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武汉一男子饭后用牙签剔牙引发重症破伤风,专家提醒

  • 2026-10-08 19:16:10
武汉一男子饭后用牙签剔牙引发重症破伤风,专家提醒
一根牙签能有多大杀伤力？
武汉市民张先生的遭遇给出了令人后怕的答案——因自行用牙签剔牙扎破牙龈，他竟感染了重症破伤风，被紧急送往武汉大学中南医院急救中心。好在经医护团队精心施治，36天后，他顺利康复出院。这起非典型病例提醒大家：小而深的伤口，皆可能成为破伤风的“入口”。
牙龈出血全身痉挛 医生火眼识别狡猾破伤风
今年4月的一天中午，家住武昌的张先生和往常一样，饭后用竹签挑牙，不慎扎伤牙龈，导致出血。因为伤口很小，出血也很快停止，张先生没有在意，然而大约1周后，他渐出现张口困难等症状，于是赶紧到中南医院急诊中心就医，随后出现颈背部肌肉僵硬、全身痉挛。急救中心考虑他实为患上破伤风，当即收入院治疗。主任医师陈海华介绍，破伤风的诊断主要依靠外伤史加上典型临床表现，缺乏特异性实验室指标，待到破伤风毒素与人体神经轴突结合以后，才引发明显发病症状，此时致病的破伤风杆菌已难以检出，这也是破伤风早期特别是尚无典型症状时诊断比较困难的原因。
张先生住院后全身骨骼肌持续痉挛，无法吞咽，参与呼吸的肌肉也痉挛，无法正常进食与呼吸，医疗团队立即实施气管插管，后期行气管切开、呼吸机辅助呼吸，并留置鼻饲管保障营养供给。在悉心治疗下，历经36天，他最终脱险，康复出院。
“破伤风毒素一旦与神经轴突结合，暂无特效方法将其快速解离，处理方式以支持治疗为主。”陈海华介绍，目前主要以镇静镇痛来解除痉挛，机械通气呼吸支持，保证患者足够营养，并防治随后出现的各种并发症，待新生神经轴突再生，病程才能结束。这个过程大约需3~6周。需警惕的是，肺部感染等并发症是该病主要的致死原因。
破伤风并非铁锈划伤“专属” 警惕小而深的伤口
陈海华提醒，很多人误以为只有被生锈金属扎伤才会感染破伤风，事实上，任何突破皮肤、形成密闭缺氧环境的深、窄创口都可能成为破伤风杆菌滋生的温床。临床上可见牙签挑牙、不规范的肛肠手术、木刺扎伤等非典型伤口导致的破伤风病例。
因破伤风治疗周期较长且难以预估准确的康复时间，患者及家属容易产生疑虑甚至丧失信心，但实际上只要正规治疗，破伤风治愈率很高。据记者了解，中南医院针对破伤风的治疗手段成熟、经验丰富，近3年急救中心病房收治的20名重症破伤风患者中，仅1例因家属选择放弃治疗离世，整体救治成功率远高于业内平均30~50%的成功率。“大多数患者可以痊愈，且疾病本身不会留下后遗症，康复后可回归正常工作与生活。”陈海华说。
破伤风疫苗属于国家免疫规划疫苗，绝大部分人群儿时均接种过，但疫苗保护效力并非终身有效，常规保护周期约10年，随着时间推移，体内抗体水平会逐步下降。对于经常从事体力劳动、易发生外伤的高危人群，建议每隔10年进行一次疫苗加强接种，筑牢免疫防线。陈海华表示，若不慎受伤，特别是小而深的伤口，一定要去医院就诊，需做伤口清创，注射破伤风抗毒素或破伤风人免疫球蛋白等预防性措施。受伤约1周后若出现张口困难、吞咽障碍、颈部及肢体肌肉发紧、僵硬等异常表现，要考虑破伤风的可能，建议立即就医。
陈海华主任医师讲解破伤风案例
来源：经视直播
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  1. CONNECT:[ UseTime:0.000523s ] mysql:host=127.0.0.1;port=3306;dbname=f460;charset=utf8mb4
  2. SHOW FULL COLUMNS FROM `fenlei` [ RunTime:0.001692s ]
  3. SELECT * FROM `fenlei` WHERE `fid` = 0 [ RunTime:0.000345s ]
  4. SELECT * FROM `fenlei` WHERE `fid` = 63 [ RunTime:0.000459s ]
  5. SHOW FULL COLUMNS FROM `set` [ RunTime:0.000981s ]
  6. SELECT * FROM `set` [ RunTime:0.000292s ]
  7. SHOW FULL COLUMNS FROM `article` [ RunTime:0.001028s ]
  8. SELECT * FROM `article` WHERE `id` = 564809 LIMIT 1 [ RunTime:0.000332s ]
  9. UPDATE `article` SET `lasttime` = 1791794440 WHERE `id` = 564809 [ RunTime:0.002202s ]
  10. SELECT * FROM `fenlei` WHERE `id` = 64 LIMIT 1 [ RunTime:0.000381s ]
  11. SELECT * FROM `article` WHERE `id` < 564809 ORDER BY `id` DESC LIMIT 1 [ RunTime:0.000406s ]
  12. SELECT * FROM `article` WHERE `id` > 564809 ORDER BY `id` ASC LIMIT 1 [ RunTime:0.000554s ]
  13. SELECT * FROM `article` WHERE `id` < 564809 ORDER BY `id` DESC LIMIT 10 [ RunTime:0.000700s ]
  14. SELECT * FROM `article` WHERE `id` < 564809 ORDER BY `id` DESC LIMIT 10,10 [ RunTime:0.000704s ]
  15. SELECT * FROM `article` WHERE `id` < 564809 ORDER BY `id` DESC LIMIT 20,10 [ RunTime:0.000742s ]
0.058192s