论文部分内容阅读
目的研究湖南省茶陵县狂犬病发生的相关危险因素,为现场干预研究提供科学依据。方法以2000～2004年茶陵县全部狂犬病病例为研究对象,以与病例组具有同源犬伤暴露史的健康存活者为对照组,进行病例对照研究,统计学分析采用χ2检验。结果病例组平均潜伏期为60d(9～412d),平均病程为2d(0～7d),其中头面部、手部和上肢、躯干和下肢受伤者平均潜伏期分别为28、52和77d,浅表伤口与深度伤口患者平均潜伏期分别为56和68d,有狂犬病疫苗接种史与无狂犬病疫苗接种史患者的平均潜伏期分别为39和62d。相关危险因素分析,未接种狂犬病疫苗(χ2=48.776,P<0.01,OR=41.67)、伤口部位接近中枢神经(χ2=35.143,P<0.01)、深度伤(χ2=6.800,P<0.05,OR=3.23)和未进行伤口处理(χ2=6.174,P<0.05,OR=2.84)等因素相对危险性明显高于对照组,差异均有显著统计学意义。结论未接种狂犬病疫苗、接种非正规途径来源的狂犬病疫苗、伤口未处理、深度伤口、伤口位置靠近中枢神经等为茶陵县狂犬病发生的相关危险因素。应重点加强犬伤暴露后的伤口规范化处理及接种狂犬病疫苗等防制措施。
Objective To study the related risk factors of rabies in Chaling County, Hunan Province, and provide a scientific basis for field intervention research. Methods From 2000 to 2004, all the rabies cases in Chaling County were studied. Case-control study was conducted with healthy survivors who had the same history of canine injuries as the control group. Chi-square test was used for statistical analysis. Results The average incubation period was 60 days (range, 9 days to 412 days) and average course of disease was 2 days (0 ~ 7 days). The average latency of head, face and upper limbs, trunk and lower extremities were 28, 52 and 77 days respectively. Patients with deep wounds had an average incubation period of 56 and 68 days, respectively. The average incubation period with and without rabies vaccination was 39 and 62 days, respectively. (Χ2 = 6.817, P <0.05, OR = 41.67), the risk of wound infection was lower than that of the central nervous system (χ2 = 35.143, P <0.01) = 3.23) and no wound treatment (χ2 = 6.174, P <0.05, OR = 2.84) and other factors were significantly higher than the control group, the differences were statistically significant. Conclusions Unrelated rabies vaccines, rabies vaccination from non-formal sources, untreated wounds, deep wounds and wounds near the central nervous system are the risk factors for rabies in Chaling County. Should focus on strengthening the dog wounds after exposure to standardized treatment and rabies vaccination and other control measures.