武汉市武昌区犬伤情况及防治对策
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摘要
目的狂犬病是目前病死率最高的急性传染病。本研究了解武汉市武昌区的犬类伤人和暴露后处理情况,为控制狂犬病制定防治对策。方法选择2014-2017年在狂犬病暴露处置门诊就诊的11 322例犬伤情况进行描述性分析,数据经Excel录入及导入SPSS 19.0进行统计处理,采用频数和百分率(构成比)进行描述。结果犬伤患者11 322例,男5 198例(45.91%),女6 124例(54.09%);年龄以21～30岁多见(25.26%);受伤方式以咬伤为主(79.51%);受伤部位以上肢为主(54.63%),下肢占41.26%;受伤时间以5～8月份多发(42.10%);暴露分级以Ⅱ级为主(71.83%),Ⅲ级占28.17%;就诊时间以<24h主(86.24%);伤口冲洗以自行为主(80.26%);Ⅲ级暴露者中人狂犬病免疫球蛋白的使用率仅为15.8%。结论武昌区犬类伤人的主要对象为年轻人,以夏季、上下肢和咬伤为多见,需加强犬只管理和普及狂犬病预防知识,同时加强医务人员狂犬病暴露后规范化处置。
OBJECTIVE Rabies is currently the most deadly acute infectious disease.The purpuse of this study is to understand the injuries by canine and post-exposure treatment in Wuchang District of Wuhan city,and to develop prevention and control measures for the control of rabies.METHODS Descriptive analysis was performed on 11 322 cases of injury by dog in the rabies exposure treatment clinic from 2014 to 2017.The data were recorded by Excel and imported into SPSS19.0 software for statistical processing.The frequency and percentage(composition ratio)were used for description.RESULTS Among 11 322 cases of injury by canine,there were 5 198 of males,accounting for 45.91%,and 6 124 of females,accounting for 54.09%.The cases were mainly aged 21 to 30,accounting for 25.26%.The injuries were mainly bite,accounting for 79.51%.The injured part was mainly upper limbs,accounting for 54.63%,and the lower limbs accounted for 41.26%.The injury time was more frequent in May to August,accounting for 42.10%.The exposure classification was mainly gradeⅡ,accounting for 71.83%,and gradeⅢaccounting for 28.17%;Injuries treated within 24 hours accounted for 86.24%.Wound washing was performed mainly by the people on their own,accounting for 80.26%.The use rate of rabies immunoglobulin was only 15.8%.CONCLUSIONS The main target of canine wounds in Wuchang District is young people.It is more common that bite by dog at upper or lower limbs happens in summer.It is necessary to strengthen the management of dogs and popularize the prevention of rabies,and strengthen the standardized treatment of rabies for medical staff after exposure.
OBJECTIVE Rabies is currently the most deadly acute infectious disease.The purpuse of this study is to understand the injuries by canine and post-exposure treatment in Wuchang District of Wuhan city,and to develop prevention and control measures for the control of rabies.METHODS Descriptive analysis was performed on 11 322 cases of injury by dog in the rabies exposure treatment clinic from 2014 to 2017.The data were recorded by Excel and imported into SPSS19.0 software for statistical processing.The frequency and percentage(composition ratio)were used for description.RESULTS Among 11 322 cases of injury by canine,there were 5 198 of males,accounting for 45.91%,and 6 124 of females,accounting for 54.09%.The cases were mainly aged 21 to 30,accounting for 25.26%.The injuries were mainly bite,accounting for 79.51%.The injured part was mainly upper limbs,accounting for 54.63%,and the lower limbs accounted for 41.26%.The injury time was more frequent in May to August,accounting for 42.10%.The exposure classification was mainly gradeⅡ,accounting for 71.83%,and gradeⅢaccounting for 28.17%;Injuries treated within 24 hours accounted for 86.24%.Wound washing was performed mainly by the people on their own,accounting for 80.26%.The use rate of rabies immunoglobulin was only 15.8%.CONCLUSIONS The main target of canine wounds in Wuchang District is young people.It is more common that bite by dog at upper or lower limbs happens in summer.It is necessary to strengthen the management of dogs and popularize the prevention of rabies,and strengthen the standardized treatment of rabies for medical staff after exposure.
引文
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[15] Zhang JY,Zhang B,Zhang SF,et al.Dog-transmitted rabies in Beijing,China[J].Biomed Environ Sci,2017,30(7):526-529.
[16] Ruan S.Modeling the transmission dynamics and control of rabies in China[J].Math Biosci,2017,286:65-93.
[17] Qi L,Su K,Shen T,et al.Epidemiological characteristics and post-exposure prophylaxis of human rabies in Chongqing,China,2007-2016[J].BMC Infect Dis,2018,18(1):6.
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[3]中华人民共和国国家卫生和健康委员会.2017年全国法定传染病疫情概况[EB/OL].http://www.moh.gov.cn/jkj/s3578/201802/de926bdb046749abb7b0a8e23d929104.shtml
[4] Tan J,Wang R,Ji S,et al.One health strategies for rabies control in rural areas of China[J].Lancet Infect Dis,2017,17(4):365-367.
[5]肖雷,王凤双,唐莹,等.2008-2014年北京市顺义区狂犬病暴露人群流行病学特征分析[J].中国生物制品学杂志,2016,29(3):283-287.
[6]李艳红.狂犬病预防控制新问题[J].饮食保健,2017,4(19):337.
[7]任江萍,陈直平,孙继民,等.全国人间狂犬病疫情的时间序列分析[J].中国人兽共患病学报,2018,34(3):239-242.
[8] Liu Q,Wang X,Liu B,et al.Improper wound treatment and delay of rabies post-exposure prophylaxis of animal bite victims in China:Prevalence and determinants[J].PLoS Negl Trop Dis,2017,11(7):e0005663.
[9] Huang XY,Li XL,Wu SY,et al.Bites from the same dog,different outcomes for two patients:a case report[J].Infect Dis Poverty,2017,6(1):107.
[10]裘灵洁,俞凤英,杨丽琴,等.8 525例犬咬伤的调查分析与对策思考[J].医学信息,2014(7):468-469.
[11]邓常青,张莹,钟贵良,等.2010-2013年长沙县狂犬病暴露人群流行病学特征分析[J].实用预防医学,2015,22(8):966-968.
[12]赵东丽,赵夏钗,吴月华.690例狂犬病暴露人群流行病学特征分析[J].中国公共卫生管理,2013,29(3):364-365.
[13]闫萍,韦凤琴,吴炜彬.2014-2016年来宾市兴宾区狂犬病暴露流行特征分析[J].应用预防医学,2018,34(1):41-42,46.
[14]郑日真,廖旭菱.我国狂犬病流行现状与防控对策[J].预防医学论坛,2016,22(12):946-948.
[15] Zhang JY,Zhang B,Zhang SF,et al.Dog-transmitted rabies in Beijing,China[J].Biomed Environ Sci,2017,30(7):526-529.
[16] Ruan S.Modeling the transmission dynamics and control of rabies in China[J].Math Biosci,2017,286:65-93.
[17] Qi L,Su K,Shen T,et al.Epidemiological characteristics and post-exposure prophylaxis of human rabies in Chongqing,China,2007-2016[J].BMC Infect Dis,2018,18(1):6.