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目的分析东莞市狂犬病门诊暴露人群流行病学特征及暴露后处理情况,为狂犬病防治制工作提供科学依据。方法根据《广东省狂犬病暴露后医学处理工作指引(2007年版)》,对2007年全市各狂犬病门诊暴露人群监测月报表进行统计分析。结果2007年全市共报告暴露人数58822例,每月暴露4201-6159例,5-8月为暴露的高峰期,男∶女为1.64∶1,15-44岁组占暴露总数的56.74%,下肢和上肢暴露占91.38%,单处伤占85.34%,Ⅱ、Ⅲ级暴露分别占46.01%和34.89%;暴露后,伤口处理率和疫苗接种率分别为93.96%和99.74%,但狂犬病人免疫球蛋白注射率仅为5.82%;犬伤暴露占80.08%,其次为猫占11.26%。结论2007年东莞市狂犬病门诊暴露人数为近五年来的新高,其中犬伤占绝大多数。坚持以犬只免疫为主的综合性防治措施,特别是用进口灭活犬用疫苗并实行免费接种,对狂犬病的防制成效显著。建议应加强培训和教育,不仅要让医务人员掌握犬伤医学处理技术,还应该让群众知晓有关预防狂犬病的基本常识,做到暴露后及时处理伤口、接种疫苗和注射狂犬免疫球蛋白。
Objective To analyze the epidemiological characteristics and post-exposure treatment of rabies outpatients in Dongguan City, and provide a scientific basis for the prevention and control of rabies. Methods According to the Guidelines for Medical Treatment of Rabies after Exposure in Guangdong Province (2007 Edition), statistical analysis was conducted on monthly monitoring reports on the population of rabies outpatients exposed in 2007 in the city. Results In 2007, a total of 58,822 cases were reported in the city, 4201-6159 cases were exposed monthly. The peak period of exposure was from May to August. Male: female 1.64:1, 15-44 years old accounted for 56.74% of total exposure, 91.38% were exposed to the upper extremity, 85.34% were injured in the upper extremity, and 46.01% and 34.89% were exposed to the second and third grade respectively. After the exposure, the wound healing rate and vaccination rate were 93.96% and 99.74% respectively. However, rabies immunoglobulin The rate of protein injection was only 5.82%; dogs exposed to dogs accounted for 80.08%, followed by cats accounted for 11.26%. Conclusion The number of outpatients exposed to rabies in Dongguan City in 2007 was the highest in recent five years, of which dogs accounted for the overwhelming majority. Adhere to a dog immunization-based comprehensive prevention and control measures, in particular the use of imported vaccines inactivated dogs and the implementation of free vaccination, prevention and control of rabies significantly. It is suggested that training and education should be stepped up. Not only medical staff should be trained in medical treatment of dog wounded, but also basic knowledge of rabies prevention should be provided to the public so that wounds, vaccinations and rabies immunoglobulin can be treated promptly after exposure.