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目的调查四川省狂犬病高发地区农村居民狂犬病暴露率及暴露后伤口处置行为。方法自制调查表,采用分层整群抽样方法进行调查和查阅档案资料收集相关信息。结果四川省狂犬病高发地区农村居民狂犬病年均暴露率为3.6%;男女性别暴露比为1.04∶1;10岁以下年龄组暴露率高于其他年龄组;暴露时间以4~5月和9月为主,暴露方式以咬伤为主(82.5%);45.3%暴露者去医疗机构处置伤口,去医疗机构处置伤口人群中有82.3%选择乡镇卫生院就诊。暴露越严重,文化程度高或家庭经济好者,去医疗机构处理率相对高。暴露后疫苗接种率为44.4%,狂犬病免疫球蛋白使用率为8.0%。结论四川省狂犬病高发地区农村居民年均狂犬病暴露率高且无性别差异;高暴露人群为儿童。暴露者规范化处置伤口率低。针对文化程度低者,狂犬病预防知识宣传还需加强;医疗费用和心存侥幸心理依然是阻碍狂犬病暴露后伤口规范处置的主要因素。
Objective To investigate the rabies exposure rate and the post-exposure wound treatment in rural residents with high incidence of rabies in Sichuan Province. Methods Self-made questionnaires, stratified cluster sampling method for investigation and access to archives data collection related information. Results The annual average rate of rabies in rural residents with high incidence of rabies in Sichuan Province was 3.6%. The sex ratio of men to women was 1.04:1. The exposure rate of age group under 10 years old was higher than that of other age groups. The exposure time ranged from April to May and September The main way of exposure was bite (82.5%); 45.3% of the exposed persons went to the medical institutions to treat the wounds, and 82.3% of them went to the township hospitals for medical treatment of the wounds. The more exposed, highly educated or well-to-do family economists, the relatively high rates go to medical institutions. Post-exposure vaccination coverage was 44.4% and rabies immunoglobulin usage was 8.0%. Conclusions The annual average rabies exposure rate of rural residents in areas with high incidence of rabies in Sichuan Province is high and there is no gender difference. Highly exposed people are children. Exposure to standardized treatment of wounds is low. For those with lower educational level, awareness of rabies prevention knowledge needs to be strengthened; medical expenses and luck are still the main factors that hinder the normative treatment of rabies after exposure.