摘要
目的 对地方性斑疹伤寒的临床资料进行分析和探讨,以提高该病早期诊断的水平。方法 搜集15年342例地方性斑疹伤寒住院患者的详细资料,并登记于标准化数据分类表中,以入院和出院作为研究的终末点。结果 342例地方性斑疹伤寒,男266例,女76例(男女比例3.5:1),年龄中位值28岁。;有鼠蚤媒介传播史者64例(18.7％);发病季节秋冬居多(202,59.1％);发热(342,100％)、头痛(331,96.8％)、咽充血(310,90.6％)、球结膜充血(231,67.5％)和皮疹(108,31.6％)为本病的主要症状和体征。258例(75.4％)并发脏器损害:肝脏98例(28.7％),血液系统68例(19.9％),呼吸系统56例(16.4％),心脏17例(5.0％),肾脏16(4.7％),神经系统3例(0.9％);入院时仅有66例(19.3％)首诊为斑疹伤寒。结论 地方性斑疹伤寒的误诊常与忽视流行病学调查、对其早期症状缺乏足够的认识以及缺乏早期实验室检查数据有关。地方性斑疹伤寒全年散发,发病季节后移,临床症状不典型,更趋向于多样化。因此,如何提高地方性斑疹伤寒的早期诊断,仍有待于进一步探讨。
Objective To explore methods raised frequence of early clinical diagnosis on murine typhus. Methods 342 patients with murine typhus during recent 15 years were surveyed and standard data analysis tables were filled and classified with detailed information. Results Among these 342 cases ,266 were male and 76 were female,The average age was 28 and the ratio of male to female was 3.5:1. 64 cases (18.7%) had the experiences of contacting with murine fleas. The murine typhus often takes place in autum or winter ( 202,59.1 % ) and usual symptoms and characters were suffering fever (342,100% )or headache(331,96.8% )or throatic hyperemia (310,90.6% ) or bulbar conjunctiva hyperemia(231,67.5%)or rashes(108,31.6%)or splenomegaly(56,16.4%) .In this paper, 258 cases(75.4%)complicated by the injury of viscera, Among these cases,98(28.7%Complicated by the injury of liver,68(19.9%) bloodsystems,56(16.4%)respiratory system, 17(5.0%)hearts, 16(4.7%)kidneys and 3(0.9%) neural systems. Only 66 cases (19.3%) were diagnosed as murine typhus when they first visit.Conclusion It indicated the cause for clinical misdiagnosis include ignoring the epidemiological survey,poor knowledge on early clinical symptoms and incomplete early laboratory data collection. The cases of murine typhus may present year around and the pathogenic season comes to delay . it is hard to diagnose very early due to complexity and no typical of clinical manifestations , shifts in its patterns and occurrence of new symptoms.
出处
《疑难病杂志》
CAS
2002年第4期196-199,共4页
Chinese Journal of Difficult and Complicated Cases
