目的 總結嚴重犬咬傷三級暴露傷口感染的處置及護理經驗。 方法 對2010年1月－2012年10月收治的30例下肢嚴重犬咬傷三級暴露患者，及時采用流動清水沖洗，局部麻醉，復方黃柏液紗條換藥等處置方法，并對患者及家屬進行心理疏導和飲食指導，使患者的犬傷得到有效控制和治療。 結果 30 例患者無狂犬病發生， 25例傷口Ⅰ期愈合， 5例傷口延緩Ⅱ期愈合，雙下肢活動自如，患者及家屬滿意。 結論 正確處理傷口和規范全程疫苗接種及精心護理是控制傷口感染，減輕患者疼痛，促進傷口最佳愈合、預防人狂犬病發生的重要因素。
目的:分析犬傷暴露后到我院犬傷門診就診病例的流行病學相關因素,為制定狂犬病的防治策略提供科學依據。方法:采用描述性統計方法根據犬傷門診記錄,對就診患者的年齡、性別、發病時間、暴露級別、傷口處理、疫苗接種和犬傷Ⅲ度暴露者狂犬免疫球蛋白的接種及傷人犬只情況等相關因素進行統計。結果:2008年我院犬傷門診共接診2 589例,咬傷人犬只的接種率為46.26 %。就診病例的年齡有兩個高峰,分別是0～10歲組和21～30歲組。就診時間除1～2月和11～12月病例較少外,全年各月份均在198～342人之間。犬傷暴露后,只有2.16 %病例及時、正確地處理了傷口。100%的犬傷暴露者進行了狂犬疫苗的注射。犬傷Ⅲ度暴露中,狂犬免疫球蛋白的使用僅為28.4%。結論:加強犬類動物的管理,對家犬實行免疫,加強對低年齡組兒童的保護。做好狂犬病的防治和知識的宣傳工作,合理設置犬傷醫學門診。加大政府投入力度提供全程、免費接種服務。
ObjectiveTo investigate the situation of internal antibody positive rate of Chinese who exposed to rabies virus and received full procedure of rabies vaccination, and to provide the basis for the adjustment of rabies vaccination procedure and policy. MethodsWe electronically searched databases including WanFang Data, VIP, CNKI, PubMed and EMbase from inception to May 2015 to collect studies about Chinese exposed to rabies virus and received full procedure rabies vaccination. Two reviewers independently screened literature, extracted data, and assessed the methodological quality of included studies. Then, meta-analysis was performed using R software (R3.2.1). ResultsA total of 33 studies were included. The combined antibody positive rate was 93.99% with 95%CI 92.02% to 95.70%. Antibody positive rate among male was 93.73% with 95%CI 91.65% to 95.54%, while among female was 94.33% with 95%CI 92.35% to 96.04%, and there was no significant difference between male and female (P>0.05). The antibody positive rate of hamster kidney cell rabies vaccine was 89.94% with 95%CI 86.09% to 95%, while the antibody positive rate of vero cell rabies vaccine was 96.65% with 95%CI 94.99% to 94.99%, and there was significant difference between both groups (P<0.05). There was no statistical difference in antibody positive rates among different years of rabies vaccine (P>0.05). However, the antibody positive rate of rabies vaccine had a tendency to reduce with the increasing age ConclusionAntibody positive rate of vero cell rabies vaccine is higher than that of hamster kidney cell rabies vaccine. Older people have lower antibody positive rate after receiving rabies vaccination. We suggest using vero cell rabies vaccine when giving rabies vaccination; elderly people should receive booster vaccination after basic vaccination.