小儿肾综合征出血热临床特征分析

Clinical characteristics of pediatric hemorrhagic fever with renal syndrome

目的：总结小儿肾综合征出血热（HFRS）发病特点，增强临床医师对此类疾病的认识，减少误诊。方法回顾性分析2009年1月至2012年12月收治的26例小儿HFRS的临床资料。结果患儿发病年龄多在7~14岁（23例，88%）；男女性别比为1.89：1。患儿临床表现多样，早期症状类似感冒，病程中多有呕吐、腹痛等消化症状。实验室检查多见血小板改变，影像学检查可见多浆膜腔渗出。突出的并发症是心肌损害。结论小儿HFRS多发生于学龄儿童，且多见于男孩；该病症状不典型，初期应与感冒、阑尾炎等疾病鉴别。在补液治疗过程中需严密监控心功能指标，预防心力衰竭的发生。

Objective To study the clinical characteristics of pediatric hemorrhagic fever with renal syndrome （HFRS）, and to improve its understanding so as to reduce the misdiagnosis. Methods A retrospective analysis was performed on the clinical data of 26 children with HFRS between January 2009 and December 2012. Results The age of disease onset was mainly distributed between 7 and 14 years （23 cases, 88%）, and the male-to-female ratio was 1.89：l. The clinical manifestations of pediatric HFRS varied. The early symptoms resembled those of a cold, and in the course of HFRS, most patients developed digestive symptoms such as vomiting and abdominal pain. The laboratory examinations usually implicated platelet changes, and the imaging examinations revealed polyserous effusions. The prominent complication was myocardial injury. Conclusions Pediatric HFRS mainly occurs in school-age children, more commonly in males. HFRS does not have typical clinical manifestations or symptoms, so it should be distinguished from cold or appendicitis at the early stage. When applying the lfuid replacement therapy, the cardiac function should be carefully monitored in case of heart failure.