1408例婴幼儿狂犬病暴露及处置特点分析  

Analysis of rabies exposure and disposal characteristics about 1408 infants

作　　者：金燕[1] 朱申茵[1] 唐荔伟[1] 章媛英[1] 喻迎九[1] 

机构地区：[1]江西省南昌市疾病预防控制中心预防医学门诊部,江西南昌330006

出　　处：《现代预防医学》2013年第15期2797-2798,2801,共3页Modern Preventive Medicine

摘　　要：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 present a thorough investigation into current state of infants （0-6 years old） exposed to rabies. METHODS According requirements in Specification for Rabies Prevention issued by the National Ministry of Health, the investigation was conducted based on 1 408 cases of infants who were exposed to rabies and cured in clinics 2010 within the 11 jurisdictions in Nanchang city. The data on these cases were analyzed by using the software package SPSS 12.0. RESULTS Infants exposed to rabies had the following epidemiological characteristics： number of cases of infants exposed to rabies in rural areas was larger than that in urban areas, more male infants than female ones. 5 to 6 years old infants accounted for the largest part of exposed infants for 32.10% , while the smallest part was that of the infants ﹤1 year old for 6.04% ; Cases exposed to rabies occurred most frequently from May to August. This trend was consistent with the incidence of rabies in different seasons. Such exposure was primary due to injuries caused by dogs, which accounted for 76.99% , followed by the cats and mice, but rat injury in ﹤ 1 year old group accounted for 47.06% . The animals with clear vaccination history accounted for 11.29% , stray animals 12.43%. For the exposed parts of bodies, the head and face accounted for largest part of 53.20% , followed by trunk, upper limbs, lower limbs, and combined injury; 92.54% infants sought treatment within 24 h after injuries. 639 cases with import vaccine accounted for 45.38% , while domestic rabies vaccine 769 cases for 54.61% ; II degree of exposure accounted for 87.29%, III degree of exposure 12.71%. 78.77% of infants with III degree of exposure agreed to use vaccination of rabies vaccine with rabies immune globulin immune. All the injured were free of rabies death cases by being observed after one year. CONCLUSION The physical features of infants reflect the particularity in rabies exposure and disposal, more likely to hurt the head and face and upper body by animal attacks, in

关 键 词：婴幼儿 狂犬病 流行病学 暴露处置 

分 类 号：R512.99[医药卫生—内科学]