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目的了解济南市狂犬病的流行病学特征和发病因素,为防控狂犬病提供科学对策。方法采用流行病学方法进行个案调查和描述统计分析。结果 2006-2008年济南市发生狂犬病17例,均死亡。患者以农民为主,占64.71%(11/17)。1例患者暴露史不详,有明确暴露史的患者100%(16/16)因犬咬伤引起发病。有暴露史的患者中87.50%(14/16)为Ⅲ级暴露,暴露后31.25%(5/16)的患者伤口未做任何处理,37.50%(6/16)的患者未接种狂犬病疫苗。在正规门诊规范处置伤口和接种疫苗者仅1例,但该患者伤口位于头面部,伤势严重,且使用狂犬病免疫球蛋白不规范。结论济南市狂犬病发病以农民为主,与暴露人群未能及时规范处理伤口,未及时注射狂犬病疫苗和抗狂犬病被动免疫剂有关。应继续加大狂犬病防治知识的宣传力度,同时加强对医务人员的培训,以提高人群处置伤口和疫苗接种的及时性。
Objective To understand the epidemiological characteristics and pathogenesis of rabies in Ji’nan city and provide scientific measures for the prevention and control of rabies. Methods Epidemiological methods were used to conduct case studies and describe statistical analysis. Results In 2006-2008, 17 rabies cases occurred in Jinan City, all of which died. The majority of patients were farmers, accounting for 64.71% (11/17). One patient had a history of unexplained exposure and 100% (16/16) of patients with a clear history of the disease were caused by bites. 87.50% (14/16) of the patients with history of exposure were Grade III, and 31.25% (5/16) of the patients had no treatment after exposure. 37.50% (6/16) of the patients were not vaccinated against rabies. In the formal outpatient norms of wounds and vaccination were only 1 case, but the patient is located in the head and face wounds, a serious condition, and the use of rabies immunoglobulin non-standard. Conclusion The incidence of rabies in Jinan is dominated by peasants, which is not related to the timely and standardized treatment of wounds, the lack of timely injection of rabies vaccine and the anti-rabies passive immunization agent. Should continue to increase the awareness of rabies prevention and control efforts, while strengthening the training of medical personnel to improve the population to deal with timely delivery of wounds and vaccinations.