17例发热伴血小板减少综合征死亡病例临床分析

Clinical Analysis of 17 Death Cases of Severe Fever with Thrombocytopenia Syndrome

收集以发热为首发症状的发热伴血小板减少综合征死亡病例17例,回顾性分析其流行病学史、临床症状体征、实验室检查及影像学检查、综合治疗经过及死亡原因,探讨早期诊断方法。17例死亡患者平均年龄61岁,以男性为主,均有野外作业史或田间劳作史,15例有基础疾病,均死于多器官功能障碍期。1例死于急性心功能衰竭肺水肿,1例死于阿斯综合征,6例死于难治性休克、DIC,9例死于病毒性脑炎、心力衰竭、呼吸衰竭。以发热为首发症状的患者要警惕发热伴血小板减少综合征的可能,接诊医师应详细问诊,行实验室检查,早期明确诊断并及时给予综合治疗,防止病情进展加重,甚至死亡。

To collect the clinical data of 17 dead cases of severe fever with thrombocytopenia syndrome （SFTS） with the initial symptom of fever, to retrospectively analyze the epidemiological characteristics, clinical manifestations, physical signs, laboratory and imaging results, treatments and the causes of death and to investigate a method for early diagnosis. The average age of 17 death cases was 61 years old, and the most were male. They had. all worked in the field. 15 cases were complicate with underlying disorders. They all died in the phase of multiple organ dysfunction. 1 case died of acute cardiac pulmonary edema. 1 case died of Adams Stokes syndrome. 6 cases died of refractory shock and DIC, and 9 cases died of viral encephalitis, heart failure and respiratory failure. Patients with initial symptom of fever cloud be SFTS, clinician should be alert to the disease and inquiry contact history in detail, and laboratory tests should be performed. Early diagnose and prompt treatment could prevent the progression of disease and decrease the mortality.