赖桂萍 詹小涛 吴新略

[摘要] 目的 总结狂犬病流行病学和临床特征。 方法 回顾分析2010年1月～2011年9月我院感染科收治的22例狂犬病住院病例资料。 结果 农民和少儿为高危人群；77.2%有暴露史，暴露后无1例规范处理伤口、应用疫苗及免疫血清；潜伏期最短12d，最长30年余；首发症状多样，但普遍有烦躁不安、失眠（90.9%），后续特征表现为恐风怕水、惊恐不安（81.8%）、多汗、多涎（86.3%）以及咽肌痉挛、呼吸困难（81.8%）；90.9%须予镇静剂；起病后生存期36h～9d，病死率100%。 结论 狂犬病目前不可治，重在预防，暴露后应正确处理，充分认识其特征，避免误诊。

[关键词] 狂犬病；流行病学；首发症状；临床特征

[中图分类号] R373 [文献标识码] B[文章编号] 1673-9701（2012）02-0157-03

The epidemiological and clinical characteristic of rabies in Heyuan area during 2010 to 2011

LAI GuipingZHAN XiaotaoWU Xinlue

Department of Infectious Diseases, Heyuan People′s Hospital in Guangdong Province,Heyuan 517000, China

[Abstract] Objective To summary and analysis epidemiological and clinical characteristic of rabies. Methods Retrospective analysis was performed on the data of 22 cases rabiators from 2010 to 2011 in department of infectious diseases. Results Farmers and children were high risk people of rabies; 77.2% of rabiators had exposure but no one post-exposure case managed wound, vaccinated and applied immune serum by standards; the shortest latency was 12 days, and the longest 30 years; the initial symptom was varied, but restlessness and insomnia were common (90.9%); the follow-up characteristic manifestation were fearing of wind and water，panic (81.8%), sweat and hypersalivation (86.3%), throat spasm and dyspnea (81.8%) ; 90.9% of rabiators had to be given calmative; survival period after onset was 36h to 9 days and the mortality was 100%. Conclusion So far, there is no effective treatment of rabies yet. Prophylaxis is the most important, and stress standard management for post-exposure is necessary. We should take an adequate realization of this disease in order to avoid misdiagnosis.

[Key words] Rabies; Epidemiology; Initial symptoms; Clinical characteristics

狂犬病是由狂犬病病毒引起的主要侵害中枢神经系统的人兽共患传染病，目前尚无有效治疗措施，病死率几乎达100%[1]，是最可怕的传染病之一。我国狂犬病随发病率连年增长，而且还出现一些新的流行特征[2]，基层医院不时面临着暴露后处理和狂犬病患者的接诊。我院2010年1月～2011年9月间共收治狂犬病22例，现报道如下。

1 资料与方法

1.1一般资料

我院感染科2010年1月～2011年9月收治的22例狂犬病患者，男17例，女5例；年龄4～83岁，平均46.47岁；11例为农民，2例为无业人员，3例为流动人口，6例未成年人（5例为中小学生，1例儿童，最小4岁，最大17岁）。

1.2 研究方法

采用回顾性研究方法分析狂犬病的流行病学、临床特征。

2 结果

2.1 流行病学资料

本组22例狂犬病患者中，77.2%（17例）有明确暴露史，其中3例为猫咬/抓伤，14例为犬咬/抓伤，但无1例按规范处理伤口和应用疫苗及免疫血清，其中82.4%（14/17）的伤口未作任何处理、未注射疫苗，17.6%（3例）不规范清洗伤口、注射或未注射狂犬病疫苗；……