肾综合征出血热102例早期临床特点分析

STUDY ON THE EARLY CLINICAL CHARACTERISTICS OF HEMORRHAGIC FEVER WITH RENAL SYNDROME

目的探讨肾综合征出血热的早期临床特点。方法回顾性分析102例肾综合征出血热入院前的诊疗情况及预后。结果肾综合症出血热早期临床表现缺乏特异性,误诊率高达80.39%。发病早期补液量≤1 000ml/d的患者肾脏损害较重,病程长,越期率低而合并其他脏器损害的发生率较高。结论强化肾综合征出血热的继续医学教育。流行季节对发热性疾病本着疑诊从宽的原则,合理补充液体并密切观察尿量,血、尿常规变化,是减少由于早期诊断困难造成治疗延误的方法。

Objective To investigate the early clinical characteristics of hemorrhagic fever with renal syndrome （HFRS）. Methods The diagnosis, treatment and prognosis of 102 HFRS cases were studied retrospectively. Results Since lacking specific early clinical symptoms of hemorrhagic fever with renal syndrome, the misdiagnosis rate of HFRS was over 80.39%. The patients with less than 1000ml per day of fluid replacement presented a severe damaged renal function, a long course of disease and complicated other damaged organs. Conclusion The early diagnosis should be strengthened. In epidemic seasons, the princi- ple of suspicious diagnosis should be handled leniently to the fevered disease. Fluid should be replaced properly and the routine changes of urine and blood must be supervised carefully, which could be important ways to reduce the difficulties of early diagnosis and misdiagnosis of HFRS.