流行性出血热患者自发性肾破裂临床分析

Clinical Analysis of Spontaneous Renal Rupture Due to Epidemic Hemorrhagic Fever

目的分析流行性出血热(EHF)患者自发性肾破裂的临床特点,探讨降低其发生率的对策及内科有效治疗措施。方法对9例EHF自发性肾破裂及同期文献报道的25例同类病例进行回顾性分析。结果34例EHF自发性肾破裂患者有明显诱因31例,发生在少尿期30例,左肾破裂14例,右肾破裂17例,双肾破裂3例,血小板数值<80×109/L者20例。内科保守治疗治愈25例,手术治愈1例,死亡8例,其中手术治疗死亡3例,血透后死亡5例。结论EHF自发性肾破裂大多发生在少尿期,患者血小板数值很低,频繁搬动和腹内压增大如咳嗽或便秘为其主要危险因素。EHF少尿期患者应予严密监护,避免上述危险因素;对血小板极低者谨慎血透;内科保守治疗为有效的治疗措施。

Objective To study the clinical feature and the effective treatment of spontaneous renal rupture due to epidemic hemorrhagic fever（EHF）, so as to decrease it＇ s incidence rate, Methods The clinical data of 9 cases and 25 cases of literature in the same period were analyzed retrospectively. Results In all 34 cases, 31 cases had inducements, 30 cases of spontaneous renal rupture occurred in oligurla stage. 14 cases were left renal rupture, 17cases were right renal rupture, but 3 cases are both renal rupture. Conclusions Spontaneous renal rupture is apt to occur in oliguria stage, The number of blood plate count（BPC） is lower. The major risk factors are frequently been moved and more press in abdomen such as severe cough and constipation, Patients of EHF should be monitored strictly oliguria stage and decrease above- mentioned risk factors, Patients with lower BPC should be more carefully to hemodialysis. Active drug treatment is effective method to reduce the mortality rate of renal rupture.