狂犬病29例临床分析

目的探讨狂犬病的防治措施，以期降低发病率。方法对绵阳市404医院2007年7月-2010年7月收治的29例狂犬病患者的临床资料进行回顾性分析。结果2007年7月-2010年7月，共收治29例狂犬病患者，男女之比1.9∶1，平均年龄49.34±17.78岁，以农民为主，占86.21%。96.55%的病例有狂犬病典型症状。实验室检查发现患者存在多器官功能损害，表现为心肌酶学升高，肝脏酶学升高，心电图异常。从发病到死亡时间1~6d。潜伏期长短与暴露部位及数量有一定相关性。24.14%的患者到医院处理伤口，10.34%病例暴露后接种狂犬疫苗，仅有6.9%病例接种了抗狂犬免疫球蛋白。结论预防处置率低，未按要求进行暴露后的预防处置，是造成狂犬病发生的重要原因之一。加强犬只管理，狂犬病预防知识的宣教和暴露后规范预防措施是防治狂犬病的重要措施。

Clinical analysis of 29 patients with rabies

In order to find the key methods for preventing,controlling and reducing incidence of the rabies,the data of 29 patients with rabies admitted to Mianyang 404 hospital from July 2007 to 2010 were analyze retrospectively.A total of 29 patients with rabies were cured in Mianyang 404 hospital.The average age was 49.34±17.78 years and the gender ratio of male to female was 1.9∶1.The peasants were predominantly affected（86.21%）.Of 96.55% cases had the typical symptom of rabies.The patients had MOS in experiment.Most enzymes in cases,such as CK,HBDH and ECG,increased.The time from the onset to death was 1d to 6d.The incubation period was relative to the exposed spot and quantity.About 24.14% and 10.34% of the cases had receive treatment on wounds and vaccine respectively.Only 6.9% was injected with antiserum.In conclusion,low rates of treatment on wounds and failure to carry out preventive treatment after exposure are two of the reasons for the increase of rabies.Some important methods such as strengthening education in general public,managing the dogs and treating cases with post-exposure standard treatment should be practised well for preventing and controlling rabies.