破伤风的科学防治  

Scientific treatment and prevention of tetanus

作　　者：沈银忠[1] 张永信[2] 

机构地区：[1]复旦大学附属公共卫生临床中心,上海201508 [2]复旦大学附属华山医院,上海200040

出　　处：《上海医药》2012年第19期9-12,共4页Shanghai Medical & Pharmaceutical Journal

摘　　要：尽管破伤风已不再是一种多发病,但因破伤风杆菌广泛存在于环境中且引起其感染的外伤性因素依然很多、病死率又高,故破伤风仍是威胁人类健康的主要疾病之一。破伤风的诊断主要依赖外伤史和临床表现,早期识别并给予科学的治疗是改善预后的关键,而关键的治疗措施包括对伤口的彻底处理以及控制肌肉痉挛和肺部感染等。破伤风抗毒素是防治破伤风的重要药物,但其明显的不良反应限制了临床应用。新型抗毒素免疫制剂如人破伤风免疫球蛋白和马破伤风免疫球蛋白F(ab′)2将在今后破伤风的防治中发挥重要作用。预防接种是预防破伤风的主要措施。推广新法接生、外伤后正确处理伤口等也有助于预防破伤风。外伤后应首先清洁伤口,而后根据伤口情况及患者受伤前的免疫接种史来决定如何进行抗毒素预防接种。Tetanus is no longer a common disease nowadays, however, it is still a serious disease threatening the human health and has a high mortality because Clostridium tetani is distributed widely in the environment, and there exist many traumatic factors which can cause tetanus. The diagnosis of tetanus is entirely dependent on the history of trauma and clinical manifestations. Early identification and scientific treatment is the key to improve the prognosis. The key measure of treatment includes the wound thoroughly cleaned and controls of muscle cramps and pulmonary infection. Tetanus antitoxin is an important drug to prevent and treat tetanus but its side effect restricts the clinical usage. A new type antitoxin immune agent such as tetanus immunoglobulin will play an important role in prevention and treatment of tetanus in the future. Immunization is a main measure to prevent tetanus. Popularizing hospital delivery and correct treating wounds post-traumatic are also benefit for preventing tetanus. After trauma, the wound should be cleaned first and then what antitoxin vaccination is decided according to the condition of the patient＇s wound and immunization history.

关 键 词：破伤风 破伤风抗毒素 破伤风免疫球蛋白 

分 类 号：R517.3[医药卫生—内科学]