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台南市安養機構病患及工作人員之皮膚疾患調查

Skin Diseases Among Patients and Health Care Workers in Nursing Homes in Tainan City

摘要


目的:調查安養照護機構中,病患以及工作人員的皮膚疾患之盛行率及其潛在危害因子。方法:在1999年11月至2000年2月間,自台南市衛生局登記的21家安養照護機構,隨機選取受照護者人數5人以上的11家,對所有病患和工作人員做全身皮膚檢查及問卷調查。懷疑疥瘡或黴菌感染的檢體,都經標準程序處理後,再以顯微鏡檢查加以證實。結果:由臨床診斷,發現61.6%的病患患有黴菌感染,其病灶多發生在蹠部(95.1%)。58.3%的病患有乾皮症,但多集中在小腿(94.0%),甲癬佔病患總數57.3%,癬34.4%,以及手癬11.6%。懷疑黴菌感染的病患中,顯微鏡鏡檢檢出率高達62.9%。另外,有3.3%的病患和10.7%的工作人員被診斷出疥瘡感染,經疥虫檢體檢查,在病患中確認出30.8%,以及工作人員中確認出12.5%帶有疥虫,共集中在三家(27.3%)安養機構中。針對病患來看,統計上發現黴菌感染與男性性別及長期臥床相關,乾皮症與年齡相關,而疥瘡感染的危險因子主要為過去的疥瘡病史。在工作人員方面,可能是取樣數目太少的原因(N=75),我們並未發現任何皮膚疾患的危險因子。結論:在台南市安養機構的病患及工作人員中,特定的皮膚疾患確實有很高的盛行率。雖然統計未達顯著的意義,我們仍有理由相信工作人員的疥瘡感染和職業上的接觸有著密切的關係。

並列摘要


Objectives:To establish the prevalence of skin diseases in nursing homes, and determine possible risk factors for these disease. Methods:We undertook an investigation of patients and health care workers between November 1999 and February 2000 in Tainan City .Eleven palliative care institutions with more than 5 cared patients were randomly selected from 21 institutions registered by the Tainan Government Health Bureau. A structured questionnaire was completed before patients and staff were individually examined. For individuals with suspected scabies or fungal infections, skin samples were collected, prepared by standard procedures, and then examined microscopically. Results:Fungal infections were found in 61.6% of nursing home patients, of which most (95.1%) were on the foot. 58.3%of patients were diagnosed with xerosis, mainly on the lower leg (94.0%).57.3% patients were detected with Tinea unguium , 34.4% with Tinea pedis and 11.6% with Tinea manus. 62.9% of fungal diagnoses were authenticated by microscopic techniques. Scabies was noted in 3.3% patients and 10.7% stuff. We also confirmed scabies creatures in 30.8% and 12.5%of patients and staff with clinical diagnoses, gathered form three (27.3%) separate institutions . Among the patients, fungal infections wee correlated with male gender and bedridden status while xerosis was associated with increasing age. For scabies infection, a previous history of scabies was the most significant statistical risk factor. Among stuff, we could not determine any important statistical associations due to the relatively small number actually suffering skin disease (N=75) .Conclusions:Our study has revealed high skin diseases prevalence among patients and staff in nursing homes of Tainan city .Although not statistically significant, we believe there may be a relationship between staff with scabies and occupational contact with patients.

並列關鍵字

Skin Disease Nursing Home Scabies Fungus,Xerosis

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