Epidemiological characteristics of tick bite in the surrounding areas of Beijing from 2019 to 2023
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摘要: 目的 回顾5年来北京及周边地区蜱虫咬伤的流行病学特征，为蜱虫咬伤的院内规范化诊治提供依据。 方法 对解放军总医院第四医学中心急诊科2019年1月1日-2023年12月31日接诊及收治的蜱虫咬伤患者的流行病学特征进行描述性分析。 结果 5年共接诊260 602例，收治蜱虫咬伤患者493例，其中收住院210例。其中仅出现局部症状患者362例，占73.4%(362/493)；发热31例，占6.3%(31/493)。患者地区分布以顺义、平谷、门头沟区为主，门头沟区伤者最多占66.9%(330例)；每年5~8月是咬伤高发月份，占98.8%(487例)；被咬伤者均为户外活动，占100%(493例)；30~39岁为主要高发年龄；下肢咬伤占61.9%(305例)。咬伤后的就诊原因主要为去除虫体(无症状)，伴随瘙痒、疼痛、发热等症状，应用多西环素治疗均临床治愈。 结论 蜱虫咬伤后多数无症状，以去除虫体为目的就诊为主，合并瘙痒、发热等症状，患者应立即到正规医院诊治，推荐多西环素口服治疗。Abstract: Objective To review the epidemiological characteristics of tick bites in Beijing and surrounding areas over the past 5 years, and to provide a basis for standardized in-hospital diagnosis and treatment. Methods The epidemiological characteristics of tick bite patients seen and admitted to the emergency department of the Fourth Medical Center of the General Hospital of the People's Liberation Army(PLA) from January 1, 2019, to December 31, 2023, were descriptively analyzed. Results A total of 493 cases were disposed of in the emergency department and 210 cases admitted to the hospital in 5 years, of which 362 cases(73.4%) were localized and 31 cases(0.06%) were febrile. The distribution of patients was mainly in Shunyi, Pinggu and Mentougou districts(330 cases), with Mentougou district(330 cases) having the largest number of injuries, accounting for 66.9%, and May to August being the high incidence months of bites, accounting for 98.7%(487 cases), with 100% of the bitten persons(493 cases) being outdoor activities, and with the age of 30-39 years old being the main high incidence age, and 49.9 %(246 cases) of the bites on the lower limbs. The main reason for consultation after bite was removal of the insect(asymptomatic), accompanied by itching, pain, fever and other symptoms, which were all clinically cured by application of doxycycline. Conclusion Most of the tick bites were asymptomatic, and the main reason for consultation was to remove the insect, with local symptoms such as itching, and if symptoms such as itching and fever appeared, they should go to a regular hospital immediately, and Doxycycline was recommended for oral treatment.
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Key words:
- tick bite /
- epidemiologic profile /
- treatment
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表 1 急诊科年接诊量及蜱咬伤患者所占比例
项目 2019年 2020年 2021年 2022年 2023年 急诊年接诊量/例 67 497 44 275 44 094 44 309 60 427 蜱咬伤患者/例 102 89 95 93 114 比例/% 0.15 0.20 0.22 0.22 0.19 
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表 2 蜱虫咬伤后凝血功能在发热组与未发热组患者的临床特点比较
M(Q1，Q3) 因素 未发热组(462例) 发热组(31例) Z P 血小板计数/(×109/L) 227.0(184.0，268.0) 229.0(129.5，278.0) -1.087 0.277 凝血酶原时间/s 11.7(11.2，12.3) 11.4(11.1，12.3) -0.766 0.444 活化部分凝血酶原时间/s 32.3(29.6，34.8) 34.1(29.0，39.2) -2.220 0.026 凝血酶时间/s 14.4(13.7，15.3) 14.6(13.4，16.1) -0.994 0.320 血浆纤维蛋白原/(g/L) 2.60(2.26，2.94) 2.36(1.52，2.81) -2.371 0.018 凝血酶原活动度/% 91.0(86.0，97.0) 89.0(81.5，97.0) -1.191 0.234 国际标准化比值 1.07(1.03，1.12) 1.08(1.01，1.12) -0.282 0.779
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