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中国福建省破伤风患者的多中心研究:95 例回顾性分析。

Multicenter Study of Tetanus Patients in Fujian Province of China: A Retrospective Review of 95 Cases.

机构信息

Department of Critical Care Medicine, Fujian Provincial Hospital, Fujian Provincial Center for Critical Care Medicine, Fujian Medical University, Fuzhou, Fujian 350001, China.

Department of Critical Care Medicine, Mindong Hospital of Ningde City, Ningde, Fujian 355000, China.

出版信息

Biomed Res Int. 2020 Mar 15;2020:8508547. doi: 10.1155/2020/8508547. eCollection 2020.

Abstract

BACKGROUND

Tetanus is a life-threatening disease in developing countries and is accompanied by a high mortality rate. Although China is the world's largest developing country, there have been few clinical studies on tetanus in China. The purpose of this study was to investigate the epidemiology, incidence, and management of tetanus in Fujian Province and to understand the current treatment and prognosis of tetanus patients.

METHODS

This was a retrospective, multicenter observational study of patients who presented with a clinical diagnosis of tetanus at 5 general hospitals in Fujian from January 2008 to December 2018. Data were analyzed using a computer software system.

RESULTS

A total of 95 patients were recruited, including 6 newborns. The average age of the adult tetanus patients was 55.53 ± 15.39 years old. None of the patients knew their previous history of tetanus immunization. The rate of having received human tetanus immunoglobulin (HTIG) was 9.47%. A total of 73 (76.84%) patients were cured, 17 (17.89%) patients had an unknown prognosis, and 5 (5.26%) patients died. Age, severity of illness, and complications all increased the total duration of hospitalization. Compared with endotracheal intubation, tracheotomy increased the length of stay in the ICU (Intensive Care Unit) but did not affect the total hospital length of stay for mechanical ventilation.

CONCLUSIONS

With the promotion of nationwide immunization against tetanus and the development of critical care medicine, morbidity and mortality rates of tetanus in Fujian are low. It is important to increase awareness among local physicians and staff in charge of tetanus immunization programs and with regard to neonatal tetanus and drug-induced tetanus. The prevention and treatment of tetanus in developing countries should arouse widespread concern in society.

摘要

背景

破伤风是发展中国家危及生命的疾病,死亡率高。虽然中国是世界上最大的发展中国家,但中国对破伤风的临床研究较少。本研究旨在调查福建省破伤风的流行病学、发病率和管理情况,了解当前破伤风患者的治疗和预后情况。

方法

这是一项回顾性、多中心观察性研究,共纳入 2008 年 1 月至 2018 年 12 月期间福建省 5 家综合医院以临床诊断为破伤风的患者。使用计算机软件系统对数据进行分析。

结果

共纳入 95 例患者,包括 6 例新生儿。成人破伤风患者的平均年龄为 55.53 ± 15.39 岁。所有患者均不知道自己既往破伤风免疫史。人破伤风免疫球蛋白(HTIG)的使用率为 9.47%。73 例(76.84%)患者治愈,17 例(17.89%)患者预后不明,5 例(5.26%)患者死亡。年龄、疾病严重程度和并发症均增加了总住院时间。与气管插管相比,气管切开增加了 ICU 住院时间,但不影响机械通气的总住院时间。

结论

随着全国范围内破伤风免疫的推广和重症监护医学的发展,福建省破伤风的发病率和死亡率较低。提高当地医生和负责破伤风免疫计划以及新生儿破伤风和药物性破伤风的工作人员的认识非常重要。发展中国家的破伤风预防和治疗应引起社会的广泛关注。

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本文引用的文献

1
Tetanus.破伤风。
Lancet. 2019 Apr 20;393(10181):1657-1668. doi: 10.1016/S0140-6736(18)33131-3. Epub 2019 Mar 29.
2
[Chinese expert consensus on tetanus immunization].
Zhonghua Wai Ke Za Zhi. 2018 Mar 1;56(3):161-167. doi: 10.3760/cma.j.issn.0529-5815.2018.03.001.

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