如何处理猫抓伤

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共同创作者是 Chris M. Matsko, MD

参考

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猫好玩、古灵精怪，但是偶尔也会有攻击性。只要和猫一起，就难免会被抓伤。这是它们的一种自我保护行为。猫的爪子很锋利，如果被它们不小心抓到，皮肤上可能留下深深的伤痕。被猫抓伤后，正确处理伤口可以避免一些并发症的发生。

方法 1
方法 1 的 5:

评估伤口情况

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    被猫抓伤后，收集这只猫的信息。如果是自己家或者好朋友的猫，就可以将它认定为“家猫”。如果伤势不严重，而且你确信以下关于这只猫的信息真实无误，就可以自行处理伤口： [1]
    • 这只猫已经严格按照要求接种疫苗。
    • 这是一只健康的猫。
    • 这只猫大部分时间都待在室内。
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    陌生的猫可能并没有接种疫苗，所以需要采取措施，预防细菌感染、破伤风或者狂犬病。尤其如果你既被抓伤，又被咬伤（感染几率高达80%），更加需要去看医生。
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    根据伤口的严重程度作适当处理。被猫抓伤后，你会感到疼痛。伤口的深浅决定伤势严重程度。
    • 浅表性伤口伤及皮肤最上层组织，有少量渗血。
    • 如果伤及多层皮肤组织，并伴有中度出血，就属于严重的皮肤创伤。 [2]
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    家猫造成的浅表层伤口可以在家自行处理。但是，被陌生的猫抓伤，或是被家猫重度抓伤（伤口很深），就应该去医疗机构，让医生评估你的伤势。
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方法 2
方法 2 的 5:

处理浅表抓伤

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    在处理伤口前，先洗净双手，并消毒。用肥皂和温水（也可以用热水）至少清洗20秒钟。别疏忽了指间和指甲缝。接着，再用净水冲洗。 [3]
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    用水龙头流出的净水冲洗伤口和周围皮肤。 [4] 不要用过热的水，以免加剧出血。
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    用成分温和的肥皂仔细清洗抓伤部位的皮肤。除此之外，周围的皮肤也要清洗。例如，如果前臂某处被抓伤，那么要清洗整条前臂，而不仅限于抓伤的部位。接着，再用自来水彻底冲洗干净。 [5]
    • 清洗的时候，不要摩擦患处，以免对受损组织造成进一步伤害（比如淤青）。
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    在抓伤处涂抹抗菌消炎药膏。 [6] 你可以用新孢霉素等三联抗生素软膏。这类药膏含新霉素，能有效促进伤口愈合。 [7]
    • 三联抗生素软膏每天涂抹三次。 [8]
    • 如果你对普通三联抗生素软膏过敏，杆菌肽也是一个不错的选择。
    • 如果是被家猫抓伤，而且只是造成浅表伤口，就没必要口服抗生素。 [9]
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    既然可以自己在家护理，抓伤处的伤口应该不深，你不需要用绷带包扎它们。在愈合的过程中，确保伤口干净、透气。
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方法 3
方法 3 的 5:

治疗很深的划痕

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    即使你是被一只严格接种疫苗的猫抓伤，如果伤口较深，也可能引起大出血，需要服用抗生素药物，防止伤口发炎。 [10] 通常，医生会开奥格门汀875/125毫克，每天两次，连续服用7到10天。
    • 接受医学专业人士的治疗前，先自己在家作一些处理。
    • 做好下面这些处理后再去见医生。
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    如果出血严重，用干净的毛巾敷压伤口。用毛巾大力按压出血部位，直到出血量减少。如果有可能，将抓伤处的肢体举过头部。 [11]
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    彻底洗净双手后，轻轻地用肥皂清洁伤口，接着再用干净的水冲洗。 [12] 洗的时候，不要摩擦伤处，避免引起出血。
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    用另一条干净的毛巾擦干伤口和周围皮肤。
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    如果伤口比较深，你应该用黏性绷带（比如邦迪）、蝶状绷带或干净的纱布敷料遮盖。 [13]
    • 如果伤口裂开，将伤口两侧缩进，使伤口闭合，再贴上蝶状绷带，固定伤口。如果有必要，可以多贴几张蝶状绷带，使伤口闭合。这有助于伤口快速愈合。
    • 如果手头没有黏性绷带，也可以用纱布敷料遮住伤口，并用医用胶带固定。
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方法 4
方法 4 的 5:

评估被猫抓伤的风险

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    一些抓伤和大部分咬伤会引起感染。彻底清洁伤口，涂上新孢霉素或杆菌肽等抗生素药膏，可以大大降低感染风险。伤口受感染后，你可能还需要口服抗生素药物。伤口感染的症状包括： [14]
    • 疼痛、肿胀、发红或伤口周围发热等症状有所加剧
    • 伤口四周出现红色条纹
    • 伤口有渗出物
    • 发高烧
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    猫抓病是猫最常引起的疾病，由人体感染汉塞巴尔通体引起。猫是塞巴尔通体的载体，尤其是小猫和长虱子的猫。大约有40%的猫一生中的某个阶段会携带这种病菌，但不会显示任何症状。 [15]
    • 一些有猫抓病的猫可能会患上心脏病、口腔溃疡或眼部感染。 [16]
    • 人要是患上猫抓病，最初的表现就是被抓、被咬的部位会微微肿胀，随之而来的是腋下、腹股沟或颈部淋巴节肿大。接着，患者会出现发烧、疲乏、眼睛发红、关节疼痛和喉咙肿痛等症状。 [17]
    • 人得了猫抓病后，如果不经治疗，眼、脑、肝或脾等器官可能会严重受损。 [18]
    • 免疫力低下的人更容易得并发症。如果得了猫抓热，甚至有可能死亡。
    • 猫抓病通常可以通过血清巴尔通体抗体检测进行诊断，也可以通过细菌培养、组织病理学，或聚合酶链式反应等检查手段进行诊断。阿奇霉素、利福平、庆大霉素、环丙沙星、克拉霉素、复方新诺明片等抗生素药物可用来治疗猫抓病。 [19]
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    体癣是一种真菌感染疾病，患处皮肤丘形鼓起，并起皮屑。 [20]
    • 体癣通常瘙痒难忍。
    • 体癣可用咪康唑、克霉唑等抗真菌药膏治疗。
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    弓形虫寄生在猫体内，可以通过猫粪传播。人一旦被猫抓伤，特别是如果猫爪上有猫粪，就有可能感染刚地弓形虫。 [21]
    • 感染后会出现发烧、全身疼痛、淋巴结肿大等症状，严重的甚至会损伤脑、眼、肺等器官，而且，对孕妇的危害尤其严重。因此，孕妇应该避免接触猫的便盒和粪便。
    • 你可以用息疟定等抗寄生物药物治疗弓形虫病。 [22]
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    猫可能会携带致命病菌。被猫抓伤后，如果出现以下症状，请立即就医：
    • 发烧
    • 头、颈部肿胀
    • 皮肤发红、瘙痒、疼痛、起屑
    • 剧烈头痛、头昏或晕眩
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方法 5
方法 5 的 5:

预防被猫抓伤

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    猫抓人是它的正常防卫行为，惩罚猫只会增强它以后的攻击性。
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    你可以用普通的指甲剪在家里修剪。每周修剪一次猫爪，可以降低抓伤人的风险。 [23]
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    不管是大猫还是小猫，逗它玩的时候，动作尽量不要太粗鲁，不然它们会抓挠、啃咬你或者身边的其他人。
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    大多数的猫，过了从幼猫到成猫的成长阶段（1到2岁之间），抓、咬的行为会收敛很多。如果你对猫抓伤敏感，或者免疫力低下，建议你不要养幼猫，养一只年龄稍大一点儿的猫。 [24]
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小提示

  • 给猫除虱。这虽然不能改变猫的抓挠行为，但是可以减少猫抓热等并发症的可能。向兽医咨询给猫除虱的好办法。
  • 给猫去爪要慎重。有人说，这就跟将人的手指切除一样。猫在去爪术后也可能会因此变得胆怯，或郁郁寡欢。
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警告

  • 如果被陌生的猫抓伤、伤口比较深，或者你免疫力低下，务必就医治疗。
  • 尽量避免接触野猫，或是流浪猫。
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参考

  1. ↑ http://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=90&ContentID=P01897
  2. ↑ http://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=90&ContentID=P01897
  3. ↑ http://www.cdc.gov/features/handwashing/
  4. ↑ http://www.mayoclinic.org/first-aid/first-aid-cuts/basics/art-20056711
  5. ↑ http://www.mayoclinic.org/first-aid/first-aid-cuts/basics/art-20056711
  6. ↑ http://www.mayoclinic.org/first-aid/first-aid-cuts/basics/art-20056711
  7. ↑ Diehr S, Hamp A, Jamieson B. Do topical antibiotics improve wound healing? Journal of Family Practice, 56(2);2007:140. http://hdl.handle.net/10355/3613
  8. ↑ http://reference.medscape.com/drug/neosporin-original-ointment-triple-antibiotic-ointment-neomycin-polymyxin-b-bacitracin-topical-343475
  9. ↑ Dire DJ.Cat bite wounds: risk factors for infection.Annals of Emergency Medicine, 20(9);1991:973-979.
  1. ↑ http://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeI到D=90&ContentID=P01897
  2. ↑ http://www.mayoclinic.org/first-aid/first-aid-cuts/basics/art-20056711
  3. ↑ http://www.mayoclinic.org/first-aid/first-aid-cuts/basics/art-20056711
  4. ↑ http://www.mayoclinic.org/first-aid/first-aid-cuts/basics/art-20056711
  5. ↑ http://www.webmd.com/skin-problems-and-treatments/symptoms-of-infection-after-a-skin-injury
  6. ↑ http://www.cdc.gov/healthypets/diseases/cat-scratch.html
  7. ↑ http://www.cdc.gov/healthypets/diseases/cat-scratch.html
  8. ↑ http://www.cdc.gov/healthypets/diseases/cat-scratch.html
  9. ↑ http://www.cdc.gov/healthypets/diseases/cat-scratch.html
  10. ↑ http://www.cdc.gov/healthypets/diseases/cat-scratch.html
  11. ↑ http://www.nlm.nih.gov/medlineplus/ency/article/001439.htm
  12. ↑ http://www.nlm.nih.gov/medlineplus/toxoplasmosis.html
  13. ↑ http://www.nlm.nih.gov/medlineplus/toxoplasmosis.html
  14. ↑ http://www.paws.org/index.php/library/cats/behavior/destructive-scratching/
  15. ↑ http://www.cdc.gov/healthypets/diseases/cat-scratch.html

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