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Ȯư취

ʱ:2017-05-05 07:15Դ:δ֪ :ѧ :
Ȯư취 һ 壺 Ȯ蹷֢ˮ֢һֺϵͳļԲԴȾѪܱ࣬ȾȾĶҧ˶áһΪڱ߳ɫĭķ蹷ҧȾʵèܣ

 Ȯư취

һ

Ȯ蹷֢ˮ֢һֺϵͳļԲԴȾѪܱ࣬ȾȾĶҧ˶áһΪڱ߳ɫĭķ蹷ҧȾʵèܣҲܻȾĶᆳ÷dzҰҺIJҧƵ˿ڽһˡ 

ȮȾ45%

Ȯ(rabies virus)ڵ״(rhabdoviridae)Ȯ(lyssavirus)̬ӵֱ7580nm175200nmڲΪ˿ǣ40nmģΪܵİĤ˿״ͻͻԶΪ״ʷ״νṹĻΪRNAΪ4.6×10611932ᣬԼ91%ĺ֪Ľṹףǵ(GP)Ĥʵ(M2P)ʵ(M1P)˵(NP)ת¼ø(LP)RNA180NPӽϳɺǺ˵(ribose nucleoproteinRNP)ʹRNAܵõı⣬ͬʱҲΪĸƺת¼ṩһ˵Ľṹ

M2PǿȮСĽṹ(Ϊ25×103)ӲĤĤGPͺ˿ǣGPһֵ͵ĿĤǵףʹ񾭶ԣͬʱշڲкͿʹ̼ϸߣԿȮĹбãNPΪȮȺԿԭʹϿ壬NPĿȮɸϸ(翹壬Ӻܰϸ)໥ò;ܶкͿдٽãȮGPNPյء

߽鵼𺦣30%

ĿǰΪľֲڲǵٴֲΩһأҺ߼ϸ鵼бãϸ߽鵼𺦺ͷҲһϵСֿȮӳ٣Ѫϸ٣ȮܰϸԿȮϸӦΪ߶ΪͣϿ죬֬(MBP)߷ӦҲΪͣչѸ٣֯пɼɿ壬弰ϸTϸ鵼𺦡

ȾԴ20%

ɽڼߣԣҲڵϸϸ붯IJǴȻеҰ꣬˻﷢IJԭ壬Ϊ“ֲ(street virus)”صǶǿDZڳ(ڽ1530)зֳ;Ⱦʹ﷢ֲڶڴ(50)󣬶ͣDẒ̶36죬˺Ȯʧȥ²ַҺγڻ壬Ϊ“̶(fixed virus)”̶м죬ԱҪԭԣƱȮ磬Ԥá

Ȯױߣȩ50%70%ҴȻͼ໯籽淋Һ56 3060min100 2minʧȥױӺͼ׷Һɱڱ¿ɱ꣬Ⱦ֯ɱ50%ĸͼ졣

Ȯ

Ȯ֯ǿ׺ҪͨУഫһ㲻Ѫ

1.Сֳ ҧ˲λƤĤھֲ˿ڵĺƼϸСֳͨ񾭼ͷϣ븽ĩ񾭣Ӿֲ˿Χ񾭲72h

2.Χ Χ񾭵ɢٶԼ5cm/dڵﱳ񾭽ں󣬿ʼֳȻ뼹裬ٲϵͳҪַԸɺСԵȲλԪɢֹijλγٴ֡

3.ɢ ϵͳΧɢ֯٣٣ಿζ٣Ƥȴ࣬񾭺ˣ񾭺˼񾭺˵𣬿ɷʼٴϻֿ߳ˮѣ֢״;ܴ̼ʹҺںͳ;񾭽ڣ񾭽ں񾭽𣬿ѪϵͳңͻȻ

ġȮٴ

DZڳ̲һΪص֮һ3ڷռ4%10%1Լ1%׼110꣬ӰDZڳ̵Ϊ(ͯ϶)˿ڲλ(ͷ沿)˿dz(߷)Ķ˺ǷͽֿȮԤȣˣܺ۵Ⱦܴʹǰ

ٴֿɷΪ()()ͣΪڣ

1.ǰ ͵ǰƣ˷״̬ǰ˯ʳȱŻ£ͷʹ()ʹ;ʹ⣬ȴ̼ʼУʺУش֢ϵ˿ڲλͨ·ϣľʹߵȸо쳣Լ80%IJڲֳ̼ԪرǸоԪ𣬴֢״άСʱ죬ڳ12죬ٳ4ϡ

2.˷ڻ ɷͣ͵ıֲͬ

(1)ͿȮԼռ2/3𽥽߶˷״̬ͻΪȿֲдͷԤ׸Уˮ⣬ȴ̼dzУʼΣȡ

ˮDZ֢״һÿУһڳ֣ˮˮˮἰˮʱʺΣˣ߿ʼʹҲ޷ʣմ۴ܺ£Σֲ壬˻ʧ·DZе֢״΢磬磬÷ȶɵʼΣ죬ȣҲͬ

ʼηʹ߼ʹ࣬޷ˮͽʳҳиΣºѺȱȫʹ״̬ÿηдˮ

⣬񾭹ִܿ߳󺹣ѣߴ38ϣʼӿ죬Ѫѹߣͫ󣬻߱ʹ࣬־Ϊ˷״ֻ̬߿ɳ־ʧײе֢״̽չܿ죬ڷ˥ѭ˥ڳ13

(2)ͿȮ(paralytic rabies)ӡȼ̩ϳԼռ1/3ڱ10ٴ˷ڣˮ֢״ͷʹŻ£ҧ˴ʹʼ֫ʧֻȫ̱СʧȣֺԼ׻ԼԱ֣ߵﴸߵؼɼߵ¡Ӻƽڽߵﴦּˮë̳45

3.ڻ ͿȮ𣬾ֹͣʱпǿˮʳӦʧתΪڻ̱̱֫Ϊۼ沿׽̱Ϊб˶ʧ׹ڲܱպϺ沿ȱٱ飬⣬ʧоˣʧͫɢȡ

ڱлߵĺ𽥱Ϊ΢򲻹򣬲ɳʽϸѪѹ½Ͷ֫䣬Ѹѭ˥߶ǰ߶״̬ڳ618h

Ọ̇ǰڣƽ8죬Ϊ13

ͿȮIJҪԸɣ񾭻߲λϵͳͿȮIJڼ裬ٴ֢״IJ졣

ѪҧĿȮ˷ڣҲʼκͿˮ󣬶̱ΪҪٴ֡

 

塢ȮʵҼ 

1.Ѫ򳣹ԼҺ ϸ(1230)×109/Lȣϸٷʴ80%ϣ󵥺ϸٷӣ򳣹鳣ɷȵż͸ͣԼҺѹΧߣߣϸ࣬ٳ200×106/LҪΪܰϸ

2.ѧ

(1)ѪкͿӫ⿹ⶨδע磬ȮѪ򵰰ϼֵȱڲ̵8ǰײֹĻߣкͿЧ۳15000ʱϿȮмֵע俹Ч۽ϵͣвELISAп⡣

(2)Ȯԭ⣺Ӧӫ⿹֯ͿƬĤӡƬ䶳ƤƬеIJԭǰɻԽ㣬СʱڿɣСڽּС巽нϸߵķʣʵӦüֵϴһ飬оʵУӫĿɿԿɴ95%ϣÿٿȮøϷ(rapid rabies enzyme immuno diagnosisRREID)ڼ֯пȮԭֻ۹۲øDzⶨɣԷӦʾٻɫԷӦɫΪټ㡣

3. ӻ֯裬٣٣⣬Σ٣ٵ֯ɷ뵽࣬ԼҺҺ׷;ߵĴʱԽķҲԽѣ벡ɲ֣֯кԼ

4.֯ УΪ֯Ƴ10%ҺС(23ϳΪ)С68ڳëβǿֱԵ1015˥߶С֯ƬпɷС塣

5.ת¼ۺøӦ(RT-PCR)Ȯ ΪܼȮͿȮزѡȮ˵׻(N)N1( )(587)5-TTTTGAGACTGCTCCTTTTTG-3(605),N2(-)(1029)5-CCCATATAGCATCCTAC-3(1013)ȡ֯򲡶ȾϸȻòRNAN1ںϳcDNAȻPCRӦ֬Ӿ

֯ҧ˶֯ƬѹƬSellerȾɫֱӫⷨС壬ʿɴ70%

ӦXƬBĵͼCT

ȮϺͼ 

׶εIJݻ߹ȥбȮɿȮèǣȶҧʷϼɳ˽ⱻҧöĽ״ϱмֵ粻ȷҧ˵ȮèǷ񻼿ȮӦ綯710ڲһųпȮֵ߳͵ ֢״˷ܣ꣬ˮ·磬ʺΣѣ̱ȣȮٴϣ֢״رע“”(ˮ⣬)󣬱Ҫʱȷ磬ˮ飬֢״Ӧעʼˮ׺ëǰѧԭļԣּ֯Ԫ Сȷ

ijЩҧʷȷڳΪ֢֢״ߣʱΪ񲡣˷Ĥ̱֫Ϊ-ۺ˷综DZڽ϶̣Ϊ614죬֢״ΪؽգЦݣȫԼγϾãнǹţȮ⾷γʼЪԷҪʼ˷综޸߶˷ܼˮ󣬻ƶ

ص־ı()Ĥ̼֢ԼҺı估ٴתڱĤϵͳѧԭ⣬϶ϡ

ȮӦȮ֢(ԿȮ)໼бȮҶȷΪȮҧʷ뻼ӴʷСʱ켴ƿȮ֢״ʺнУˮ˷֢ܵ״ȣѣ·磬ʾˮɲʺ⾷Σ໼߾ʾ˵֢ƣɺָܿ

Sempleֺ󣬿ɷۼϵͳIJ֢ӦȮ𣬽DZΪע俪ʼ13ܣע16죬52죬ٴΪֹͻȻȰԻȫԺԼ財䣬н̱Լʧ粢ԼĤ򷢲ϳ٣DZ58ܣٴ֢״ΪͷʹȣԸȾʶϰ뼹ױֲ֣֢ͿȮԼҺкͿĴڿȮϣж̬۲ԼƤʼЧжϣٴ֣С弰ԭϡ

ߡȮ 

ȮƷ

ȮдȾյIJԼһԤ󼫲ЧƣٴӦöҩαաתӺʹ˿Ȯ򵰰ƣʧܡǿҧ˺ʱԤƣԷԶ֢ۺΪ

1ҧ˺󣬶˿ڵĴ÷ˮϴҧλ˿ڣȻ40-70%ľƾȰ(benzyl ammonium chloride)(zephiran)ϴעⲻҪ˿ڡ

2ϸڽϰ߽ϰĵ˲ⲻҪĴ̼ϸ˵йȣֹҺȾ

3쿪ʼȫע䣺õĿȮ֣֯(ɭն)Ѽ硢鶯֯缰֯硣ǰӦýϾãΪֲڵƷдķDzԭʣܵصIJ֢ԼסĤ׵;ԭԵͣעϳʱ䡣ĿǰӦ֯磬硢̥ţ硢ϸ缰˶ϸȣ˶ϸãԤЧãҲزӦѽֹȫȮ磬עһμɡйĿǰĵ֮ƣֵù㷺Ӧáҧأжദ˿ڻ˿ͷ桢ָߣڽͬʱӦע俹ȮѪ塣ϲʹÿȮѪ壬ѪĿؿԼʱкڵ벡ֹɢԵӳȮDZڣʹ㹻ʱĿ壬ٷĻᡣ

ʹÿȮѪӦ顣Ѫк벡ҲܼϸڲֳɢٶȣʹDZӳȡԶʱ䣬ӶЧӦÿȮѪԶЧۺӻʱ䣬ȮѪעķһ뼡ע䣬һ˿Χע䡣Ȯ޻˽Ӵ϶ԱӦиȾǰԤ֡ ȮӦֱڵ0371428ע1룬ע50ָע1ĵ죬ԺԴơע俹ȮѪʱʹǰһʹãӦȫע5ĵ1020ٸǿע1롣עȮѪҪʱȫ̡

4໤Ӧɾֵ߽ҽԱɡҪܹ⣬ΧҪˮԱҪӲЬҪҡȡҪšҪ߳д̼ԵʳԿꡢλ߿򾲼籽ͱ(ͱ)ʹ䱣ְעάӪˮƽ⣬˾עˮ40Ѫغ;ƽʧˮʼƽʧ;Է겻ʹø򾲼簲ͱסˮȩҩȡˮ׸ˮֹεϢҪʱпĶ١ʧѪѹʱβͼǿļ

5ö֢θֲ֢

A)ϵͳпˮӦʳٸִ̼η豽Ӣȡˮ׿¶ˮЧʱ

B)幦ϰعӦˮ룬֢農ҺôҶѹ(Pitressin)

C)ϵͳп礡ȱήݲ߸˹ƷҩߣʩзθעֹԷס

D)ѪϵͳҶΪԣѪ֢йӦ벡ļй߰ļ״ѪѹѪݲҺ˥ˮ֣ӦõҸǿļѪ˨γߣɽ;ǻӦܡĶͣʩи

E)ƶѪѪθѪѪҺ죬¹̺ѪͻߣӦʱԵ

ȮҽƷ

֤Σ

1綾֤񣬶磬ȷȣͷʹʳη⡢ηԭ˿ڴľиУ൭죬̦ףⶾ˲ΰܶɢӴҶ

2ηڶ֤򾪻鴤ˮˮ̸ˮʺΣ겻ູѣűѣ̦ףҡϨ⾷ɢǡۻơȡ

ˣȮж 

  Ȯרҵ

1˱ҧ˺20%ˮ1%½𳤳׳ϴ˿30ӣ˿עϴϴ50%-70%Ҵ2%˿ڣ˿ڲ˷ϣҲ˰

2ҽÿȮѪ˿ܼײнע䡣

3ҽʹ˷翹ؼء

4ӦÿȮ߹ȫԤ֡

5Ⱦһ㻤滤ҽԱƤӦ齺ס

6Ӵ롣ҺմȾƷӦھηץҧˡ

7ܸʳʳҪʱʲ0.5%1%ǡ

Ȯճ

1ⲻҪĴ̼⡢紵졢ˮȡ

2ѡʵİʻʳ㹻ʺάء

šȮԤ

ڱȱЧֶΣӦǿԤʩԿƼӣԤֶԷֹп϶ֵϸִȮĹʹԽ͡

ȮճԤ

ӦڸעȮ磬ߡֳƤë࣬ڼͳϷҪʱϴ֡èȳõļͨﴫˣ⣬èȳϻܲ棬ƤѢʪȼֳƤ֢״ʱ輰ʱƣ⴫ȾȾϿȮξΪʱˡ

ȮרҵԤ

(һ)ȾԴɱҰȮԱȮȮʵȮӦеǼǣԤֲ֣ȮIJèʱУˣҧ˵ļȮèӦ跨񣬲۲10죬ԴĶȷΪǻȮ߿ɽ룬Ӧȡ֯м飬ٻٻвɰƤʳ

()˿ڴڵ˿ڴΪҪ˱ҧ˺Ӧʱ20%ˮֵϴ˿ڣϲã˿ڽõ룬ԷˮעϴѪ壬ƤԺ󣬿ע˿ڵײܣ˿ڲ˷ϻ

()ԤֶֽΪ

ٱǣҰҧߣ

ڱ(۲)䲻Ȯèҧߣ

Ϊѱк֯ѸܵĶҧߣ

Ƥ˿ΪȮҺմߣ

˿ͷ˿ڽϴߣҧ˶(ָ)5պ԰Σע伴ֹ

ҽԱƤΪȮմߵȣѷһЩҧ˷ȮIJУȮȴȻ֤ʵȮҺڴȮҧ߾Ӧ֣1ʾȮԤֵӦ֤

ҹ㷺ʹϸ磬1979人ƷͨͶҧڵ0714ע2mlضҧ˼ͷ棬ҧڵ0371430ע2ml

Ч治һ£еΪЧ˶1/6ˣѰһ硣

ѪпȮѪ忹Ȯ򵰰֣ҹĿǰǰߣÿ֧10ml1,000IU;˼Ϊ20ml;ͯΪ40IU/kgƤԺ󷽿Ӧãһֲ˿ڴע䣬һע˿Ȯ򵰰׵һעΪ20IU/kgѪɸ߶Ӱ쿹ɣ˱ڽֽ102090ٸ輤磬Դ䷴ӦϴӦ塣

()Ҫ˷翹ػ඾أԼ˵ĿҩԤֺ󲢷ϵͳӦ߿ɸƤʼأؼյԶʵȾбã˵ԤǷЧдһٴʵ

1.춯ڷĹè

2.ڵҧߣӦȫԤע䡣

ʮȮʳ

ʳƷ(Ͻοϸѯҽ)

Ȯճ

1ˮ߲ˡ

2յĵʳţ̡ࡢƷȡ

Ȯʳ

(1)ʳȴ̼ʳʳĩ;ʳ⡢ȴ̼ʳɼز顣

(2)ʳ̺ʳƷ̺ʳ̲ˡ̴ȿԣڲ˰ʹ֢״;ʳġ⡢ʹƢθˣؿԣڲ˰ʹ֢״أӦʳ

(3)ɾơȣ߾ɴ̼˷ܣշ˿귢ز顣

(4)ʳࡢϺзͷͷ⡢⡢ᡢצȡ

 

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