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“狗苗”一定要打吗？

2016-09-28 璇子 璇子的医笔医画

疫苗狂犬病
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狂犬病病毒外形似子弹可通过破损的皮肤或粘膜侵入人体主要攻击中枢神经系统。

前段时间看了个新闻：

很！震！惊！这都什么年代了，还会有人因为心疼钱不打狂犬疫苗
今天就来强行科普一下狂犬病到底是怎么回事~

狂犬病病毒外形似子弹可通过破损的皮肤或粘膜侵入人体主要攻击中枢神经系统
所有的哺乳动物都可能得病
而我们最常接触到的有：
99%的传染源是狗
其他还有：猫、猴、蝙蝠、狼、狐、豹...
还有...
这个人见人爱花见花开的萌货——方便面君(小浣熊)

万一被咬了怎么办？？？
先不要慌张，要看伤口的严重程度
伤口暴露可分为三级：
所以这个相当于没说...
敲黑板啦！
注意画重点啦！有抓伤就要打疫苗哦！如果是流浪狗，打疫苗没商量如果是自家的健康宠物WHO推荐可以“十日观察法”：如果你被咬10天以后狗狗还健康活着你也就算安全的啦~

最严重的三级暴露就很血腥暴力了......比如这样：
再比如这样：
其实在急诊，这种狗咬伤也不算最重的
实习那会儿见过一例 YJ 被藏獒咬成了紫茄子
啥？想看照片
嗯......


这是一张有点污像紫茄子看了会蛋疼的狗咬伤照片.jpg
请自行脑补

三级暴露处理：处理伤口＋被动免疫＋狂犬疫苗
必要时手术
【总之去医院就对了】

前面提到的处理伤口什么意思？
有条件的话，自己在家可以先清洗，然后去医院

说了这么多，疫苗到底该怎么打？
所有疫苗均可使用“五针法”
目前WHO和国内推荐也可以“2-1-1”程免疫一共打三次，第一次剂量加倍分别是第0、7、21 天注射
临床远比教科书复杂：
1、先问问狂犬病病毒会放过小孩子么~

2、打疫苗都可能会出现副作用
最常见的有：注射部位一过性红疹、疼痛
一过性发热、头痛、头晕、胃肠道症状
严重不良反应罕见
能

以前打过狗苗，又被咬了还要打吗？
免疫期间：正常接种即可
全程免疫后半年内：不用再打
半年至一年内：第0、3天各接种一次
一至三年内：第0、3、7天各打一针
三年后：重新打！

狂犬病到底是什么表现？
是病人像疯狗一样到处咬人吗？？
典型表现：极度恐惧、恐水、怕风、呼吸困难等
会死吗？
会！
所以不要心疼钱！
参考文献：
    WHO GUIDE for Rabies Pre and Post-exposure Prophylaxis in Humans (revised 15 June 2010)  
    狂犬病预防控制技术指南（2016版） 
    丁香园 
    果壳网

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  1. [GetPortalCommentsPageByObjectIdResponse(id=147761, encodeId=09db14e7613e, content=文章真好，喜欢阅读, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Thu Oct 13 14:47:19 CST 2016, time=2016-10-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=144347, encodeId=567d14434e24, content=好文章，长见识, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Tue Oct 11 15:00:48 CST 2016, time=2016-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=138225, encodeId=eccf13822507, content=分享一下！！, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160817/IMG57B3C3F6DC2FD8753.jpg, createdBy=81321934679, createdName=1e0d99ddm02(暂无匿称), createdTime=Fri Sep 30 17:33:22 CST 2016, time=2016-09-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=137238, encodeId=948a13e2381a, content=继续关注！, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Wed Sep 28 19:54:46 CST 2016, time=2016-09-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=137237, encodeId=53a213e23764, content=谢谢分享！, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Wed Sep 28 19:54:28 CST 2016, time=2016-09-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=137057, encodeId=aa2113e057ee, content=学习了，继续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=17, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6b0d1671629, createdName=1de11f7fm56(暂无匿称), createdTime=Wed Sep 28 17:19:24 CST 2016, time=2016-09-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=137024, encodeId=988a13e024ff, content=讲的挺好，谢谢！, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo5nmIH5IQqCKjJgSCuicPWUWOUcdqt1ROPnEiaOYN4pSHibDv8la3OxNLalvuvUXn8clpJlrpuyTpckgt9OPkeSSdT/0, createdBy=8fd71930726, createdName=半夏微凉, createdTime=Wed Sep 28 15:40:16 CST 2016, time=2016-09-28, status=1, ipAttribution=)]
    2016-10-13 1e10c84am36(暂无匿称)

    文章真好，喜欢阅读

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=147761, encodeId=09db14e7613e, content=文章真好，喜欢阅读, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Thu Oct 13 14:47:19 CST 2016, time=2016-10-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=144347, encodeId=567d14434e24, content=好文章，长见识, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Tue Oct 11 15:00:48 CST 2016, time=2016-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=138225, encodeId=eccf13822507, content=分享一下！！, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160817/IMG57B3C3F6DC2FD8753.jpg, createdBy=81321934679, createdName=1e0d99ddm02(暂无匿称), createdTime=Fri Sep 30 17:33:22 CST 2016, time=2016-09-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=137238, encodeId=948a13e2381a, content=继续关注！, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Wed Sep 28 19:54:46 CST 2016, time=2016-09-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=137237, encodeId=53a213e23764, content=谢谢分享！, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Wed Sep 28 19:54:28 CST 2016, time=2016-09-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=137057, encodeId=aa2113e057ee, content=学习了，继续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=17, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6b0d1671629, createdName=1de11f7fm56(暂无匿称), createdTime=Wed Sep 28 17:19:24 CST 2016, time=2016-09-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=137024, encodeId=988a13e024ff, content=讲的挺好，谢谢！, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo5nmIH5IQqCKjJgSCuicPWUWOUcdqt1ROPnEiaOYN4pSHibDv8la3OxNLalvuvUXn8clpJlrpuyTpckgt9OPkeSSdT/0, createdBy=8fd71930726, createdName=半夏微凉, createdTime=Wed Sep 28 15:40:16 CST 2016, time=2016-09-28, status=1, ipAttribution=)]
    2016-10-11 1e10c84am36(暂无匿称)

    好文章，长见识

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=147761, encodeId=09db14e7613e, content=文章真好，喜欢阅读, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Thu Oct 13 14:47:19 CST 2016, time=2016-10-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=144347, encodeId=567d14434e24, content=好文章，长见识, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Tue Oct 11 15:00:48 CST 2016, time=2016-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=138225, encodeId=eccf13822507, content=分享一下！！, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160817/IMG57B3C3F6DC2FD8753.jpg, createdBy=81321934679, createdName=1e0d99ddm02(暂无匿称), createdTime=Fri Sep 30 17:33:22 CST 2016, time=2016-09-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=137238, encodeId=948a13e2381a, content=继续关注！, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Wed Sep 28 19:54:46 CST 2016, time=2016-09-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=137237, encodeId=53a213e23764, content=谢谢分享！, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Wed Sep 28 19:54:28 CST 2016, time=2016-09-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=137057, encodeId=aa2113e057ee, content=学习了，继续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=17, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6b0d1671629, createdName=1de11f7fm56(暂无匿称), createdTime=Wed Sep 28 17:19:24 CST 2016, time=2016-09-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=137024, encodeId=988a13e024ff, content=讲的挺好，谢谢！, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo5nmIH5IQqCKjJgSCuicPWUWOUcdqt1ROPnEiaOYN4pSHibDv8la3OxNLalvuvUXn8clpJlrpuyTpckgt9OPkeSSdT/0, createdBy=8fd71930726, createdName=半夏微凉, createdTime=Wed Sep 28 15:40:16 CST 2016, time=2016-09-28, status=1, ipAttribution=)]
    2016-09-30 1e0d99ddm02(暂无匿称)

    分享一下！！

    0

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    2016-09-28 知难而进

    继续关注！

    0

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    2016-09-28 知难而进

    谢谢分享！

    0

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    2016-09-28 1de11f7fm56(暂无匿称)

    学习了，继续关注

    0

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    2016-09-28 半夏微凉

    讲的挺好，谢谢！

    0

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