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[转贴]中国疾病预防控制中心专家答如何预防狂犬病
<P class=MsoNormal style="MARGIN: 0cm 0cm 0pt; TEXT-ALIGN: center" align=center><B style="mso-bidi-font-weight: normal"><FONT size=3><SPAN style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'">中国疾病预防控制中心专家答如何预防狂犬病</SPAN><SPAN lang=EN-US><?xml:namespace prefix = o ns = "urn:schemas-microsoft-com fficeffice" /><o:p></o:p></SPAN></FONT></B></P><P class=MsoNormal style="MARGIN: 0cm 0cm 0pt"><SPAN lang=EN-US><FONT size=3><SPAN style="mso-spacerun: yes"> </SPAN><o:p></o:p></FONT></SPAN></P><P class=MsoNormal style="MARGIN: 0cm 0cm 0pt; TEXT-INDENT: 5.25pt; mso-char-indent-count: .5" align=right><FONT size=3><SPAN style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'">来源</SPAN><SPAN lang=EN-US>: </SPAN><SPAN style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'">江南时报</SPAN><SPAN lang=EN-US> <?xml:namespace prefix = st1 ns = "urn:schemas-microsoft-comffice:smarttags" /><st1:chsdate w:st="on" IsROCDate="False" IsLunarDate="False" Day="11" Month="11" Year="2004">11<SPAN lang=EN-US style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'"><SPAN lang=EN-US>月</SPAN></SPAN>11<SPAN lang=EN-US style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'"><SPAN lang=EN-US>日</SPAN></SPAN></st1:chsdate><SPAN style="mso-spacerun: yes"> </SPAN></SPAN></FONT></P><P class=MsoNormal style="MARGIN: 0cm 0cm 0pt; TEXT-INDENT: 5.25pt; mso-char-indent-count: .5" align=right><FONT size=3><SPAN lang=EN-US><SPAN style="mso-spacerun: yes"> </SPAN><SPAN style="mso-spacerun: yes"> </SPAN><o:p></o:p></SPAN></FONT></P><P class=MsoNormal style="MARGIN: 0cm 0cm 0pt"><FONT size=3><SPAN lang=EN-US><SPAN style="mso-spacerun: yes"> </SPAN></SPAN><SPAN style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'">狂犬病是人畜共患的急性传染病，病死率高达百分之百；近年来我国年发病死亡人数显著上升；狗、猫、猪、牛、马及野生动物等都可能成为传染源；除了被咬伤，人与带病毒动物接触也可能感染狂犬病；应做好预防性免疫接种；人一旦被疯动物咬伤抓伤，要及时、规范处理伤口，并全程足量接种疫苗。</SPAN><SPAN lang=EN-US>>>></SPAN><SPAN style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'">狂犬病（</SPAN><SPAN lang=EN-US>rabies</SPAN><SPAN style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'">）</SPAN><SPAN lang=EN-US><o:p></o:p></SPAN></FONT></P><P class=MsoNormal style="MARGIN: 0cm 0cm 0pt"><SPAN lang=EN-US><o:p><FONT size=3> </FONT></o:p></SPAN></P><P class=MsoNormal style="MARGIN: 0cm 0cm 0pt"><FONT size=3><SPAN lang=EN-US><SPAN style="mso-spacerun: yes"> </SPAN></SPAN><SPAN style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'">如何预防狂犬病？一旦被疯动物咬伤该怎么办？日前，记者采访了中国疾病预防控制中心传染病预防控制所病毒室主任张永振博士。</SPAN><SPAN lang=EN-US><o:p></o:p></SPAN></FONT></P><P class=MsoNormal style="MARGIN: 0cm 0cm 0pt"><SPAN lang=EN-US><o:p><FONT size=3> </FONT></o:p></SPAN></P><P class=MsoNormal style="MARGIN: 0cm 0cm 0pt"><FONT size=3><SPAN lang=EN-US><SPAN style="mso-spacerun: yes"> </SPAN><B style="mso-bidi-font-weight: normal"><SPAN style="mso-spacerun: yes"> </SPAN></B></SPAN><B style="mso-bidi-font-weight: normal"><SPAN style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'">问：哪些动物可以传染狂犬病？</SPAN><SPAN lang=EN-US><o:p></o:p></SPAN></B></FONT></P><P class=MsoNormal style="MARGIN: 0cm 0cm 0pt"><SPAN lang=EN-US><o:p><FONT size=3> </FONT></o:p></SPAN></P><P class=MsoNormal style="MARGIN: 0cm 0cm 0pt"><FONT size=3><SPAN lang=EN-US><SPAN style="mso-spacerun: yes"> </SPAN></SPAN><SPAN style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'">答：人及所有温血动物，包括鸟类皆能感染，而野生动物可长期隐匿病毒，是自然界中传播狂犬病病毒的贮存宿主。狗、猫、猪、牛、马及野生食肉类动物，如狼、狐、貂、臭鼬、豺以及松鼠、家鼠几乎全能感染。此外，吸血蝙蝠以及某些食虫及食果蝙蝠也可成为狂犬病毒的自然宿主。人被各种动物咬伤而患狂犬病的比例为：被犬咬伤者占</SPAN><SPAN lang=EN-US>88%</SPAN><SPAN style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'">；被猫咬伤者占</SPAN><SPAN lang=EN-US>4.7%</SPAN><SPAN style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'">；被狼咬伤者占</SPAN><SPAN lang=EN-US>4%</SPAN><SPAN style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'">；被其它野生动物和家畜咬伤者占</SPAN><SPAN lang=EN-US>3.3%.</SPAN><SPAN style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'">值得注意的是，外貌健康而携带病毒的犬及其它动物，亦有传染源的作用感染人类。</SPAN><SPAN lang=EN-US><o:p></o:p></SPAN></FONT></P><P class=MsoNormal style="MARGIN: 0cm 0cm 0pt"><SPAN lang=EN-US><o:p><FONT size=3> </FONT></o:p></SPAN></P><P class=MsoNormal style="MARGIN: 0cm 0cm 0pt"><FONT size=3><SPAN lang=EN-US><SPAN style="mso-spacerun: yes"> </SPAN></SPAN><SPAN style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'">人对狂犬病没有自然免疫力。人感染狂犬病，基本上是被唾液中含有病毒的狂犬病动物咬伤所致。狂犬病病毒不能穿入非破损皮肤，但如果皮肤受到抓伤或擦伤，被狂犬病动物舔一下也是很危险的。除了通过皮肤和黏膜的创伤感染之外，还可能通过非创伤性途径感染，如消化道摄入、呼吸道吸入、狗舔肛门或溃疡面等。</SPAN><SPAN lang=EN-US><o:p></o:p></SPAN></FONT></P><P class=MsoNormal style="MARGIN: 0cm 0cm 0pt"><SPAN lang=EN-US><o:p><FONT size=3> </FONT></o:p></SPAN></P><P class=MsoNormal style="MARGIN: 0cm 0cm 0pt"><FONT size=3><SPAN lang=EN-US><SPAN style="mso-spacerun: yes"> </SPAN><B style="mso-bidi-font-weight: normal"><SPAN style="mso-spacerun: yes"> </SPAN></B></SPAN><B style="mso-bidi-font-weight: normal"><SPAN style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'">问：感染上狂犬病有哪些症状？</SPAN><SPAN lang=EN-US><o:p></o:p></SPAN></B></FONT></P><P class=MsoNormal style="MARGIN: 0cm 0cm 0pt"><SPAN lang=EN-US><o:p><FONT size=3> </FONT></o:p></SPAN></P><P class=MsoNormal style="MARGIN: 0cm 0cm 0pt"><FONT size=3><SPAN lang=EN-US><SPAN style="mso-spacerun: yes"> </SPAN></SPAN><SPAN style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'">答：狂犬病的临床表现分为狂躁型、麻痹型两种，我国常见的为狂躁型。狂躁型分为前驱期、兴奋期、麻痹期。前驱期：常有低热、倦怠、头痛、恶心、全身不适症状，类似感冒。继而出现恐惧不安，烦躁失眠，对声、光、风等刺激敏感，喉头有紧缩感。在愈合的伤口及其神经支配区有痒、痛、麻及蚁走等异样感觉。兴奋期：表现为高度兴奋，突出表现为极度恐怖，恐水、怕风、发作性咽肌痉挛，体温常升高。麻痹期：肌肉痉挛停止，进入全身弛缓性瘫痪，患者由安静进入昏迷状态，最后呼吸、循环系统衰竭死亡。</SPAN><SPAN lang=EN-US><o:p></o:p></SPAN></FONT></P><P class=MsoNormal style="MARGIN: 0cm 0cm 0pt"><SPAN lang=EN-US><o:p><FONT size=3> </FONT></o:p></SPAN></P><P class=MsoNormal style="MARGIN: 0cm 0cm 0pt"><FONT size=3><SPAN lang=EN-US><SPAN style="mso-spacerun: yes"> </SPAN><B style="mso-bidi-font-weight: normal"><SPAN style="mso-spacerun: yes"> </SPAN></B></SPAN><B style="mso-bidi-font-weight: normal"><SPAN style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'">问：如何预防狂犬病？</SPAN><SPAN lang=EN-US><o:p></o:p></SPAN></B></FONT></P><P class=MsoNormal style="MARGIN: 0cm 0cm 0pt"><SPAN lang=EN-US><o:p><FONT size=3> </FONT></o:p></SPAN></P><P class=MsoNormal style="MARGIN: 0cm 0cm 0pt"><FONT size=3><SPAN lang=EN-US><SPAN style="mso-spacerun: yes"> </SPAN></SPAN><SPAN style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'">答：尽管狂犬病的病死率为</SPAN><SPAN lang=EN-US>100%</SPAN><SPAN style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'">，却是可以预防的。应以预防动物传染源的发生为主，加强暴露前预防及受伤后及时正确的医疗处理。对狗等动物实施预防性接种，保证动物不携带病毒。消灭流浪犬。</SPAN><SPAN lang=EN-US><o:p></o:p></SPAN></FONT></P><P class=MsoNormal style="MARGIN: 0cm 0cm 0pt"><SPAN lang=EN-US><o:p><FONT size=3> </FONT></o:p></SPAN></P><P class=MsoNormal style="MARGIN: 0cm 0cm 0pt"><FONT size=3><SPAN lang=EN-US><SPAN style="mso-spacerun: yes"> </SPAN><B style="mso-bidi-font-weight: normal"><SPAN style="mso-spacerun: yes"> </SPAN></B></SPAN><B style="mso-bidi-font-weight: normal"><SPAN style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'">问：被疯动物咬伤抓伤怎么办？</SPAN><SPAN lang=EN-US><o:p></o:p></SPAN></B></FONT></P><P class=MsoNormal style="MARGIN: 0cm 0cm 0pt"><SPAN lang=EN-US><o:p><FONT size=3> </FONT></o:p></SPAN></P><P class=MsoNormal style="MARGIN: 0cm 0cm 0pt"><FONT size=3><SPAN lang=EN-US><SPAN style="mso-spacerun: yes"> </SPAN></SPAN><SPAN style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'">答：这是预防狂犬病的决定性环节。一旦被疯动物咬伤抓伤，受伤者应尽快用</SPAN><SPAN lang=EN-US>20%</SPAN><SPAN style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'">的肥皂水彻底清洗伤口，再用大量清水冲洗，清洗和冲洗时间不少于</SPAN><SPAN lang=EN-US>20</SPAN><SPAN style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'">分钟。然后用</SPAN><SPAN lang=EN-US>2%</SPAN><SPAN style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'">至</SPAN><SPAN lang=EN-US>5%</SPAN><SPAN style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'">碘酒和</SPAN><SPAN lang=EN-US>75%</SPAN><SPAN style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'">酒精涂擦伤口，以清除或杀灭局部的病毒。只要未伤及大血管，尽量不要缝合，也不必包扎。伤口较大或面部重伤影响面容时，在做完清创消毒后，作松散的缝合和包扎，如伤口深、创面大，应放置引流条，以利于伤口污染物及分泌物的排除。创伤严重或发生在头、面、手、颈等处，在上述处理的基础上，皮试阴性后立即在伤口周围做抗狂犬病免疫血清浸润注射，而且必须在伤口缝合前应用。</SPAN><SPAN lang=EN-US><o:p></o:p></SPAN></FONT></P><P class=MsoNormal style="MARGIN: 0cm 0cm 0pt"><SPAN lang=EN-US><o:p><FONT size=3> </FONT></o:p></SPAN></P><P class=MsoNormal style="MARGIN: 0cm 0cm 0pt"><FONT size=3><SPAN lang=EN-US><SPAN style="mso-spacerun: yes"> </SPAN></SPAN><SPAN style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'">暴露后的预防接种也很重要。人被疯动物咬伤后，应立即到狂犬病防治门诊接种狂犬病疫苗，并保证全程足量接种。疫苗接种后应检测抗体是否产生，如没有抗体产生或抗体的滴度过低，应继续接种。一年内接种过全程有效疫苗，被可疑疯动物咬伤者，应于</SPAN><SPAN lang=EN-US>0</SPAN><SPAN style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'">和</SPAN><SPAN lang=EN-US>3</SPAN><SPAN style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'">天各接种一剂疫苗。全程接种疫苗（</SPAN><SPAN lang=EN-US>0</SPAN><SPAN style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'">、</SPAN><SPAN lang=EN-US>3</SPAN><SPAN style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'">、</SPAN><SPAN lang=EN-US>7</SPAN><SPAN style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'">、</SPAN><SPAN lang=EN-US>14</SPAN><SPAN style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'">、</SPAN><SPAN lang=EN-US>28</SPAN><SPAN style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'">天共</SPAN><SPAN lang=EN-US>5</SPAN><SPAN style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'">针）超过一年以上，被可疑疯动物咬伤者，则应再接种全程疫苗。</SPAN><SPAN lang=EN-US><o:p></o:p></SPAN></FONT></P><P class=MsoNormal style="MARGIN: 0cm 0cm 0pt"><SPAN lang=EN-US><o:p><FONT size=3> </FONT></o:p></SPAN></P><P class=MsoNormal style="MARGIN: 0cm 0cm 0pt"><FONT size=3><SPAN lang=EN-US><SPAN style="mso-spacerun: yes"> </SPAN></SPAN><SPAN style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman'">目前，狂犬病仍然是一种不可避免的致死性疾病，发病后以对症治疗为主，包括隔离病人，防止唾液污染，尽量保持病人安静，减少光、风、声等刺激，狂躁时用镇静剂等。</SPAN><SPAN lang=EN-US><o:p></o:p></SPAN></FONT></P><P class=MsoNormal style="MARGIN: 0cm 0cm 0pt"><SPAN lang=EN-US><o:p><FONT size=3> </FONT></o:p></SPAN></P><P class=MsoNormal style="MARGIN: 0cm 0cm 0pt"><SPAN lang=EN-US><o:p><FONT size=3> </FONT></o:p></SPAN></P> |
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