目的 分析2009－2016年天津市85家动物致伤处置门诊暴露人群流行病学特征及暴露后处置情况，为狂犬病防控提供科学依据。方法 收集天津市动物致伤处置门诊报告的人群资料及狂犬病病例资料，采用Excel 2007软件进行数据录入，SPSS 22.0软件进行率的χ2检验及Mann-kendall趋势检验。结果 天津市2009－2016年累计接诊636 286人次，年平均暴露率为558.20/10万，不同年度暴露率差异有统计学意义（χ2=9 016.882，P=0.000），其中Ⅲ级伤口暴露率呈上升趋势（Z=2.230，P < 0.05）。暴露人群分布呈现明显季节性，5－8月累计暴露人数占全部暴露人数的43.50%。男性暴露率高于女性（χ2=223.512，P=0.000），0～14岁年龄组人群暴露率为117.13/10万，远高于其他年龄组。犬暴露占82.28%，70.67%的伤口为Ⅱ级暴露，52.35%的暴露部位为上肢。门诊伤口处置率为86.60%。疫苗接种率为99.80%，Ⅲ级暴露人群被动免疫制剂接种率有上升趋势（Z=2.969，P < 0.05），但总体接种率仅为31.48%。结论 应依托规范化动物致伤门诊建设进一步规范门诊处置，同时加强狂犬病防治宣传，特别是针对重点地区重点人群进行健康教育。
Objective To provide evidence for rabies control and prevention by investigating the epidemiological characteristics of rabies post-exposure prophylaxis in Tianjin, China, from 2009-2016. Methods The data of 85 rabies post-exposure prophylaxis and human rabies cases were collected. Excel 2007 was used for data entry and SPSS 22.0 for Chi-square test and Mann-Kendall test. Results A total of 636 286 cases were reported with an average of 558.20/100 000 during 2009-2016 in Tianjin. The difference among annual exposure rate was statistically significant (χ2=9 016.882, P=0.000). The exposure rate of degree Ⅱ wound showed an upward trend (Z=2.230, P<0.05). The number of incidents from May to August constituted 43.50% of all the incidents. The exposure rate was higher in males (χ2=223.512, P=0.000). The exposure rate in 0-14 years of age was 117.13/100 000, the highest rate during all age groups. Dog bites constituted 82.28% of all exposures. The number of person with degree Ⅱ exposure accounted for 70.67%, 52.35% of the wounds were on the upper limb. Clinical wound cleaning constituted 86.60% of the wounds and 99.80% of the exposed persons were inoculated with rabies vaccines. The inoculation rate of passive immunizing agents showed an upward trend but only 31.48% of persons with degree Ⅲ exposure was given. Conclusion We should standardize the outpatient treatment relying on the establishment of post-exposure prophylaxis clinics. The health education and intervention should be strengthened.
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