贵州省医疗机构外伤后破伤风预防处置现状调查  

Investigation on prevention and treatment of post-traumatic tetanus in medical institutions in Guizhou Province

作　　者：张丹丹 赵玲璐 刘铭[1] 任丽娟[1] 芮莉萍[1] 徐飞[1] 李阳[2] 瞿彬[3] 郭豫[4] 冯磊[5] 雷世光[1] Zhang Dandan;Zhao Linglu;Liu Ming;Ren Lijuan;Rui Liping;Xu Fei;Li Yang;Qu Bin;Guo Yu;Feng Lei;Lei Shiguang(Guizhou Provincial Center for Disease Control and Prevention,Guiyang 550004,Guizhou,China;Anshun Center for Disease Control and Prevention,Anshun 561000,Guizhou,China;Zunyi Center for Disease Control and Prevention,Zunyi 563000,Guizhou,China;Qiandongnan Center for Disease Control and Prevention,Kaili 556000,Guizhou,China;Qiannan Center for Disease Control and Prevention,Duyun 551200,Guizhou,China)

机构地区：[1]贵州省疾病预防控制中心,贵州贵阳550004 [2]安顺市疾病预防控制中心,贵州安顺561000 [3]遵义市疾病预防控制中心,贵州遵义563000 [4]黔东南州疾病预防控制中心,贵州凯里556000 [5]黔南州疾病预防控制中心,贵州都匀551200

出　　处：《贵州医药》2024年第10期1558-1560,共3页Guizhou Medical Journal

摘　　要：目的了解贵州省外伤后破伤风预防处置现状和医务人员破伤风防病知识知晓情况,为制定破伤风预防处置规范提供依据。方法实地调查全省所有三级甲等医院28家、所有县(区)人民医院87家;从贵州省免疫规划信息管理系统获取破伤风疫苗接种剂次;设计问卷随机抽取部分医院开展医务人员破伤风防病知识知晓情况调查。结果外伤后破伤风预防处置,5.21%的医疗机构只开展外伤处置,仅13.04%的医疗机构同时开展疫苗接种服务和被动免疫制剂注射,其余81.74%的医疗机构只开展破伤风被动免疫制剂注射服务。近5年,全省共接种破伤风疫苗24862剂次,年均仅4972剂次。与同期狂犬疫苗比,使用量极少。医务人员破伤风防病知识知晓率为30.60%,其中,含破伤风类毒素成分疫苗种类知晓率最低,仅11.72%,儿童含破伤风类毒素成分疫苗免疫规划程序知晓率最高,为62.76%。2021年1月1日至2023年6月30日,115家医疗机构诊断破伤风93例,其中28家三级甲等医院诊断62例,占66.67%。结论贵州省破伤风暴露后预防处置服务的可及性和规范性亟待提高,存在仅单纯使用破伤风被动免疫制剂、忽视除儿童常规免疫以外含破伤风类毒素成分疫苗的现象。医务人员对相关知识认知不足,有待进一步培训提高。Objective To understand the status quo of prevention and treatment of post-traumatic tetanus and the knowledge of medical personnel in Guizhou Province,so as to provide basis for formulating norms of prevention and treatment of tetanus.Methods Field investigated 28 hospitals and 87 people's hospitals in all counties(districts)in the province;obtained tetanus vaccination agents from immunization planning information management system of Guizhou Province,and some hospitals were randomly selected to investigate the knowledge of tetanus prevention.Results Preventive treatment of post-traumatic tetanus,5.21%of medical institutions only carried out trauma treatment,only 13.04%of medical institutions simultaneously provided vaccination service and passive immunization preparation injection,and the remaining 81.74%of medical institutions only provided tetanus passive immunization injection service.In the past five years,a total of 24,862 doses of tetanus vaccine have been administered in the province,with only 4,972 doses administered annually.Compared with the same rabies vaccine,little use.The knowledge rate of medical staff on tetanus prevention was 30.60%,among which the awareness rate of tetanus-containing toxin vaccine was the lowest,only 11.72%,and the awareness rate of children was the highest,62.76%.From January 1,2021 to June 30,2023,93 cases of tetanus were diagnosed in 115 medical institutions,of which 62 cases were diagnosed in 28 grade A hospitals,accounting for 66.67%.Conclusion The accessibility and standardization of post-tetanus exposure prevention and disposal services in Guizhou Province need to be improved.There is a phenomenon that only passive tetanus immunization preparations are used,and vaccines containing tetanus toxoid components are ignored except for routine immunization of children.Medical staff have insufficient knowledge of relevant knowledge,which needs further training and improvement.

关 键 词：破伤风 外伤后预防 疫苗 医务人员 知晓率 

分 类 号：R378.81[医药卫生—病原生物学] R517.3[医药卫生—基础医学]