45例狂犬病分析及防控启示

Analysis of 45 Patients with Rabies and the Enlightenment of Rabies Prevention and Control

目的探讨狂犬病的防控和诊断,以降低其发病率。方法对该院1984～2008年收治的45例狂犬病住院患者资料进行回顾性研究。结果 1984～2008年收治的45例狂犬病住院患者,其中男28例,女17例,男女之比1.6∶1,88.4%的患者被犬所伤。8.89%的患者暴露后到当地医院处理伤口,所有患者在暴露前后及发病后均未进行主动及被动免疫。前驱期临床表现多样,95.56%的患者在兴奋期出现典型的临床表现。97.62%的患者血清中和抗体阳性,40%的患者脑脊液中和抗体阳性。结论预防处置率低是造成狂犬病发生的重要原因之一;其次犬仍是狂犬病主要的传染源,因此应该严格贯彻"QDV"措施,宣传狂犬病防控知识;该病极易误诊、漏诊,应结合临床表现和实验室检测以提高其诊断率。

Objective To discuss the prevention,control and diagnosis of rabies,in order to reduce its incidence.Methods The data of 45 patients with rabies admitted to the hospital from 1984 to 2008 were analyzed retrospective1y.Results There were 28 male,17 female cases in the 45 patients with rabies,the gender ratio of male to female was 1.6∶ 1.88.4% of the cases were bitten by dogs.8.89% of the cases had received treatment on wound,all cases did not receive active and passive immunity before and after exposure and after the onset.Clinical manifestations of prodromal stage were multiform.95.56% cases had the typical symptom of rabies in exciting period.The sera positive rate of neutralizing antibody was 97.62%,while the positive rate of neutralizing antibody in CSF was 40%.Conclusion Firstly,low rates of treatment on wounds and vaccination were one reason of the occurrence of rabies;secondly the ＂QDV＂ measures should be strictly implemented to publicize prevention and control knowledge of rabies;thirdly,rabies is easy to be misdiag-nosed and missed diagnosed,so the diagnosis rate will be elevated if clinical manifestation laboratory detection can be combined.