者经外科手术干预前后HBV-DNA的变化及其院内传染性的分析。方法采用时间分辨免疫荧光分析法,检测58例HBsAg阳性手术患者术前血清HBV-M;采用实时荧光定量PCR检测HBsAg阳性患者术前和术后第3、7天血清及术后胃引流液、腹腔引流液及医务人员接触HBsAg阳性手术患者后手指采样的HBV-DNA。结果58例HBsAg阳性手术患者中27例检测到HBV-DNA,阳性率为46.1%,经外科手术干预后第3、7天,血清HBV-DNA拷贝数比术前显著增高差异有统计学意义(P<0.01);胃引流液HBV-DNA的阳性率为31.0%,腹腔引流液为48.3%;医务人员手指采样HBV-DNA的阳性率为8.6%,其中医生6.7%,护士8.2%,护工12.0%。结论HBsAg阳性手术患者体内存在乙型肝炎病毒的活动,外科手术的干预可引起病毒复制增强,临床应重视HBV-DNA的监测,进行必要的抗病毒治疗;手术干预可使其传染性和传播途径增加,医务人员应重视防护和消毒,避免乙型肝炎病毒的院内传播。
OBJECTIVE To investigate the changes in serum HBV-DNA level in HBsAg positive patients before and after operation and their infectious risk in hospital. METHODS HBV markers（HBV-M） in serum was detected in 58 HBsAg positive patients by time-resolved fluoroimmunometric assay before operation. HBV-DNA level in serum of them before operation and at 3rd, and 7th day after operation was detected by real time fluorescent quantitative polymerase chain reaction. We also detected HBV-DNA in gastric drainage juice and abdominal drainage after operation. RESULTS HBV-DNA was detected in 27 of 58 HBsAg positive patients＇ serum, the positive rate was 46. 1%. After operation, serum HBV-DNA was increased remarkably at 3rd and 7th day compared with before operation in these patients respectively（P〈 0. 01）, the positive rate of HBV-DNA was 8. 6% in gastric drainage juice and 48.3% in abdominal drainage;in contacting with the patients, the positive rate of HBV-DNA on the hands was 31.0% among medical personnel. CONCLUSIONS It is suggested that hepatitis B virus strongly replicate in HBsAg positive patients. Surgical interventions may result in promoting replication of HBV, and increase the infectivity and spread ways, disinfection and isolation should be emphasized for the prevention of the cross infection.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2007年第2期148-150,178,共4页
Chinese Journal of Nosocomiology
