24例狂犬病流行病学及临床特点分析

Epidemiological and clinical features of 24 rabies

目的回顾性研究北京地坛医院2008年11月至2010年12月，收治的24例狂犬病例，分析研究狂犬病的流行病学及临床特点，以提高诊治水平，加强狂犬病防治能力。结果本组病例壮年人群发病多，男性多，农村地区病例多，夏秋季节发病多，潜伏期随暴露部位距头部的距离而延长。36．8％的患者在暴露后处理了伤口，15．8％的患者注射了狂犬病疫苗，仅有5．3％的患者注射了狂犬病抗毒血清，25％的病例以恐水、恐风症状起病，绝大多数的患者在兴奋期有典型的恐水、恐风、流涎等症状；70．8％患者出现了一种以上的并发症；自然病程平均天数为5．92±3．8天；41．7％的患者在初诊时被误诊。结论由于狂犬病的病死率几乎为100％，对人民继康危害极大，将狂犬病病原学诊断尽快应用于临床诊疗可有效提高确诊率，积极采取防控措施非常重要。

Objective To understand epidemiological and clinical features of rabies to improve diagnosis and treatment level and enhance capacity in rabies prevention and control. Methods 24 cases of human rabies recruited in Beijing Ditan hospital during November,2008 to December, 2010 were investigated. Results Major cases were young and middle-aged, male, living in rural area, disease occurred mainly in summer, incubation period , which was consistent with rules, increased with the distance between exposure site and head. 36. 8% went through post exposure treatment, 15.8% received post-exposure vaccination, only 5.3% were injected with received rabiesimmune globulin or serum, onset symptoms of 25% cases were hydrophobia, fear of wind, almost all cases presented with typical symptoms such as hydrophobia, fear of wind, salivation; 70. 8% appeared more than one complications, average natural disease course was 5.92 ±3.8 days, 41.7% were misdiagnosed dunng first clinical visit, but there were no difference of accurate diagnosis rate in second and third level hospitals. Conclusion because rabies has 100%case fatality rate, causing great harm to public health, it holds great importance to prompt application of pathogenic diagnosis into clinical diagnosis and implement active prevention and control measures.