浙江省丽水市6471例狂犬病暴露者流行病学特征分析  

Epidemiological features of 6471 individuals with rabies exposure in Lishui city,Zhejiang province

作　　者：赖林杰 陈义 杜望 刘皖娟 麻帅婷 谢璐涛 兰频[1] Lai Linjie;Chen Yi;Du Wang;Liu Wanjuan;Ma Shuaiting;Xie Lutao;Lan Pin(Department of Emergency Medicine,The Fifth Afiliated Hospital of Wenzhou Medical University,Lishui Central Hospital,Lishui 323000,China)

机构地区：[1]温州医科大学附属第五医院、丽水市中心医院急诊医学科,丽水323000

出　　处：《中华实验和临床病毒学杂志》2024年第4期383-387,共5页Chinese Journal of Experimental and Clinical Virology

基　　金：丽水市科技计划项目(2022GYX36、2022SJZC019)。

摘　　要：目的了解丽水市中心医院动物致伤门诊接诊的狂犬病暴露预防处置人群的流行病学特征及暴露后处置情况,为本地区狂犬病防控提供参考。方法回顾性分析丽水市中心医院2021-2023年6471例狂犬病暴露者流行病学资料,包括暴露人群性别与年龄、致伤月份及部位、致伤动物种类、暴露等级、狂犬病疫苗接种情况、狂犬病被动免疫制剂注射等。结果2021-2023年丽水市中心医院动物致伤门诊收治狂犬病暴露者共计6471例,2021-2023年分别接诊1133例、2135例和3203例,4~11月为暴露的高峰期,其中年龄21~30岁人群就诊率最高,达27.79%(1798/6471),为暴露的高危人群,3年间狂犬病暴露年龄构成比差异具有统计学意义(χ^(2)=43.82,P<0.001);男、女性别比为1∶1.14(χ^(2)=1.63,P=0.442);其中猫致伤3317例(51.26%,3317/6471),犬致伤2614例(42.16%,2614/6471),猫和犬为主要致伤动物(χ^(2)=18.63,P=0.098)。暴露部位以上肢(4131/6471,63.84%)和下肢(1848/6471,28.56%)居多,3年间各部位的暴露构成比差异具有统计学意义(χ^(2)=105.79,P<0.001);其中Ⅱ级暴露占31.79%(2057/6471),Ⅲ级暴露占62.31%(4032/6471),Ⅲ级暴露者中应用被动免疫制剂者占55.13%(2232/4032)。结论丽水市中心医院动物致伤门诊狂犬病暴露者就诊数量逐年增高,就诊人群被猫和犬致伤的情况较突出,Ⅲ级暴露者被动免疫制剂使用率仍然有待继续提高。ObjectiveTo understand the epidemiological characteristics and post-exposure prophylaxis(PEP)situation of rabies exposure population in the animal injury outpatient department of Lishui Central Hospital,so as to provide reference for rabies prevention and control in this region.MethodsThe epidemiological data of 6471 rabies-exposed persons in Lishui Central Hospital from 2021 to 2023 were retrospectively analyzed,including the gender and age of exposed persons,the month and location of injury,the species of injured animals,the exposure grade,rabies vaccination,rabies passive immunization agents,etc.ResultsFrom 2021 to 2023,a total of 6471 cases of rabies exposure were treated in the animal injury outpatient department of Lishui Central Hospital.From 2021 to 2023,1133 cases,2135 cases and 3203 cases were treated respectively.April to November was the peak period of exposure.The population of 21 to 30 years had the highest rate of treatment,reaching 27.79%(1798/6471),and was a high-risk group of exposure.The age composition ratio of rabies exposure in the three years was statistically significantly different(χ^(2)=43.82,P<0.001);the male to female ratio was 1∶1.14(χ^(2)=1.63,P=0.442);3317 cases(51.26%,3317/6471)were injured by cats,and 2614 cases(42.16%,2614/6471)were injured by dogs,cats and dogs were the main injured animals(χ^(2)=18.63,P=0.098).The upper limbs(4131/6471,63.84%)and lower limbs(1848/6471,28.56%)were the most exposed sites,and there was a statistically significant difference in the exposure composition ratio of each site in three years(χ^(2)=105.79,P<0.001).Grade II exposure accounted for 31.79%(2057/6471),grade III exposure accounted for 62.31%(4032/6471).Among grade III exposure individuals,those who used passive immune preparations accounted for 55.13%(2232/4032).ConclusionsThe number of rabies-exposed patients in the animal injury outpatient department of Lishui Central Hospital has been increasing year by year,and the population of patients injured by cats and dogs is particularly promin

关 键 词：狂犬病 暴露后预防处置 疫苗 被动免疫制剂 

分 类 号：R512.99[医药卫生—内科学] R181.3[医药卫生—临床医学]