实习医生规范化诊疗流行性出血热常见错误及对策探讨

Common Errors and Countermeasures of Interns for the Standardized Treatment on Epidemic Hemorrhagic Fever

目的:探讨实习医生规范化诊疗流行性出血热常见错误,并总结相关对策,为提高实习医生对流行性出血热诊断正确率提供可靠依据,保障患者疗效及生活质量。方法:对77例流行性出血热患者临床资料进行回顾性分析,内容包括误诊情况、临床表现、实验室检查项目及结果、治疗措施、治疗结果等。结果:77例流行性出血热患者经治疗后73例患者成功治愈出院,所占比例为94.81%;4例患者死亡,死亡率为5.19%。4例死亡患者均为临床误诊后未及时采用流行性出血热疾病对症治疗措施,贻误治疗时机导致死亡,死亡原因为1例严重休克、1例并发严重败血症、2例急性心力衰竭。结论:实习医生应根据患者临床表现,排除相似疾病类型,结合临床各种实验室检查结果,对患者病情进行综合判断,从而提高流行性出血热诊断正确率,降低误诊、漏诊几率,提高患者治疗效果,保障其生命安全。

Objective： This article aims to investigate the standardization of medical interns EHF common errors and summarize the related countermeasures so as to provide a reliable basis of interns diagnose the epidemic hemorrhagic fever and protect the quality of treatment and patients＇ life. Methods： A retrospective analysis was conducted on the clinical date of 77 patients with epidemic hemorrhag-ic. The content including misdiagnosis, clinical manifestations, laboratory tests, results of treatment, treatment outcome and so on were observed and analyzed. Results： 77 cases of epidemic hemorrhagic fever patients after treatment, 73 patients successfully treated and dis-charged, the proportion was 94.81%; 4 patients died, the mortality rate was 5.19%. 4 deaths were clinically misdiagnosed patients, not the timely adoption of epidemic hemorrhagic fever disease symptomatic treatment measures, delaying the timing of treatment can result in death, cause of death was one case of severe shock, one case with severe sepsis, two cases of acute heart failure. Conclusions： It is sug-gested that the interns should pay attention to make a comprehensive judgment on the patients＇ condition on the basis of their manifesta-tions as well as excluding the similar types of disease with a variety of clinical laboratory test results in order to improve the diagnostic accuracy and clinical effects of patients with the epidemic hemorrhagic fever and reduce the misdiagnosis.