犬与猫咬伤创口特点及感染的研究

The infectious characteristies of dog and cat bites

目的探讨犬和猫咬伤创口的特点及感染的临床表现、并发症的差别及原因。方法 800例犬和猫咬伤患者,按伤部分为手足组、上下肢组,分别观察各组的感染率、感染时间、临床表现及并发症情况。结果犬咬伤创口80.0%为撕裂伤,猫咬伤创口85.0%为穿刺伤。400例犬咬伤患者中共有59例出现感染,感染率14.8%,59例感染中有30例(50.8%)出现不同程度的并发症。400例猫咬伤患者中共有107例出现感染,感染率26.8%(与犬咬伤比较,P<0.05),107例感染中有58例(54.2%)出现不同程度的并发症。各组感染时间不同且差异均有统计学意义(P<0.05),以手足部猫咬伤最短,为(5.3±2.4)h,上下肢犬咬伤最长为(23.1±8.4)h。感染率在手足部猫咬伤最高,达33.5%,与其他各组比较差异均有统计学意义(P<0.05);上下肢犬咬伤感染率最低为9.0%,与其他各组比较差异亦有统计学意义(P<0.05);而手足部犬咬伤与上下肢猫咬伤感染率均约20%,差异无统计学意义(P>0.05)。各部位感染的临床表现主要是局部皮肤发红、水肿、明显触痛及发热;并发症主要是脓肿、淋巴管炎/丹毒、关节炎、腱鞘炎、败血症。结论四肢部位的猫咬伤创口在感染率、感染时间、并发症上较犬咬伤严重,尤其在手足部位。

ObjectiveTo study the characters of dog and cat bite wounds and the difference between dog and cat bites on infection rates and the complications. MethodsFour groups of 200 bite patients （totally 800 patients） with the wounds at their hand or foot, upper limb or lower limb, underwent observation of the infection rate, infection time, clinical manifestations, and complications. ResultsEighty point five percent of dog bite wounds was lacertion and 850% of cat bite wounds was puncture. There were 59 wounds got infected in 400 dog bites, and the total infection rate was 148%. Complications emerged from 30 of the 59 infected cases （508%）. On the other hand, there were 107 （542%） wounds got infected in 400 cat bites, and the total infection rate was 268% which was significantly different from that of the dog bites （P〈005）. Fifty eight cases （542%） appeared complications. The infection time of the hand and foot bited by cat was （53±24）h that was significantly different from those of the other groups （P〈005）.And the longest infection time was （231±84）h in limb bited by dog. The highest infection rate was the hand and foot bited by cat at 335%,and the lowest was the limb （90%） bited by dog which was significantly different from those of the other groups （P〈005）. The main clinical manifestations of wound infection included local redness, edema, purulent drainage, and fever. The main complications included abscess, lymphangitis/ erysipelas, arthritis, and tenosynovitis. ConclusionHand or foot wounds are the sites most liable to suffer from infection and severe complications among the dog and cat bite wounds, more serious at cat bites.