92例狂犬病病例流行病学特征及暴露后未就医情况分析  

Epidemiological features of 92 cases of rabies and analysis of not seeking medical care after exposure

作　　者：李金强 谢青 唐臻 刘凤娥 刘文婕 LI Jinqiang;XIE Qing;TANG Zhen;LIU Feng′e;LIU Wenjie(Changsha Hospital Affiliated to Xiangya Medical College of Central South University,Changsha,Hunan 410000,China)

机构地区：[1]中南大学湘雅医学院附属长沙医院,湖南长沙410000

出　　处：《医学动物防制》2024年第4期349-352,共4页Journal of Medical Pest Control

基　　金：国家临床重点专科建设项目与培育项目(湘卫医发〔2023〕5号);长沙市市级医学重点学(专)科建设项目(长财社指[2021]89号);长沙市第一医院院级课题(Y2022-15)。

摘　　要：目的分析92例狂犬病病例的流行病学特点,探讨病例狂犬病暴露后未及时就医的原因,为狂犬病防控及消除工作提供策略。方法收集2012年1月—2022年12月在长沙市某医院诊治的92例狂犬病病例的个案调查资料,用描述流行病学方法进行分析。结果92例狂犬病病例来自湖南省14个市、州,狂犬病发病例数呈下降趋势(χ^(2)=644.000,P<0.001)。男性多于女性,男女性别比为2.8∶1,96.7%的病例为农村人口,以青壮年和10岁内儿童居多。79例狂犬病病例有明确暴露史,手部受伤最多(55.7%,44/79),头面部致伤者中10岁以下儿童病例占比高(76.9%,10/13)。潜伏期在1年以内的占97.5%(77/79),1周~1个月的占13.9%(11/79),1~3月内的占57.0%(45/79)。致伤动物以犬类为主,占80.4%(74/92)。认为致伤动物健康、伤口未出血、迷信其他方法治疗是79例暴露对象未就医的主要原因。结论农村和农民是狂犬病防控重点,应加大儿童关注度,规范犬猫管理及免疫,推进农民科普宣教,加强基层服务能力建设,提高居民狂犬病认知和就医意识,多维度齐抓共管,以减少狂犬病的发病率。Objective To analyze the epidemiological features of 92 rabies cases,explore the reasons for the failure of patients to seek medical attention in time after rabies exposure,and provide strategies for the prevention,control,and elimination of rabies.Methods The case study data of 92 rabies cases diagnosed and treated in a hospital in Changsha City from January 2012 to December 2022 were collected and analyzed using descriptive epidemiological methods.Results Among the 92 rabies cases from 14 cities and states in Hunan Province showed a downward trend in the number of rabies cases(χ^(2)=644.000,P<0.001).There were more males than females,with a male-to-female sex ratio of 2.8∶1,and 96.7%of the patients were in rural areas,with the majority of young adults and children under 10 years old.A total of 79 rabies cases had a clear history of exposure,with the most hand injuries(55.7%,44/79),and children under 10 years old accounted for a large proportion of head and face injuries(76.9%,10/13).The incubation period of 97.5%(77/97)was within 1 year,13.9%(11/79)was between 1 week and 1 month,and 57.0%(45/79)was between 1 and 3 months.Most of the animals causing injuries were dogs,accounting for 80.4%(74/92).It was believed that animals causing injuries were healthy,the absence of bleeding from the wound,and superstitious treatment with other methods were the main reasons for not seeking medical care in the 79 exposed subjects.Conclusion Rural areas and farmers are the focus of rabies prevention and control,and increase the attention of children,standardize the management and immunization of dogs and cats,promote the popularization of science and education among farmers,strengthen the construction of grass-roots service capacity,improve residents′awareness of rabies and medical awareness,and work together in multiple dimensions to reduce the incidence of rabies.

关 键 词：狂犬病 流行病学特征 暴露后预防 就医意愿 分析 

分 类 号：R181.3[医药卫生—流行病学]