Sharma N, Trubuhovich R, Thomas M G
Auckland Hospital.
N Z Med J. 1994 Mar 9;107(973):82-4.
To determine the clinical features, management and outcome for patients admitted to hospital with tetanus in Auckland.
Medical records of all patients with tetanus admitted to hospitals in Auckland between January 1982 and December 1992 were retrospectively reviewed.
Fifteen patients were admitted to hospital during the study period. All patients were more than 40 years old and no patient had a history of more than one tetanus toxoid immunisation before the injury presumed responsible for tetanus. Failure to consider the diagnosis led to delay in starting appropriate treatment in most patients. Eleven patients required mechanical ventilation. The median duration of hospital stay was 44 days. All patients survived.
Tetanus is rare in Auckland and almost exclusively affects those born before 1960 when universal childhood immunisation against tetanus was started. The disease causes significant morbidity which could be avoided by increased efforts to ensure that all persons have completed a full course of immunisation. Universal vaccination against tetanus with regular boosters to maintain immunity would also circumvent the problems encountered with postexposure tetanus prophylaxis.
确定奥克兰因破伤风入院患者的临床特征、治疗方法及预后。
对1982年1月至1992年12月期间奥克兰各医院收治的所有破伤风患者的病历进行回顾性研究。
研究期间有15例患者入院。所有患者年龄均超过40岁，且在导致破伤风的受伤前均无超过一次破伤风类毒素免疫史。多数患者因未考虑到该诊断而导致开始适当治疗延迟。11例患者需要机械通气。住院时间中位数为44天。所有患者均存活。
破伤风在奥克兰较为罕见，几乎仅影响1960年以前出生的人，当时开始实施儿童破伤风普遍免疫。该疾病会导致严重发病，通过加大力度确保所有人完成全程免疫可避免这种情况。破伤风普遍接种并定期加强免疫以维持免疫力，也可避免暴露后破伤风预防中遇到的问题。
