102例肾综合征出血热患者的救治阶段的临床特征分析  

Analysis of Clinical Characteristics During the Treatment Phase of 102 Patients with Hemorrhagic Fever with Renal Syndrome

作　　者：王明深 杨舒珺 李霜梅[1] 王彤[1] WANG Ming-shen;YANG Shu-jun;LI Shuang-mei;WANG Tong(Department of Emergence Medicine,The Eighth Affiliated Hospital of Sun Yat-sen University,Shenzhen,518033)

机构地区：[1]中山大学附属第八医院急诊科,518033

出　　处：《岭南急诊医学杂志》2024年第5期511-515,共5页Lingnan Journal of Emergency Medicine

摘　　要：目的:通过分析肾综合征出血热(HFRS)患者的流行病学特点及临床特征,为早期正确诊断及病情严重程度评估提供指导意见。方法:分析中山大学孙逸仙纪念医院1997年1月至2023年7月收治的确诊为HFRS患者的临床资料。结果:研究纳入HFRS患者102例,男性82例、女性20例,平均年龄(43.12±13.10)岁。春冬季发病63例,有可疑鼠类接触史的58例。3例患者死亡,其余均好转;仅有8例表现为典型的“三红三痛”症状,首诊正确率仅为40.20%;102例患者中,轻型37例、中型38例、重型16例、危重型11例,重度及极重度的患者入院首次检查肌酐、尿素氮、血小板、凝血功能、合并积液情况等指标的异常程度显著高于轻中度患者。结论:HFRS患者临床症状多样,首诊正确率偏低,急诊医生接诊不明发热患者时应注重多系统的症状体征,重视肝肾功能及凝血指标,必要时完善肾综合征出血热抗体检查明确诊断并及时治疗。Objective:To provide guidance for early correct diagnosis and assessment of disease severity by analyzing the epidemiological characteristics and clinical features of patients with Hemorrhagic Fever with Renal Syndrome(HFRS).Method:Analyzing the clinical data of patients diagnosed with HFRS admitted to Sun Yat-sen Memorial Hospital of Sun Yat-sen University from January 1997 to July 2023.Results:The study included 102 HFRS patients,with 82 males and 20 females,and an average age of 43.12±13.10 years.There were 63 cases with onset in spring and winter,and 58 cases with a history of suspected rodent contact.Three patients died,and the rest improved;only 8 cases presented with typical‘three reds and three pains’symptoms,with an initial diagnosis accuracy of only 40.20%.Among the 102 patients,there were 37 cases of mild,38 cases of moderate,16 cases of severe,and 11 cases of critical illness.The degree of abnormality in initial tests such as creatinine,urea nitrogen,platelet count,coagulation function,and concurrent fluid accumulation was significantly higher in severe and critically ill patients compared to mild and moderate cases.Conclusion:The clinical symptoms of HFRS patients are diverse,with a low initial diagnosis accuracy.Emergency physicians should pay attention to multi-system symptoms and signs when encountering patients with unexplained fever,focus on liver and kidney function as well as coagulation indicators,and,if necessary,perform HFRS antibody tests for accurate diagnosis and timely treatment.

关 键 词：肾综合征出血热 流行病学特点 临床特征 严重程度 

分 类 号：R512.8[医药卫生—内科学]