陕西省8972例狂犬病暴露者流行病学调查  

Epidemiological analysis on 8972 patients exposed to rabies in Shanxi Province

作　　者：张义[1] 李媛洁[2] 陈飒[1] 邓勇[1] 曹磊[1] 周体操[1] 

机构地区：[1]陕西省疾病预防控制中心,西安710054 [2]西安交通大学

出　　处：《医学动物防制》2016年第11期1238-1240,1244,共4页Journal of Medical Pest Control

摘　　要：目的探讨狂犬病暴露人群分布特征及相关危险因素,为狂犬病的科学防治提供依据。方法对犬伤处置门诊8 972名暴露者按年龄、性别、时间、伤人动物、部位、分级、伤后伤口处理、疫苗接种和人狂犬免疫球蛋白注射情况等进行统计分析。结果 10岁以下和40-60岁年龄组暴露比例最高;男女暴露比为1.2∶1;6-8月暴露最多（3876人）,占全年的43.2%;职业分布以农民为主（5 134人,占57.2%）;伤及下肢者最多,为5 963人（占66.5%）;Ⅱ级暴露者4 130人（占46.0%）,Ⅲ级暴露者4 644人（占51.8%）;犬咬伤8 688人,占96.9%,其中家养犬伤7 310人（占81.5%）,流浪犬伤1 378人（占15.4%）;伤后伤口规范处置率达88.3%,疫苗接种率达89.1%,人狂犬病免疫球蛋白注射率达12.4%。结论暴露人群中儿童和中年人最多,家养犬伤人最多,伤及下肢者最多,夏季为暴露高发期,伤口规范处理和疫苗接种率尚可,人狂犬病免疫球蛋白注射率低。今后需进一步加强防控工作,应将重点放在偏远农村地区的医疗卫生机构。Objective To analyze the distribution characteristics and related risk factors on population exposed to rabies, in or- der to provide scientific evidence for the prevention and control of rabies. Methods Statistical analysis was proceeded to 8 972 rabies exposed people admitted to out -patient department, according to the age, gender, time, the species of attacking ani- mal, wounded areas, level of exposure, treatment for the bitten wound, rabies vaccine inoculation and human rabies immuno- globulins injection. Results The most susceptible age segments in the exposure to rabies was children under 10 years old and a- dults of 40 - 60 years old. The ratio of male to female was 1.2：1. The peak incidence month segments in the rabies exposure were from June to August（3 876 cases）, accounting for 43.2% of all cases. The susceptible occupation was peasants （5 134 cases, 57.2% ）. The susceptible wounded area was lower limbs（5 963 cases, 66.5% ）. 4 130 cases were class II exposure（46. 0% ） and 4 644 cases were class III exposure（51.8% ）. 96. 9% of the patients（8 688 cases） were bitten by dogs, including 7 310 ca- ses with patients bitten by the domestic dogs（81.5% ）, and 1 378 cases by the stray dogs（ 15.4% ）. The rate of standard post exposure treatment was up to 88.3%, and vaccination was up to 89. 1%, while the percentage of cases injected human rabies immunoglobulins was only 12. 4%. Conclusion Children and milled - aged people were the most susceptible age segments in ra- bies exposure. The pathogenic animal was mostly the domestic dogs, and the most susceptible wounded area was lower limbs. Summer was the peak incidence month segments. Standard post exposure treatment and vaccination were adequate, howev- er, the application of immunoglobulin injection was poor. Comprehensive measures on rabies control and prevention should be en- hanced, especially in the medical and health institutions of the remote rural areas.

关 键 词：狂犬病 暴露人群 调查 

分 类 号：R646[医药卫生—外科学]