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[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 5 d,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。
[Objective] To investigate the pathogenesis of rabies and its clinical manifestation and to analyze the factors influencing morbidity. [Method] The 21 cases of rabies who developed from December 2003 to April 2004 were investigated. [Results] The 21 rabies patients had a grade Ⅲ degree of injury and a median incubation period of 545 days. Clinical manifestations were irritable. Specific symptoms such as phobias, phobias, photophobia and dysphagia accounted for 85 71% and 71 43, respectively %, 80 95%, 76 19% and 76 19%. 85 71% of untreated and untreated wounds, 90 48% of unvaccinated or untrained rabies vaccines, and none of the patients received anti-rabies serum. 85 71% were insane, suspicious or suspected dogs or cats and dogs of unknown origin, rabies clinics were not established, and the number of registered or registered persons who were exposed was 38 9% of whom were technicians who were able to properly handle the wounds. [Conclusion] The non-standard prophylactic treatment after exposure is the main reason leading to the death of rabies exposed persons.