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目的探讨孝昌县狂犬病暴露者的流行病学特征,分析暴露后预防处置中存在的风险因素,探讨狂犬病防控的科学措施。方法收集孝昌县妇幼保健院2011—2015年预防接种门诊狂犬病暴露者处置登记资料进行回顾性流行病学分析。结果 2011—2015年就诊的暴露者共计1 241例,为犬所伤1 052例,占84.77%;为猫所伤128例,占10.31%;鼠类及其他所伤61例,占4.92%。伤人动物有免疫史193例,占15.55%,无免疫史1 048例,占84.45%。5—9月是致病高峰,共就诊664例,占53.51%,病例最少是3月份,59例,占4.75%。就诊病例中Ⅰ级暴露者154例,占12.41%;Ⅱ级暴露者395例,占31.83%;Ⅲ级暴露者692例,占55.76%。动物致伤方式主要为咬伤1 019例,占82.11%;其次为抓伤222例,占17.89%。受伤部位以四肢为主,致伤1 037例,占83.56%。在暴露后及时进行伤口处理的有1 233例,占99.36%;未对伤口进行任何处理的8例,占0.64%。按规范要求同意疫苗接种的有1 228例,占98.95%,其中能按时完成全程免疫接种有1 056例,占85.09%,能及时接种人用狂犬免疫球蛋白321例,占25.87%。结论孝昌县应加强狂犬病暴露后伤口处置重要性的宣传,提高大众人群认知高度,并进一步加强宣传疫苗联合接种效果的重要性。
Objective To explore the epidemiological characteristics of rabies exposed in Xiaochang County and to analyze the risk factors in the prevention and treatment of post exposure to explore the scientific measures to prevent and control rabies. Methods A retrospective epidemiological analysis was conducted on the registration data of rabies exposed exposed persons in vaccination clinics in Xiaochang Maternal and Child Health Hospital from 2011 to 2015. Results A total of 1 241 cases were exposed in 2011-2015, accounting for 84.77% of the total were dogs injured, 128 cases of cat injuries, accounting for 10.31% of them, and 61 cases of mice and other injuries accounting for 4.92% of cases. There were 193 cases of human immunodeficiency wounds, accounting for 15.55%, no immunization history 1 048 cases, accounting for 84.45%. May-September is the peak of the disease, a total of 664 cases were treated, accounting for 53.51%, at least in March, 59 cases, accounting for 4.75%. There were 154 grade Ⅰ exposures in the treatment cases, accounting for 12.41%; 395 grade Ⅱ exposures, accounting for 31.83%; and 692 grade Ⅲ exposures, accounting for 55.76%. The main ways of animal injury were 1 019 cases (82.11%), followed by 222 cases (17.89%). Injuries were mainly limbs, injuring 1 037 cases, accounting for 83.56%. There were 1 233 cases of wounds treated immediately after exposure, accounting for 99.36%; 8 cases without any treatment of wounds, accounting for 0.64%. There were 1 228 cases of vaccination approved by the code, accounting for 98.95%. Among them, 1,056 cases were completed on time, 85.09% of whom were vaccinated. 321 cases of rabies immunoglobulin were vaccinated in time, accounting for 25.87%. Conclusion Xiaochang County should strengthen the publicity of the importance of wound treatment after rabies exposure, raise the cognitive level of the general public, and further strengthen the importance of publicizing the combined vaccination effect of vaccines.