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目的探讨婴幼儿(﹤6岁)在狂犬病暴露及处置过程中的特点。方法按照卫生部《狂犬病暴露预防处置工作规范》的要求,对2010年在南昌市辖区内11个狂犬病暴露处置门诊就诊的婴幼儿伤者计1408例进行流行病学调查研究,采用SPSS12.0软件对资料进行统计分析与评价。结果病例分布以居住在农村地区的高于城区;男性多于女性;年龄分布以5~岁组为高占32.10%,最低的是﹤1岁组为占6.04%;时间分布以5~8月为高,与狂犬病的发病季节高低相符;暴露于犬伤占76.99%,其次是猫和鼠,但﹤1岁组鼠伤占47.06%;致伤动物有明确免疫史占11.29%;流浪动物咬伤的占12.43%;暴露部位以头面为高占53.20%,其次是躯干、上肢、下肢和多发伤;伤后24h之内就诊的占92.54%;接种进口狂犬病疫苗639例占45.38%、国产狂犬病疫苗769例占54.61%;Ⅱ度暴露占87.29%、Ⅲ度暴露占12.71%,Ⅲ度暴露中同意接种狂犬病疫苗联合狂犬病免疫球蛋白免疫者占78.77%;全部伤者观察1年后无狂犬病发病死亡病例。结论婴幼儿的生理特点反应出在狂犬病暴露与处置过程中的特殊性:在受动物攻击时易伤及头面部和上半身,属狂犬病高危的人群;暴露后家长重视度高;处置难度大;在伤口处理过程中要避免对婴幼儿造成二次损伤;在狂犬病疫苗免疫程序1个月的时间中,易发生与其他计划免疫疫苗间在时间间隔上的问题。
Objective To investigate the characteristics of infants and young children (<6 years old) during rabies exposure and treatment. Methods According to the Ministry of Health “Rabies Exposure Preventive Measures” requirements, in 2010 in the area of Nanchang City 11 rabies exposure treatment outpatient treatment of infants and young children count 1408 cases of epidemiological investigation, using SPSS12.0 software Statistical analysis of data and evaluation. Results The distribution of cases was higher in rural areas than in urban areas. There were more males than females. The distribution of age was 32.10% in 5 ~ group, the lowest was 6.04% in <1 year group, and 5-8 months in time Which was consistent with the incidence of rabies. The incidence of dogs was 76.99%, followed by that of cats and mice, but less than 1 year of age was 47.06%. The history of clear immunization was 11.29% Injuries accounted for 12.43%; exposed parts to the head surface is high for 53.20%, followed by the trunk, upper extremity, lower extremity and multiple trauma; within 24 hours after injury accounted for 92.54%; vaccinated imported rabies vaccine 639 cases accounted for 45.38%, domestic rabies 769 cases accounted for 54.61% of the vaccine, 87.29% of the second-degree exposure and 12.71% of the third-degree exposure, and 78.77% of the rabies vaccines and rabies immunoglobulin in the third-degree exposure. No rabies was observed after 1 year Deaths. Conclusion The physiological characteristics of infants and young children reflect the particularity in the process of rabies exposure and treatment: it is easy to injure the head and face and the upper body when being attacked by animals, which is a high risk group of rabies. Wound treatment to avoid secondary damage to infants and young children; rabies vaccine immunization program in a period of 1 month, prone to other planned immunization vaccine in the time interval between the problems.