Wyatt H V, Mahadevan S, Srinivasan S
Department of Public Health Medicine, University of Leeds, UK.
Trans R Soc Trop Med Hyg. 1992 Sep-Oct;86(5):546-9. doi: 10.1016/0035-9203(92)90104-k.
The effect of prior injections on the pattern and severity of paralytic poliomyelitis has been examined by a retrospective analysis of case notes from an outpatient pediatric clinic in South India. Of 262 children with acute polio, 176 had received unnecessary injections < 48 h before paralysis and 12 had received diphtheria-pertussis-tetanus or provocative injections. Two children injected in the right arm had paralysis in that limb only. Children with no injections (controls) had an equal chance of paralysis (0.73) in each left and right leg. Children with injections in the right or left gluteus or in both had a 19% greater chance of paralysis in the injected leg(s), whereas uninjected legs had a 31% lower chance of paralysis. Injected leg muscles were weaker than those of control children. Legs of control children were stronger than those with one leg injected and much stronger than those with both injected. More than 96% of the children had at least one leg paralysed. Age and vaccine status did not affect the results of injections. After injections there was greater likelihood of death or lack of recovery of muscle strength. About three-quarters of the children had received unnecessary injections; of these 60% had more severe paralysis and a non-paralytic attack became paralytic in 40%. If oral medicines for fevers and diarrhoea replaced unnecessary injections, the prevalence and severity of paralytic polio would be reduced.
通过对印度南部一家儿科门诊病例记录的回顾性分析，研究了先前注射对麻痹性脊髓灰质炎模式和严重程度的影响。在262例急性脊髓灰质炎患儿中，176例在瘫痪前<48小时接受了不必要的注射，12例接受了白喉-百日咳-破伤风疫苗注射或刺激性注射。两名右臂注射的儿童仅该肢体出现瘫痪。未注射（对照组）的儿童左右腿瘫痪的几率相同（0.73）。在右臀或左臀或双侧注射的儿童，注射侧腿瘫痪的几率高19%，而未注射侧腿瘫痪的几率低31%。注射侧腿部肌肉比对照组儿童的弱。对照组儿童的腿部比单腿注射的儿童强壮，比双腿注射的儿童强壮得多。超过96%的儿童至少有一条腿瘫痪。年龄和疫苗接种情况不影响注射结果。注射后死亡或肌肉力量未恢复的可能性更大。约四分之三的儿童接受了不必要的注射；其中60%的儿童瘫痪更严重，40%的非瘫痪发作转变为瘫痪。如果用治疗发热和腹泻的口服药物替代不必要的注射，麻痹性脊髓灰质炎的患病率和严重程度将会降低。
