Gou Yi, Li Sheng-Ming, Zhang Jun-Fei, Hei Xiao-Ping, Lv Bo-Hui, Feng Ke
Department of Emergency Medical, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, 750000, People's Republic of China.
School of Clinical Medicine, Ningxia Medical University, Yinchuan, Ningxia, 750000, People's Republic of China.
Infect Drug Resist. 2023 Apr 4;16:2007-2018. doi: 10.2147/IDR.S404747. eCollection 2023.
To describe the clinical characteristics, treatments, and outcomes of tetanus and determine the most appropriate focus for tetanus prevention and treatment to reduce morbidity and mortality in China.
Four databases, including the Chinese Bio-Medical Literature Database, Chinese National Knowledge Infrastructure, Chinese Scientific Journal Database, and Wan-fang Data, were searched from 1 January, 2000 to 30 October, 2022.
In total, 151 articles including 6084 tetanus patients met the inclusion criteria. Additionally, 5925 patients had their gender recorded in detail, among which 66.67% (3950/5925) were male, and 33.33% (1975/ 5925) were female. The average age in the detailed records was reported in 4773 cases, with an overall average age of 46.69. The number of patients' places of residence was 580. Those from rural areas comprised the highest percentage with 88.62% (514 / 580). The causes of injury were recorded in 1592 cases in total; injuries caused by metals, wood, and wooden spikes accounted for the highest percentage with 54.52% (868/1592). Patient outcomes were recorded in 4305 cases, with a mortality of 9.34% (402/4305). The leading causes of death included treatment terminated by family members, asphyxia due to persistent spasms, respiratory failure, and autonomic dysfunction, family automatic abandonment and asphyxia accounted for the highest percentage, both 24.00% (54/225).
The overall success rate of tetanus treatment in China has dramatically improved, but the prevention and control of non-neonatal tetanus is still challenging. Focus should be placed on the prevention of adult tetanus and standardizing the use of sedative and spasmolytic drugs. Additionally, medical professionals should popularize tetanus prevention and treatment knowledge among the people and strengthen training in grass-roots hospitals.
描述破伤风的临床特征、治疗方法及转归,确定中国破伤风预防和治疗的最适宜重点,以降低发病率和死亡率。
检索中国生物医学文献数据库、中国知网、维普中文科技期刊数据库和万方数据4个数据库,检索时间为2000年1月1日至2022年10月30日。
共纳入151篇文章,包括6084例破伤风患者。此外,5925例患者性别记录详细,其中男性占66.67%(3950/5925),女性占33.33%(1975/5925)。4773例有详细记录患者的平均年龄,总体平均年龄为46.69岁。患者居住地数量为580个。农村地区患者所占比例最高,为88.62%(514/580)。共1592例记录了受伤原因;金属、木头和木刺导致的损伤所占比例最高,为54.52%(868/1592)。4305例记录了患者转归,死亡率为9.34%(402/4305)。主要死亡原因包括家属终止治疗、持续性痉挛导致窒息、呼吸衰竭和自主神经功能障碍,家属自动放弃和窒息所占比例最高,均为24.00%(54/225)。
中国破伤风治疗总体成功率有显著提高,但非新生儿破伤风的预防和控制仍具有挑战性。应重点预防成人破伤风并规范镇静解痉药物的使用。此外,医务人员应向民众普及破伤风防治知识,并加强基层医院培训。