成人重症破伤风的诊断与治疗  

Diagnosis and treatment of severe adult tetanus

作　　者：张晓萌[1] 王艳华[2] 王传林[1,3] ZHANG Xiao meng;WANG Yan hua;WANG Chuan lin(Trauma Center,Peking University People's Hospital,Beijing 100044,China)

机构地区：[1]北京大学人民医院创伤救治中心,北京100044 [2]北京大学人民医院创伤骨科,北京100044 [3]北京大学人民医院急诊科,北京100044

出　　处：《中国急救复苏与灾害医学杂志》2018年第11期1087-1093,共7页China Journal of Emergency Resuscitation and Disaster Medicine

摘　　要：重症破伤风具有较高的死亡率,早期、及时明确有助于提高患者生存率。破伤风的诊断基于临床表现,并依此采用Ablett分级系统进行严重程度分级。重症破伤风的治疗包括伤口处理、抗生素治疗、中和游离毒素、解除肌肉痉挛、纠正自律性不稳定、气道管理、营养及其他支持、护理措施等。同时,针对不同患者应采用个体化治疗。破伤风痊愈后无法获得免疫力,仍需采取主、被动免疫预防措施。Severe tetanus has a high mortality rate,and early and timely identification can help improve survival rate. The diagnosis of tetanus is based on its clinical manifestations,and the Ablett grading system is used for severity grading.The treatment includes wound mangement,antibiotic treatment,neutralization of free toxins,muscle spasm control,autonomic dysfunction management,airway management,nutrition and other supportive and nursing measures. In the meanwhile,individualized treatment should be adopted for different patients.It is unable to obtain immunity after the tetanus has healed,and still necessary to take preventive measures of primary and passive immunity.

关 键 词：重症破伤风 诊断 Ablett分级系统 治疗 预防 

分 类 号：R473[医药卫生—护理学]