Objective To summarize and analyze the common allergic atlas of the adverse events following immunization (AEFI) in Hainan province in recent 10 years, and find out practical and effective clinical treatment methods, so as to accumulate cases experience for proper treatment of allergic cases.
Methods Vaccination units at all levels carried out surveillance according to the surveillance program and reported directly through the surveillance system network. The diagnosis and treatment for cases were conducted by the investigation and diagnosis expert group at or above the county level, and relevant atlas data were collected.
Results A resource base of common allergen AEFI cases, including investigation, diagnosis and treatment was established, which played a key role in guiding diagnosis and treatment of allergen AEFI at all levels. A total of 2 340 cases of common anaphylaxis cases were reported in Hainan province from 2008 to 2018, the top five types were: 1 866 cases of urticaria (79.74%), 262 cases of angioedema (11.20%), 108 cases of maculopapular rash (4.62%), 35 cases of anaphylactic shock (1.50%), 13 cases of allergic purpura and 13 cases of thrombocytopenic purpura (0.56%). All kinds of anaphylaxis were effective cured (cure rate was 100%), and only one severe anaphylaxis, laryngeal edema, case died (cure rate was 80%).
Conclusion The allergic reaction cases of vaccination account for a large proportion in the AEFI, which is a very important part of the diagnosis and treatment of AEFI. Training and improving the skills of personnel at all levels requires the combination of clinical treatment theory and case atlas analysis to achieve good results.
摘要： 目的 总结并分析海南省近10年发生的常见过敏性疑似预防接种异常反应 (adverse event following immunization, AEFI) 案例图谱, 摸索出切实有效的临床实用处理办法, 为妥善处理过敏性异常反应积累案例经验。 方法 各 级预防接种单位按照监测方案开展监测, 通过监测系统网络直报, 县级以上调查诊断专家组进行诊断和指导处置, 收 集相关图谱资料。 结果建立了我省常见过敏性AEFI案例图例、调查诊断和处置方法资源库, 对指导各级过敏性AEFI诊断及处理发挥关键作用。2008—2018年海南省报告发现常见过敏性反应2 340例, 居前五位的类型为：荨麻疹 1 866例 (79.74%) 、血管性水肿262例 (11.20%) 、斑丘疹108例 (4.62%) 、过敏性休克35例 (1.50%) 、过敏性紫癜和血小 板减少性紫癜各13例 (0.56%) 。各种过敏性反应治疗效果都很好, 治愈率100%, 只有喉头水肿这一严重过敏反应死亡 1例, 治愈率80%。 结论过敏性预防接种异常反应病例在AEFI中占比较大, 是AEFI诊断处理很重要的工作内容, 培 训提高各级人员技能需临床治疗理论结合实际案例图谱分析才能达到好的效果。