摘要破伤风是一种由专性厌氧菌感染引起的急性特异性感染,目前仍是一个严重的公共卫生问题.破伤风杆菌为专性厌氧菌,在自然界分布广泛,可存在于灰尘、土壤、人或动物粪便等,主要通过皮肤或黏膜伤口侵入人体,常见于外伤和烧烫伤患者、不洁接生的新生儿及手术器械消毒不严等情况.破伤风杆菌在化脓菌感染的伤口中繁殖产生外毒素引起中枢神经系统暂时性功能改变,表现为全身骨骼肌持续性强直和阵发性痉挛,重症患者可发生喉痉挛、窒息、肺部感染和器官功能衰竭,是一种极为严重的潜在致命性疾病.本文是关于破伤风免疫预防的专家共识,目的是预防开放性外伤后的破伤风并协助制定临床决策.根据国内外破伤风的流行病学调查结果、受伤人群的类型、伤口的暴露情况和免疫预防误区等的研究显示,预防破伤风至关重要的措施是良好的伤口处理和免疫接种.本共识描述了破伤风免疫预防过程的时间表,包括婴幼儿的破伤风免疫接种程序、妊娠期妇女的破伤风免疫接种程序、潜在高危人群的破伤风免疫接种程序、免疫缺陷患者的破伤风免疫接种程序和HIV感染母亲所生儿童的破伤风免疫接种流程.本共识仅提供学术性指导意见,具体实施时必须依据患者的医疗条件而定.

abstractsTetanus is an acute specific infection caused by obligate anaerobes,which is still a serious public health problem Tetanus bacterium is an obligate anaerobic bacterium,widely distributed in nature,which can exist in dust,soil,human or animal excrement The bacteria invade the body primarily through the skin or mucosal wounds,and most commonly in trauma and burn patients,unclean newborns,and unsafe surgical instruments Exotoxin produced by tetanus bacteria can cause temporary changes in the central nervous system,manifested as systemic skeletal muscle persistence and paroxysmal spasm,severe cases of laryngospasm,asphyxia,lung infections and organ failure,which is a very serious and potentially fatal disease This article is an expert consensus on the tetanus immunologic defense,aiming to aid the clinical decision making after open injury According to epidemiological investigation of tetanus,types of injured population,wound exposure and misunderstandings of immunologic defense,the key measures to prevent tetanus are good wound management and immunization This statement describes a preventive framework of tetanus immunization,including the tetanus immunization programs of infants,pregnant women,potentially high-risk population,immunodeficiency patients and children born to HIV-infected mothers This consensus only provides academic guidance,the treatment of the patient must be based on the prevailing medical conditions.