犬咬伤创口感染分布及特点的研究

目的探讨各部位犬咬伤创n的感染及临床特点。方法900例65岁以下的犬咬伤致撕裂伤患者，按伤部分为头面颈组、手部组、足部组、上肢组、下肢组和躯干组，分别观察各组的感染率、感染时间、临床表现及并发症情况。结果手部组感染率为26．0％，与足部组（22．0％）无显著差异（P〉0．05），但两者均显著高于头面颈组、上肢组、下肢组、躯干组（分别为7．3％、10．0％、9．3％、11．3％，均P〈0．05）。手部组的感染时间为（13．7±6．7）h、与足部组[（16．0±7．6）h]无显著性差异（P〉0．05），但两者均显著短于头面颈组、上肢组、下肢组、躯干组[分别为（23．3±11．4）h、（23．1±8．4）h、（21．9±7．8）h、（20．1±6．8）h，均P〈0．05]。头面颈组、上肢组、下肢组、躯干组各组间在感染率、感染时间上差异均无统计学意义（均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。结论手、足部位的犬咬伤创口是感染最易发生的部位，也最易发生严重的并发症。

Distribution and characteristics of infection in dog bite wounds

Objective To study the distribution and characteristics of infection in dog bite wounds in different parts of body. Methods Six groups of 150 dog bite patients with the wounds at their head, face and neck, hand, foot, upper limb （to the exclusion of the hand）, and lower limb （to the exclusion of the foot）, and trunk respectively, totally 900, underwent observation of the infection rate, infection time, clinical manifestations, and complications. Results The infection rate of the hand group was 26.0%,not significantly different from that of the foot group （22.0%, P〉0.05）, however, both were significantly higher than those of the head, face, and neck, upper limb （to the exclusion of the hand）, lower limb （to the exclusion of the foot）, and trunk groups （7.3%, 10.0%, 9.3%, and 11.3% respectively, all P〈0.05）. The infection time of the hand group was （13.7±6.7）h, not significantly different from that of the foot group [（16.0±7.6）h, P〉0.05], however, both were significantly shorter than those of the head, face and neck, upper limb （to the exclusion of the hand）, lower limb （to the exclusion of the foot）, and trunk groups [（23.3±11.4）h, （23.1±8.4）h, （21.9±7.8）h, and （20.1±6.8） h respectively, all P〈0.05]. And there were not significant differences in the infection rate and infection time among the 4 groups except the hand and foot groups （all P〉0.05）. The main clinical manifestations of the dog bite wound infection included local redness, edema, purulent drainage, and fever. The main complications included abscess, lymphangitis/erysipelas, arthritis, and tenosynovitis. Conclusion Hand and foot wounds are the sites most liable to suffer from infection and severe complications among all the dog bite wounds.