社区狂犬病暴露预防处置门诊对犬伤伤口处置、被动免疫、疫苗接种等措施的实施效果

Implementation Effect of Rabies Exposure Prevention and Treatment Clinic in the Community on Dog Bite Wound Management,Passive Immunization,and Vaccination

目的本研究旨在分析社区狂犬病暴露预防处置门诊对犬伤伤口处置、被动免疫、疫苗接种等措施的实施效果。方法选取2020年1月至2023年1月武陟县疾控中心狂犬病暴露预防处置门诊的就诊记录,选取符合条件的狂犬病暴露伤口患者1500例,采用随机数字表法分为常规护理组750例(采用常规狂犬病疫苗接种护理)和社区护理组(在常规护理组护理方案基础上予以社区专科护理成员进行针对性干预方案)750例。同时收集其伤口处置、被动免疫和疫苗接种资料,并进行统计分析。结果本研究纳入的患者中男性占比(58.13%)高于女性占比(41.87%),2~9岁年龄段患者占比最高(26.40%),≥60岁患者占比最低(7.13%)。本研究纳入的患者中伤口暴露程度为Ⅱ级的占比最高(49.47%),伤口暴露在下肢部位的占比最高(48.33%)。本研究纳入的患者伤口暴露后在24 h内就诊的占比最高(69.13%)。本研究纳入的所有患者均接受人用冻干粉类狂犬病疫苗接种,其中480例患者经狂犬病人免疫球蛋白注射(32.00%)。社区护理组伤口正确处置率达到98.27%,被动免疫率达到98.53%,疫苗接种率达到97.47%,均高于常规护理组(94.93%,95.20%,93.47%),差异有统计学意义(P<0.05)。结论在社区狂犬病暴露预防处置门诊的针对性护理干预下,对提高狂犬病暴露者的伤口处置、被动免疫、疫苗接种具有积极意义。

Objective This study aims to analyze the implementation effect of the rabies exposure prevention and treatment clinic in the community on dog bite wound management,passive immunization,and vaccination.Methods The medical records of the rabies exposure prevention and treatment clinic at Wuzhi County Center for Disease Control from January 2020 to January 2023 were selected.A total of 1,500 eligible patients with rabies exposure wounds were randomly divided into the routine care group(750 cases,receiving routine rabies vaccination care)and the community care group(750 cases,receiving targeted intervention by community specialized care members based on the routine care group care plan)using a random number table method.Data on wound management,passive immunization,and vaccination were collected and statistically analyzed.Results Among the patients included in this study,the proportion of males(58.13%)was higher than that of females(41.87%).The highest proportion of patients was in the 2~9 years age group(26.40%),and the lowest proportion was in the≥60 years age group(7.13%).The highest proportion of patients had gradeⅡwound exposure(49.47%),and the highest proportion of wound exposure was in the lower limbs(48.33%).The highest proportion of patients sought medical attention within 24 hours after wound exposure(69.13%).All patients included in this study received human lyophilized rabies vaccine,and 480 patients received human rabies immunoglobulin injection(32.00%).The correct wound management rate in the community care group reached 98.27%,the passive immunization rate reached 98.53%,and the vaccination rate reached 97.47%,all higher than those in the routine care group(94.93%,95.20%,93.47%),with statistically significant differences(P<0.05).Conclusion Targeted nursing interventions in the rabies exposure prevention and treatment clinic in the community have positive significance in improving wound management,passive immunization,and vaccination for rabies-exposed individuals.