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目的探讨狂犬病暴露人群分布特征及相关危险因素,为狂犬病的科学防治提供依据。方法对犬伤处置门诊8 972名暴露者按年龄、性别、时间、伤人动物、部位、分级、伤后伤口处理、疫苗接种和人狂犬免疫球蛋白注射情况等进行统计分析。结果 10岁以下和40~60岁年龄组暴露比例最高;男女暴露比为1.2∶1;6~8月暴露最多(3876人),占全年的43.2%;职业分布以农民为主(5 134人,占57.2%);伤及下肢者最多,为5 963人(占66.5%);Ⅱ级暴露者4 130人(占46.0%),Ⅲ级暴露者4 644人(占51.8%);犬咬伤8 688人,占96.9%,其中家养犬伤7 310人(占81.5%),流浪犬伤1 378人(占15.4%);伤后伤口规范处置率达88.3%,疫苗接种率达89.1%,人狂犬病免疫球蛋白注射率达12.4%。结论暴露人群中儿童和中年人最多,家养犬伤人最多,伤及下肢者最多,夏季为暴露高发期,伤口规范处理和疫苗接种率尚可,人狂犬病免疫球蛋白注射率低。今后需进一步加强防控工作,应将重点放在偏远农村地区的医疗卫生机构。
Objective To investigate the distribution characteristics and related risk factors of rabies exposed population and provide evidence for the scientific prevention and treatment of rabies. Methods Eighty-seven (772) outpatients with dog injuries were analyzed by age, gender, time, wounding animals, sites, grading, wounds after injury, vaccination and human immunoglobulin injection. Results The highest exposure rate was found between the age group of 10 years and the age group of 40-60 years. The exposure ratio of men and women was 1.2: 1. The highest exposure was from June to August (3876 persons), accounting for 43.2% of the whole year. The occupational distribution was dominated by peasants 57.2% of the total), 5 963 (66.5%) were injured and lower limbs, 4 130 (46.0%) were Grade Ⅱ, 4 644 (51.8%) were Grade Ⅲ, 8 688 were bites, accounting for 96.9%, of which 7 310 were domestic dogs (81.5%) and 1 378 were stray dogs (15.4%). The post-wound wound treatment rate was 88.3%, and the vaccination rate reached 89.1%, human rabies immunoglobulin injection rate of 12.4%. Conclusions The most exposed children are middle-aged children, domestic dogs are the most injured, most of which are injured in lower limbs, summer is the period of high incidence of exposure, normative treatment of wounds and vaccination rate are acceptable, and human rabies immunoglobulin injection rate is low. In the future, further efforts should be made to prevent and control diseases, and medical and health institutions in remote rural areas should be given priority.