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暑季户外,摔伤割伤要预防破伤风

2021-6-23 17:00| 发布者: jijinduoduo| 查看: 10427| 评论: 3

摘要: 每年暑假前后,医院门急诊经常出现摔伤、割伤前来就诊打破伤风针的人。 外伤出血了都要打破伤风针?成年人与儿童有什么不同?要在什么时候打?不同的破伤风药物各有何优劣势? ...

每年暑假前后,医院门急诊经常出现摔伤、割伤前来就诊打破伤风针的人。

外伤出血了都要打破伤风针?成年人与儿童有什么不同?要在什么时候打?不同的破伤风药物各有何优劣势?

外伤出血都得打破伤风针吗?

破伤风是由破伤风梭状芽孢杆菌通过伤口侵入人体引起的急性特异性感染。由于人群普遍易感,且各种类型和大小的创伤都可能被含有破伤风梭菌的污物污染,因此 建议有外伤的患者都要进行破伤风预防措施。

感染破伤风需要同时具备3个条件:组织 开放性损伤、创口较深;有 破伤风杆菌侵入(比如沾染 泥土、粪便、铁锈等);伤口内有 失活组织或局部组织缺血缺氧。因此,属于以上3种情况的必须打破伤风。

不过,接种过破伤风疫苗的患者,即按要求接种了小蓝本(免疫预防接种证)规定相关项目的人群,或是仅有浅表创口及单纯表皮擦伤,经及时清创后,可以不用再注射破伤风针。

一次破伤风针有效期多久?

这是很多患者常问的问题。预防破伤风的药物,目前有几种,特点、时效不太一样。

破伤风的预防主要依赖于抗体,并且只能通过 一级预防或二级预防实现。一级预防即 主动免疫(接种疫苗),新生儿免费,起效慢,需要在18个月内多次注射,较安全,不良反应少,作用维持时间长。完成全程免疫后,可以有效5-10年,加强免疫时效可达10年以上。不过,新生儿一般都接种了百白破疫苗,具有免疫力,因此活泼儿童容易摔伤刮伤,家长也不必过于担心。

二级预防即 被动免疫,主要指将免疫效应物如破伤风抗毒素(TAT)或破伤风免疫球蛋白(TIG)输入体内,使机体立即获得免疫力,用于破伤风的治疗和短期的应急预防。

其中,破伤风抗毒素过敏反应发生率较高,需要皮试,价格较便宜,时效是2-4天;马破伤风免疫球蛋白,过敏反应发生率降低,仍需皮试,价格稍便宜,时效是2-3周;人破伤风免疫球蛋白,价格较高,但不需要皮试,使用相对安全,时效是2-3周。

实际上,由于生产原料和价格上的限制,破伤风制剂供应在不同地区可能不稳定,所以受伤患者只要及时前往医院,按医生指引进行相关处理即可。一般来说,打疫苗要去社区卫生服务中心,打破伤风抗毒素或免疫球蛋白则到医院。

受伤后要在什么时间内打破伤风针?

一般来说,破伤风潜伏期为 3-21天,多数为 1-2周,因此应在受伤后及时注射,越早越好,一般 不超过24小时;超过24小时但未发病的,两周内打破伤风针也有预防作用。


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