恙虫病肺部合并症50例临床分析

Clinical analysis of 50 cases of pulmonary complications associated with tsutsugamushi disease

目的 分析 50例恙虫病肺部合并症的临床表现 ,以提高其早期诊断率。方法 对 2 32例恙虫病患者 ,通过X线胸片、胸部B超、肺功能检测等方法进行回顾性分析 ,并对其肺合并症与支原体肺炎、肺炎链球菌肺炎、浸润性肺结核的鉴别诊断进行了讨论。结果 肺合并症占同期恙虫病患者的 2 1 .6 % (50例 / 2 32例 )。临床误诊为其他肺疾患占 42 %。胸片基本为渗出性病变 ,表现为双侧肺浸润 36例 (72 % ) ,单侧肺浸润 1 4例 (2 8% ) ,其中 1 6例伴有胸膜病变。所有病例经氯霉素治疗痊愈。结论 肺部合并症为恙虫病的常见并发症 ,如能早期诊断 ,及时治疗 。

Objective To study the clinical features of pulmonary complications associated with tsutsugamushi disease. Methods Two hundred and thirty two patients with tsutsugamushi disease were retrospectively analyzed by chest X ray, ultrasonography and lung function test . The differential diagnosis of tsutsugamushi disease associated lung complications from mycoplasma pneumonia, streptococcal pneumonia and tuberculosis was discussed. Results Pulmonary complications were present in 21.6% (50/232) of the patients with tsutsugamushi disease .Of them 42% were initially misdiagnosed as other pulmonary diseases . The characteristic radiographic manifestation was exudative lesions. The lesions were bilateral in 36 cases (72%), and unilateral in 14 cases (28%). Pleural effusion was present in 16 cases. Chloromycetin was effective in all the cases. Conclusions Pulmonary complications were common in tsutsugamushi disease. The prognosis was good if diagnosed and treated properly at an early stage.