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Tetanus Disease: Our ICU's Statistics At Umtata General Hospital 1998-2002

机译：破伤风疾病：1998-2002年在Umtata综合医院的ICU统计

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We present a retrospective as well as a prospective study about all patients admitted with the diagnosis of Tetanus Disease between years 1998 and 2002 into de I.C.U. at Umtata General Hospital. Emphasis was put on sex, age, duration stay and outcome. Introduction Tetanus sometimes known as lockjaw is a disease manifested by uncontrolled spasms, sometimes resulting in death specially in elderly and younger patients which depend on the introduction of Clostridium tetani toxin into damage tissues along with foreign bodies and or others bacteria. It is not directly transmitted from person to person, punctures, contaminated wounds with soil, dust, burns and so on, has played a role in the development of the disease. The spores produce a neurotoxin (tetanospasmin) which selectively blocks nerve transmission from spinal cord to muscle to go in severe spasm all over the body (main characteristic) that lead the patient to painful muscle contraction, bones fracture, laryngeal spasm which interfere with breathing, muscle tears amount others1,2,3 The incubation period typically between 1-2 weeks, there is not natural acquired immunity and illness with tetanus does not result in immunity neither, however vaccination with tetanus toxoid has been proved to be effective since its introduction in 1920's. Booster immunization to whom has been injured it is advisable for those who the last immunization received was about 10 years or more. Diagnosis is done under clinical picture .The conventional treatment of Tetanus with deep sedation and mechanical ventilation associated with penicillin still the most effective to improve the outcome and reduce mortality, anyway mortality is extremely high4,5,6,7,8,9,10 Umtata General Hospital is the referral centers for 25 rural hospitals in the Eastern Cape Province of South Africa, the nearest San Barnabas Hospital (30 Km away) the farthest Reitvlei Hospital (225 Km away). With a total of 1149 beds serves a population of 2,4 million approximately. ICU is the main unit for critically ill and injured patients. Patients and Methods This was a retrospective as well as a prospective study about all patients admitted with the diagnosis of Tetanus Disease between years 1998 and 2002 into de I.C.U. at Umtata General Hospital Emphasis was put on sex, age, duration stay and outcome.A total of 11 patients were admitted, the diagnosis was done mainly clinically through the history taking and physical exam, Results Eleven patients were admitted: 8 males (72.7%) and 3 females (27.3%) with an age average about 14 year for males and 12 year for females, the youngest one a new born and the oldest was 28 years old with a stay average between 2 days and 38 days in the unit.Others researches (4) showed an stay between 5 days and 15 weeks but included infectious department ward with higher number of male than females. We don't have any isolated ICU's statistic researches to compare because they also include the infectious ward stay.
机译：我们对1998年至2002年之间进入de I.C.U.确诊为破伤风病的所有患者进行了回顾性研究和前瞻性研究。在Umtata综合医院。重点放在性别，年龄，停留时间和结局上。简介破伤风有时被称为洛克颚，是一种表现为不受控制的痉挛表现的疾病，有时会导致死亡，特别是在老年和年轻患者中，这依赖于破伤风梭菌毒素与异物和/或其他细菌一起引入受损组织。它不直接在人与人之间传播，刺孔，被土壤，灰尘，烧伤等污染的伤口在疾病的发展中起到了作用。孢子产生一种神经毒素（替他诺斯帕斯明），选择性地阻止神经从脊髓到肌肉的传播，从而在整个身体中发生严重的痉挛（主要特征），导致患者痛苦的肌肉收缩，骨折，喉痉挛，从而干扰呼吸，肌肉眼泪的其他数量1,2,3潜伏期通常在1-2周之间，没有自然获得的免疫力，破伤风的疾病也不会导致免疫力，但是自从将破伤风类毒素引入体内以来，接种疫苗已被证明是有效的1920年代。对于最近一次免疫约10年或更长时间的人，建议对已经受伤的人进行加强免疫。根据临床情况进行诊断。破伤风的深层镇静和机械通气与青霉素的常规治疗仍是改善结局和降低死亡率的最有效方法，无论如何死亡率都很高4、5、6、7、8、9、10 Umtata综合医院是南非东开普省25家乡村医院的转诊中心，距离最近的San Barnabas医院（相距30 Km）和最远的Reitvlei医院（相距225 Km）。总共1149张床，可服务大约240万人口。重症监护病房是危重病人和受伤病人的主要病房。病人和方法这是一项回顾性研究，也是一项前瞻性研究，涉及1998年至2002年之间进入德州国际中心的所有确诊为破伤风疾病的患者。在Umtata总医院，重点关注性别，年龄，住院时间和结局。共收治11例患者，主要通过病史和体格检查进行临床诊断，结果收治11例患者：男8例（72.7％） ）和3名女性（占27.3％），男性的平均年龄约为14岁，女性的平均年龄为12岁，最小的新生婴儿，年龄最大的是28岁，平均停留时间为2天至38天。其他研究（4）显示住院时间为5天至15周，但其中包括传染病房，其中男性比女性多。我们没有任何独立的ICU统计研究可以比较，因为它们还包括传染病病房。

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