Colonnello F, Calonghi G F, Fassio G, Jelasi G, Sueri L
Boll Ist Sieroter Milan. 1980 Nov 30;59(5):437-47.
The various clinical symptoms of the tetanus are included by the Authors in three different groups. In the first and the second ones are the localized forms or tetanus, which affects several skeletal muscle groups without involvement of the respiratory apparatus. In the third group, in addition to the tetanus of the new-born babies, are the most severe forms of tetanus, the dangerousness of which is due to a respiratory involvement or to the persistence of a severe hypertensive-hypotensive syndrome, associated with hyperpyrexia and an ingravescent uncontrollable circulatory failure, in the completely sedated patient. An encephalopathic coma may also occur. The highest mortality (55-70 per cent) is observed in the tetanuses of the third group. The therapy is based on the triad seroanatoxins, antibiotics and sedative drugs. Tracheotomy and assisted mechanical ventilation are essential in the patients of the third group in order to be allowed to administer curare-like drugs as choice remedy. But, in spite of all these heroic treatments, the mortality is still high.
作者将破伤风的各种临床症状分为三组。第一组和第二组为局限性破伤风，累及多个骨骼肌群，但不影响呼吸器官。第三组除新生儿破伤风外，还包括最严重的破伤风形式，其危险性在于呼吸受累，或在完全镇静的患者中持续存在严重的高血压-低血压综合征，并伴有高热和进行性不可控的循环衰竭。还可能发生脑病性昏迷。第三组破伤风的死亡率最高（55%-70%）。治疗基于血清抗毒素、抗生素和镇静药物三联疗法。对于第三组患者，气管切开术和辅助机械通气至关重要，以便能够使用箭毒样药物作为首选治疗方法。但是，尽管采取了所有这些积极的治疗措施，死亡率仍然很高。
