新生兒 破傷風의 致命率 = Tetanus Neonatorum and Case Fatality

국문 초록 (Abstract)

1972年 1月부터 1981年 12月까지 10年間 啓明大學校 東山醫療院에 入院한 新生兒 破傷風 患兒 91名을 對象으로 調査한 成績을 要約하면 다음과 같다.
年平均 發病 患兒數는 9名이었고, 致命率은 35.2%였다.
男女 比는 2:1이며, 致命率은 男子가 약간 높았다.
地域別 分布는 大邱市가 45例, 周圍地方이 46例로 거의 비슷한 分布를 나타내었다.
分娩場所別로는 家庭分娩이 90.1%로 대부분을 차지하였으며, 致命率은 家庭分娩의 경우 36.6%로서 施設分娩 22.2%에 比하여 훨씬 높았다.
臍帶切斷方法은 消毒안된 가위가 70.3%로 가장 높았으며, 致命率은 消毒되지 않은 器具使用群이 37.0%로 消毒된 器具使用群 27.8%에 比해 높았다.
平均發病年齡은 5.7日이었으며 6日째가 29例(31.9%)로 가장 많았으며 發病年齡이 어릴수록 豫後가 不良하였다.
發熱程度는 38∼39℃ 24例로 가장 많았으며 發熱이 심할수록 致命率이 높았다.
入院時 末梢血液所見은 白血球數가 10,000~30.000으로 leukocytosis를 볼 수 있었다.
入院時 體重과 致命率과의 觀察에서 低體重일수록 致命率이 높게 나타났다.
患兒 91名 中 17名이 合倂症이나 同伴된 疾患을 가졌으며, 그중 hyperbilirubinemia 가 7名(41.1%)으로 가장 많았다.
이상의 結果로 보아 破傷風에 의한 新生兒 致命率은 좀처럼 低下되지 않고 있는 실정이므로 病院分娩率을 높이고 衛生的인 臍帶處理方法이 더욱 要望된다.
??筆에 앞서 本 論文을 作成할 수 있도록 協助와 편달을 해 주신 啓明大學校 東山醫遼遠 小兒科 姜眞無 敎授님에게 감사 드립니다.

다국어 초록 (Multilingual Abstract)

The present study was conducted to investigate the relationship between neonates characteristics and case fatality rate of neonatal tetanus.
The study subjects were 91 cases who were hospitalized and diagnosed as neonatal tetanus at Keimyung University Hopital during the last 10 years (1972-1981).
The results obtained are as follows:
Annual mean number of patients were about 9 cases and the overall fatality rate was 35.2%.
The sex ratio of male to female was 2:1. Case fatality rate was higher among male than among female.
By residence distribution, 45 cases occurred in Daegu city and 46 cases in rural area.
Home delivery without sanitary facilities was most common (90.1%). Case fatality rate was higher among home delivery group than among hospital delivery group (36.6% vs.22.2%).
The most of umbilical cords were cutted by unsterilized scissor (70.3%). The case fatality rate showed higher among the group cutted by unsterilized instruments among the group cutted by sterilized instruments (37.0% vs.27.8%).
Mean age of onset was 5.7 days and the younger the onset age was, the poorer the prognosis was.
The higher the body temperature was, the worse the prognosis was.
The peripheral blood finding on adminssion revealed leukocytosis (78.3%).
The lighter the body weight on admission was, the worse the prognosis was.
Of the total 91 cases, 17 cases had suffered from complications and the other combined diseases. Hyperbilirubinemia was the most common (41.1%).