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目的探讨狂犬病Ⅲ级暴露人群应急免疫效果,为制定狂犬病防制对策提供科学依据。方法收集2005-2008年新宁县动物咬伤门诊处置登记资料、疫情报告资料及狂犬病流行病学个案调查资料进行整理分析,用χ2检验做统计学处理。结果共接诊狂犬病Ⅲ级暴露者2101例,其中,男性1487例,占70.78%;女性614例,占29.22%,男性多于女性(χ2=179.76,P<0.01)。儿童(<14周岁)820例,占39.03%,狂犬病发病10例,占83.33%,死亡10例。成人1281例,占60.97%,狂犬病发病2例,占16.67%,死亡2例。儿童发病构成显著高于成人(χ2=7.66,P<0.01)。头面部暴露发病9例,占75.00%,其他部位暴露发病3例,占25.00%,差异有显著统计学意义(χ2=8.95,P<0.01)。在县疾控中心处理的1780例中,有2例发病,发病率为0.11%;在乡镇卫生院处理的321例中,有10例发病,发病率为3.12%,差异有显著统计学意义(χ2=16.97,P<0.01)。按要求注射过狂免+狂苗者1477例,发病4例,发病率为0.27%;单纯注射狂苗拒注狂免者624例,发病8例,发病率为1.28%,差异有显著统计学意义(χ2=10.86,P<0.01)。首次注射狂苗者1785例,发病12例,再次接种者316例,无发病病例。结论狂犬病Ⅲ级暴露人群应急免疫效果与暴露部位,接种处理单位,年龄大小,首次免疫和再次免疫以及接种狂免+狂苗和单纯接种狂苗相关。在狂犬病防治过程中,应尽可能避免这些因素的影响。
Objective To investigate the effect of emergency immunization in rabies patients with stage Ⅲ exposure and to provide a scientific basis for the development of rabies prevention strategies. Methods The data of outpatient department of Xinning County during 2005-2008 were collected, the information of epidemic situation and the epidemiological data of rabies were collected and analyzed. The data were analyzed by χ2 test. Results There were 2,101 cases of rabies grade Ⅲ exposure. Among them, 1487 were males, accounting for 70.78%; 614 were females, accounting for 29.22%, more males than females (χ2 = 179.76, P <0.01). 820 cases (39.03%) of children (<14 years old), 10 cases of rabies (83.33%) and 10 deaths. 1281 adult cases, accounting for 60.97%, 2 cases of rabies, accounting for 16.67%, 2 died. The incidence of children was significantly higher than that of adults (χ2 = 7.66, P <0.01). There were 9 cases of head and face exposure, accounting for 75.00%, 3 cases of other parts of exposure, accounting for 25.00%. The difference was statistically significant (χ2 = 8.95, P <0.01). Among the 1780 cases treated in the county CDC, 2 cases were affected with a morbidity of 0.11%. Of the 321 cases handled by the township hospitals, 10 cases were reported with a morbidity of 3.12%, the difference was statistically significant ( χ2 = 16.97, P <0.01). According to the requirements of injection madman + Miao Miao 1477 cases, the incidence of 4 cases, the incidence was 0.27%; simple injection mad Miao refusing to take care of the spree 624 cases, the incidence of 8 cases, the incidence was 1.28%, the difference was statistically significant Significance (χ2 = 10.86, P <0.01). The first injection mad seedlings were 1785 cases, 12 cases of disease, another 316 cases of vaccination, no incidence of cases. Conclusions The emergency immunization effect of rabies with stage Ⅲ exposure is related to exposure site, inoculation unit, age, primary immunization and re-immunization, as well as inoculation + mad seedlings and simple inoculation. In rabies prevention and treatment process, the influence of these factors should be avoided as much as possible.