Harding-Goldson H E, Hanna W J
Department of Anaesthetics and Intensive Care, University Hospital of the West Indies, Mona, Kingston, Jamaica.
J Trop Med Hyg. 1995 Jun;98(3):179-84.
A fifteen-year retrospective study of 108 cases of tetanus admitted to the Intensive Care Unit (ICU) at the University Hospital of the West Indies is presented. Males predominated (70%), with peak incidence occurring amongst the young and the elderly. In 57% the disease was severe enough to require neuromuscular blockade and controlled ventilation. Respiratory complications occurred most commonly (80%), predominantly as a result of infection. Dysautonomia, exhibited by 55% of patients, presented the greatest difficulty in management. Mortality was high (20%), with sudden cardiac arrest being the most common cause of death. The average duration of stay in the ICU was long (27 days). As Jamaica is a Third World country with limited resources, the continued occurrence of this preventable disease represents a drain on existing intensive care funds. This must be brought to the attention of institutions responsible for planning health care programmes for developing countries.
本文呈现了对西印度群岛大学医院重症监护病房（ICU）收治的108例破伤风患者的一项为期15年的回顾性研究。男性占主导（70%），发病高峰出现在年轻人和老年人中。57%的患者病情严重到需要进行神经肌肉阻滞和控制通气。呼吸并发症最为常见（80%），主要是感染所致。55%的患者出现自主神经功能障碍，这给治疗带来了最大困难。死亡率很高（20%），心脏骤停是最常见的死亡原因。在ICU的平均住院时间很长（27天）。由于牙买加是一个资源有限的第三世界国家，这种可预防疾病的持续出现消耗了现有的重症监护资金。这必须引起负责为发展中国家制定医疗保健计划的机构的关注。
