416例狂犬病发病影响因素分析

Analysis of influence factors of rabies among 416 cases

目的分析安徽省狂犬病患者个案信息,探讨狂犬病发病的影响因素。方法收集安徽省2005～2011年416例狂犬病个案资料,采用EpiData3.1软件录入数据库,用SPSS 10.0对数据进行单因素检验分析、多因素有序回归分析和多元线性逐步回归分析。结果 93.99%患者被犬所伤,Ⅱ、Ⅲ度伤占95.67%,暴露后仅19.47%在医疗机构处理伤口,头颈和躯干部伤口占39.51%,不同暴露部位伤口处理比较差异有统计学意义(χ2=21.87,P<0.01)。暴露后狂犬疫苗接种率仅14.42%,抗血清使用率0.48%。潜伏期中位数72d(最短2 d,最长15年),病例的暴露部位、伤口未处理、暴露后未注射人用狂犬疫苗对潜伏期长短有影响。结论加强农村地区重点人群预防狂犬病的健康教育、提高暴露后伤口规范处理是狂犬病暴露后防制的主要措施。

Objective To investigate human rabies cases and explore the influence factors of rabies. Methods Data from 416 questionnaires for human rabies cases occurred during 2005 - 2011 in Anhui province were put into EpiData3.1 to build a data base. SPSS 10.0 was used for statistic analysis. Influence factors of rabies incubation period were analyzed with chi -square test, ordinal regression and multiple linear stepwise regression. Results All of the cases, 93.99% were caused by dog bites, 95.67% were with II and III degree wound, and only 19.47% received treatment from medical institutions. Rabies inoculation rate of the patients after being exposed was 14.42%, and the usage rate of antiserum immunoglobulin was only 0.48%. The median of rabies incubation period was 72 days （ ranging from 2 days to 15 years ）. Exposure position, wound disposal Methods whether or not receiving post - exposure vaccination were main influence factors of rabies incubation period. Conclusion Strengthening health education, and improving wound disposal rate and rabies vaccination rate in rural targeted population are the effective prevention and control measures for rabies after exposure.