11200例狂犬病暴露人群预防处置情况分析
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摘要
目的分析狂犬病暴露人群的预防处置情况。方法选择2011年1月至2016年12月期间在广州医科大学附属深圳沙井医院、深圳市宝安区人民医院以及深圳市光明新区人民医院就诊的11 200例动物致伤患者进行回顾性研究,分析暴露等级、致伤动物、致伤部位、伤口处理、狂犬疫苗接种者年龄、性别分布、预防接种方式。结果暴露等级以Ⅱ级为主,占79.4%;致伤动物最多为犬,占89.1%,其次为猫,占9.95%;致伤部位以四肢为主,尤其下肢为主,占47.0%;患者伤后以门诊处理为主,占91.2%;0~15岁人群暴露以男性为主,占15.0%,50岁以前人群男性暴露率高,51岁以后人群女性暴露率高;狂犬疫苗与狂犬疫苗联合狂犬免疫球蛋白两组患者伤后第一针均可100.0%完成,全程按时完成患者比率均减低,狂免+疫苗组为68.1%,狂犬疫苗为组64.0%。结论狂犬病的预防与控制需要全社会共同关注与参与,相关部门应加大狂犬病防范知识宣传力度,加强宠物管理工作,规范开展狂犬病暴露预防处置工作,提高狂犬病疫苗全程接种率。
Objective To analyze the prevention and treatment of rabies exposed population. Methods A total of 11 200 patients injured by animals in Shenzhen Shajing Hospital Affiliated to Guangzhou Medical University,Shenzhen Baoan District People's Hospital, and Shenzhen Guangming New District People's Hospital from January 2011 to December 2016 were retrospectively studied. Then the levels of exposure, animals, injured parts, wound treatment,age of vaccination against rabies, sex distribution, and vaccination methods were studied. Results The exposure level was dominated by level Ⅱ(79.4%). The animals causing rabies were mostly dogs(89.1%), followed by cats(9.95%).The injured parts were mainly limbs, especially the lower limbs(47.0%). 91.2% of the patients were treated with outpatient treatment after injury. The 0-15 year old population were mainly male(15.0%). The incidence was higher in men than women before the age of 50 years, while the incidence was higher in women after 51 years old. For vaccination methods, the first of the five needles after injury in the two groups could be completed by 100.0%, but all the five needles were completed on time in 68.1% of the patients receiving rabies vaccine combined with rabies immunoglobulin and in 64.0% in the patients receiving rabies vaccine only. Conclusion Prevention and control of rabies need the common concern and participation of the whole society. The relevant departments should strengthen the knowledge and propaganda of rabies prevention, strengthen pet management, standardize the prevention and treatment of rabies exposure,and improve the whole coverage rate of rabies vaccine.
Objective To analyze the prevention and treatment of rabies exposed population. Methods A total of 11 200 patients injured by animals in Shenzhen Shajing Hospital Affiliated to Guangzhou Medical University,Shenzhen Baoan District People's Hospital, and Shenzhen Guangming New District People's Hospital from January 2011 to December 2016 were retrospectively studied. Then the levels of exposure, animals, injured parts, wound treatment,age of vaccination against rabies, sex distribution, and vaccination methods were studied. Results The exposure level was dominated by level Ⅱ(79.4%). The animals causing rabies were mostly dogs(89.1%), followed by cats(9.95%).The injured parts were mainly limbs, especially the lower limbs(47.0%). 91.2% of the patients were treated with outpatient treatment after injury. The 0-15 year old population were mainly male(15.0%). The incidence was higher in men than women before the age of 50 years, while the incidence was higher in women after 51 years old. For vaccination methods, the first of the five needles after injury in the two groups could be completed by 100.0%, but all the five needles were completed on time in 68.1% of the patients receiving rabies vaccine combined with rabies immunoglobulin and in 64.0% in the patients receiving rabies vaccine only. Conclusion Prevention and control of rabies need the common concern and participation of the whole society. The relevant departments should strengthen the knowledge and propaganda of rabies prevention, strengthen pet management, standardize the prevention and treatment of rabies exposure,and improve the whole coverage rate of rabies vaccine.
引文
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[10]Rosatte RC,Pow er MJ,Donovan D,et al.Elimination of arctic variant rabies in red foxes,metropolitan toronto[J].Emerg Infect Dis,2007,13(1):25-27.
[11]周航,满腾飞,李群,等.2009年中国狂犬病监测分析[J].疾病监测,2010,25(12):934-937.
[12]Tepsumethanon V,Wilde H,Sitprija V.Ten-day observation of live rabies suspected dogs[J].Dev Biol(Basel),2008,131:543-546.
[13]Dietzschold B,Morimoto K,Hooper DC,et al.Genotypic and phenotypic diersity of rabies virus variants involved in human rabies:implications for post exposure prophylaxis[J].J Hum Virol,2000,3(1):50-57.
[2]茅蓉,金安宝,曹家穗.《狂犬病暴露预防处置工作规范(2009版)》实施后暴露者预防处置情况分析[J].中国农村卫生事业管理,2014,34(10):1238-1239.
[3]周航,李昱,陈瑞丰,等.狂犬病预防控制技术指南(2016版)[J].中华流行病学杂志,2016,37(2):139-163.
[4]刘华,高金慧,崔晨,等.2011-2012年临清市居民被动物致伤及狂犬病疫苗接种状况分析[J].职业与健康,2013,29(21):2823-2825.
[5]曹玲生,袁平.中国免疫规划信息管理系统建设思路[J].中国疫苗和免疫,2010,16(6):553-557.
[6]Ambrozaitis A,Laiskonis A,Balciuniene L,et al.Rabies postexposure prophylaxis vaccination with purified chickemb ryocell vaccine(PCECV)and purified vero cell rabies vaccine in Four Sit eintradermal schedule(4-0-2-0-1-1):An immunogenic,costeff ective and practical regimen[J].Vaccine,2006,24(18):4116-4121.
[7]夏咸柱,俞永新,侯云德,等.加强我国狂犬病防控[J].中国病毒病杂志,2011,1(3):161-162.
[8]Suw ansrinon K,Wilde H,Benjavongkulchai M,et al.Survival of neutralizing antibody in previously rabies vaccinated subjects:A prospective study show ing long lasting immunity[J].Vaccine,2006,24(18):3878-3880.
[9]吴慧,宋淼,申辛欣,等.1996-2009年中国狂犬病流行病学分析[J].疾病监测,2011,26(6):427-430.
[10]Rosatte RC,Pow er MJ,Donovan D,et al.Elimination of arctic variant rabies in red foxes,metropolitan toronto[J].Emerg Infect Dis,2007,13(1):25-27.
[11]周航,满腾飞,李群,等.2009年中国狂犬病监测分析[J].疾病监测,2010,25(12):934-937.
[12]Tepsumethanon V,Wilde H,Sitprija V.Ten-day observation of live rabies suspected dogs[J].Dev Biol(Basel),2008,131:543-546.
[13]Dietzschold B,Morimoto K,Hooper DC,et al.Genotypic and phenotypic diersity of rabies virus variants involved in human rabies:implications for post exposure prophylaxis[J].J Hum Virol,2000,3(1):50-57.