破伤风

最后审阅: 26 八月 2022
最后更新: 22 四月 2022

小结

定义

病史和体格检查

关键诊断因素

  • 存在破伤风易感伤口
  • 破伤风免疫接种状态
  • 张口困难(牙关紧闭)
  • 背痛
  • 肌肉强直/肌张力增加
  • 吞咽困难
  • 痉挛
更多 关键诊断因素

其他诊断因素

  • 注射吸毒习惯
  • 呼吸窘迫
  • 血压、脉搏和体温不稳
  • 出汗
其他诊断因素

危险因素

  • 不完整的破伤风免疫接种
  • 损伤
  • 无菌产科实践
  • 注射吸毒习惯
  • 无菌肌内注射
  • 腹部手术
  • 针刺疗法、穿耳洞、修脚、牙签剔牙
  • 坏死肿瘤
  • 中耳感染
更多 危险因素

诊断性检查

需考虑的检查

  • 临床诊断
  • 血清毒素
  • 伤口组织或拭子中检测到破伤风梭菌
  • 血清抗毒素抗体
  • 药物样品或者设备上的孢子
  • 腰椎穿刺:
  • 脑电图 (EEG)
  • 肌电图(EMG)
更多 需考虑的检查

治疗流程

初步治疗

清洁的小型伤口

破伤风易感伤口

急症处理

临床破伤风

撰稿人

作者

Nicholas J. Beeching, MA, BM BCh, FRCP, FRACP, FFTM RCPS (Glasg), FESCMID, FISTM, DCH, DTM&H

Honorary Consultant and Emeritus Professor of Tropical and Infectious Diseases

Liverpool University Hospitals NHS Foundation Trust and Liverpool School of Tropical Medicine

Liverpool

UK

利益声明

NJB lectures at non-commercial meetings and conferences and publishes articles in peer-reviewed publications on the topic of tetanus. He has received sponsorship from specialist societies only to attend and speak at conferences. Views expressed in this topic are those of the contributor and do not necessarily represent the official position of the National Health Service, the National Institute for Health Research, the Department of Health, or the UK Health Security Agency. NJB is an author of a number of references cited in this topic.

Christopher M. Parry, BA, MB, BCh, PhD, FRCP, FRCPath, DTMH

Consultant in Medical Microbiology

Alder Hey Children’s NHS Foundation Trust

Director of Studies for DTM&H programme & Honorary Clinical Research Fellow

Liverpool School of Tropical Medicine

Liverpool

UK

Visiting Professor

School of Tropical Medicine and Global Health

Nagasaki University

Japan

Visiting Professor

Centre for Tropical Medicine and Global Health

University of Oxford

Oxford

UK

利益声明

CMP is an author of a number of references cited in this topic.

鸣谢

Dr Nicholas J. Beeching and Dr Christopher M. Parry would like to gratefully acknowledge Dr Lucy E. Cottle and Professor Enitan D. Carrol, previous contributors to this topic.

同行评议者

Louise Thwaites, BSc, MBBS, MD

Senior Clinical Research Fellow

Oxford University Clinical Research Unit

Hospital for Tropical Diseases

Ho Chi Minh City

Vietnam

Centre for Tropical Medicine and Global Health

Oxford University

Oxford, UK

利益声明

LT is an author of a number of references cited in this topic.

Katrina Kretsinger, MD, MA

Commander

U.S. Public Health Service

Medical Epidemiologist

HIV Vaccine Team

Epidemiology Branch

Division of HIV/AIDS Prevention

National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention

Centers for Disease Control and Prevention

Atlanta, GA

利益声明

KK declares that she has no competing interests.

  • 破伤风 images
  • 鉴别诊断

    • 药物(例如吩噻嗪类)诱发性肌张力障碍
    • 士的宁中毒
    • 神经阻滞剂恶性综合征
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    更多 患者教育信息
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