早期诊断及治疗恙虫病的临床价值  

Clinical value of early diagnosis and treatment of tsutsugamushi disease

作　　者：吴秋美 WU Qiumei(Department of infection,Pu'er People's Hospital,Yunnan Province,Pu'er 665000,China)

机构地区：[1]云南省普洱市人民医院感染科,665000

出　　处：《临床合理用药杂志》2020年第26期19-20,23,共3页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的分析早期诊断及治疗恙虫病的临床价值。方法回顾性分析2015年4月-2019年8月普洱市人民医院接诊的恙虫病患者68例,分析患者病历资料,观察患者疾病的诊断时间、临床特点、治疗结局等。结果恙虫病在6~9月份发病率最高,引起该疾病的主要原因为野外草地接触,占比100.00%;其临床表现为淋巴结肿大、高热及溃疡等,其中发热者37例,占比54.41%。此类患者在1周内就诊,其中合并脏器损伤者5例,占比13.51%,治愈率为100.00%;发热后1~2周内就诊患者17例,占比25.00%,其中合并脏器损伤者4例,占比23.53%,治愈率为88.24%;发热2周后就诊者14例,其中合并脏器损伤患5例,占比35.71%,治愈率为71.43%。68例中5例曾出现误诊,占比7.35%。结论恙虫病以发热、溃疡等为主要临床表现,无特异性临床特征,易出现误诊情况,随着病程延长会加重脏器损伤,降低治疗效果,因此早期诊断及治疗可减轻恙虫病给患者带来的损害,且治疗有效率更高。Objective To analyze the clinical value of early diagnosis and treatment of tsutsugamushi disease.Methods A retrospective analysis of 68 patients with tsutsugamushi disease received from April 2015 to August 2019 in Pu’er People’s Hospital,analyzed the patient’s medical records,and observed the diagnosis time,clinical characteristics,and treatment outcomes of the patients’disease.Results The incidence of tsutsugamushi disease was the highest during the period from June to September.The main cause of the disease was field grass contact,accounting for 100.00%.The clinical manifestations were lymphadenopathy,hyperthermia and ulcers.Among them,37 patients had fever,accounting for 54.41%.Such patients in a week,including 5 patients with visceral injury,accounting for 13.51%and the cure rate was 100.00%;17 patients within 1 to 2 weeks after fever,accounting for 25.00%,including 4 patients with organ damage,accounting for23.53%,the cure rate was 88.24%;14 patients with fever after 2 weeks,including 5 patients with organ damage,accounting for 35.71%and the cure rate was 71.43%.Five of the 68 patients had misdiagnosis,accounting for 7.35%.Conclusion The main clinical manifestations of tsutsugamushi disease are fever and ulcers,no specific clinical features,and are prone to misdiagnosis.As the course of the disease prolongs,it will aggravate organ damage and reduce the therapeutic effect.Therefore,early diagnosis and treatment can reduce the incidence of tsutsugamushi disease on patients.Damage,and the treatment is more efficient.

关 键 词：恙虫病 早期诊断 早期治疗 临床特征 治疗效果 

分 类 号：R513.2[医药卫生—内科学]