Anderson C R
Department of Family Practice, Family Medical Center, Minneapolis, MN 55408.
Postgrad Med. 1992 Jul;92(1):134-6, 139-46, 149. doi: 10.1080/00325481.1992.11701396.
Several factors need to be considered when evaluating animal bites. These include type of animal involved, specific nature of the wound, circumstances of the attack, interval between injury and treatment, and location of the bite. Of concern are direct destruction of tissue and risk of infection. Use of antibiotic prophylaxis is controversial, but most authorities agree that it is needed for hand wounds, puncture wounds, or "dirty" wounds of any type in any location. The choice of antibiotic is also controversial, but initial empirical treatment generally relies on broad-spectrum coverage. Rabies prophylaxis is indicated for bites by carnivorous wild animals, bats, and unvaccinated domestic animals. Review of the patient's tetanus status is mandatory.
评估动物咬伤时需要考虑几个因素。这些因素包括涉及的动物类型、伤口的具体性质、攻击的情况、受伤与治疗之间的间隔以及咬伤的部位。值得关注的是组织的直接破坏和感染风险。抗生素预防性使用存在争议，但大多数权威人士认为，手部伤口、穿刺伤或任何部位的任何类型“污染”伤口都需要使用。抗生素的选择也存在争议，但初始经验性治疗通常依赖于广谱覆盖。对于食肉野生动物、蝙蝠和未接种疫苗的家畜咬伤，需要进行狂犬病预防。必须检查患者的破伤风状态。
