处置突发公共卫生事件的部队官兵预防破伤风发病研究：软组织损伤1782例分析

Study of tetanus prevention of troops in public health event --- 1 782 patients with soft tissue injury

目的突发公共卫生事件中破伤风发病研究及相关风险因素的分析，探讨应急突发公共卫生事件中软组织损伤破伤风的防控。方法对1782例软组织损伤者，采用碘伏、生理盐水、双氧水擦拭冲洗伤口，并行特殊缝合术及包扎；破伤风抗毒素皮试阳性者脱敏注射或注射人破伤风免疫球蛋白。结果术后观察7天，随诊60天，无一例破伤风发病；破伤风抗毒素皮试阳性率占46．2％（823／1782）。结论突发公共卫生事件中，特别是洪涝灾害，破伤风杆菌污染最多，对极易感染软组织损伤的人群，多措并举进行伤口处置是可靠有效的防控措施，推荐在突发公共卫生事件中应用破伤风免疫球蛋白。

Objective To investigate the prevalence and risk factors of tetanus in public health event and explore the approach to prevent and control the disease. Methods 1,782 patients experiencing soft tissue injury were treated with iodophored NS, hydrogen peroxide, specific suture, and tetanus anti-toxin or human tetanus immunoglobulin when there was a positive skin test. Results There is not even a single case of infection on a seven-day observation followed by a 60-day post visit. The positive skin test demonstrated as 46.2% （823/1782）. Conclusion Most likely tetanus spread in flood. Debridement combined with tetanus anti-toxin is a reliable measure to prevent tetanus infection, recommending of tetanus immune globulin application in massed public health event.