山东省21例狂犬病患者发病因素调查

目的]调查狂犬病患者的发病经过、临床表现，分析影响发病的因素。方法]对2003年12月至2004年4月发病的21例狂犬病患者进行个案调查。结果]21例狂犬病患者，伤势均属Ⅲ度，中位数潜伏期为54．5d，临床表现烦躁、恐水、怕风、畏光、吞咽困难等特异症状的分别占85．71％、71．43％、80．95％、76．19％和76．19％。伤口未处理和处理不规范者占85．71％，未接种或未全程注射狂犬病疫苗者占90．48％，所有患者均未注射抗狂犬病血清。被疯犬、可疑疯犬或不明来源的犬猫致伤的占85．71％，狂犬病门诊未建立、暴露者登记或登记不全，能正确进行伤口处理的专业技术人员占38．9％。结论]暴露后预防性治疗不规范是导致狂犬病暴露者发病死亡的主要原因。

Epideology Investigation of Rabies 21 Cases In Shandong

Objective]To investigate the exposure history, the disease course and the clinical symptoms of rabies patients, and analyze the risk factors such as the feeding rate of dogs , the preventive measure etc Methods]Case investigation and retrospective survey were used Results]21 cases were investigated, all the wounds were III degree, the average latency period of rabies was 54 5days, the rate symptoms of fidget, hydrophobia, fear of wind, photophobia and difficult swallow were 85 71%, 71 4%, 76 19% and 76 19% respectively The wound untreated and treated improperly were 85 71%, unvaccinated and non totally vaccinated were 90 48% All of the patients were injected with anti rabies serum The patients wounded by mad dogs, suspected mad dogs and unclear dogs and cats were 85 71% 38 professional were invested and 38 9% of them can deal with the wound properly and only 22 25 of them though that anti serum should be used with III degree wound Conclusions]The main reason for rabies death was the improper preventive treatment after exposure