患者男,69岁。于2个月前燃放鞭炮时致右手拇指,示指及大鱼际处爆炸伤,伤口出血,自行用草药外敷包扎。3天后伤口化脓,就诊于当地卫生院,给予换药,并从大鱼际处伤口内取出指甲大纸屑一块,同时应用红霉素、庆大霉素治疗,治疗8天后伤口愈合,但右手仍有中度肿胀。受伤后10天开始出现右手伤指阵发性抽搐及麻木感,刺激患者指则出现屈曲内收样收缩,呈鹰爪样,并有右上肢抽搐。辗转就诊于当地医疗站、卫生院及某地区医院近2个月,均未确诊及控制痉挛发作,求治我院。既往未注射过破伤风类毒素,伤后亦未注射破伤风抗毒素。入院时体温、脉博、呼吸、血压均正常,无“苦笑” Male patient, 69 years old. In the discharge of firecrackers 2 months ago caused his right thumb, index finger and the fish at the explosion injury, wound bleeding, self-dressing with herbs. 3 days after the wound was purulent, visited the local hospital, given dressing change, and from the wound at the International Hospital to take out a piece of nail paper, at the same time the application of erythromycin, gentamicin treatment, wound healing after 8 days treatment, but the right hand There is still moderate swelling. Ten days after the injury began to appear paroxysmal convulsions and numbness of the right hand injury, stimulation of the patient means buckling within the sample contraction, was eagle-like, and the right upper limb convulsions. After visiting the local medical stations, hospitals and a district hospital for nearly 2 months, none of the patients were diagnosed and controlled for spasticity and were treated in our hospital. In the past, tetanus toxoid was not injected and tetanus antitoxin was not injected after injury. Admission body temperature, pulse, breathing, blood pressure are normal, no “smile”