布氏杆菌病92例患者的临床诊断体会

Experience of clinical diagnosis of 92 patients with brucellosis

目的分析近年来布氏杆菌病的临床特征及临床诊断情况,以提高临床医师对布氏杆菌病的认识而减少延误诊断。方法收集我院2011-05~2016-05收治的92例布氏杆菌病患者的临床表现、病原学检查结果及诊断经过的资料,整理并总结92例患者的临床特征、就诊及诊断情况。结果 92例布氏杆菌病患者以发热、多汗、乏力及关节痛为主要临床表现。92例患者中28例经血液或骨髓培养布氏杆菌阳性而及时确诊为布氏杆菌病,其余64例患者除临床表现外,结合流行病学史、病原学检查及经验治疗做出临床诊断。结论 (1)布氏杆菌病临床不典型病例增多,但仍以发热、多汗、乏力及关节痛为主要临床表现。(2)通过详细询问病史、认真体格检查,结合实验室检查及其他相关辅助检查仍能及早确诊。

Objective To analyze the clinical characteristics and clinical diagnosis of brucellosis in recent years for improving the clinician＇s knowledge of brucellosis and reducing the delay diagnosis. Methods The clinical manifestations,etiological examination results and diagnosis process of 92 patients with brucellosis admitted to our hospital from May 2011 to May 2016 were collected to summarize the clinical features,diagnosis and treatment of brucellosis. Results The main clinical manifestations of 92 cases of brucellosis were fever,sweating,fatigue and joint pain. Of 92 cases,28 cases were timely diagnosed as brucellosis according to the blood or bone marrow culture of Brucella positive,and the other 64 cases were confirmed to be brucellosis by clinical manifestations combined with epidemiological history,pathogen examination and trial treatment. Conclusion（1）The clinical atypical cases of bacterial brucellosis increase,but the fever,sweating,fatigue and joint pain are still the main clinical manifestations.（2）Brucellosis can still be early diagnosed through the detailed medical history and serious physical examination combined with laboratory tests and other related auxiliary examination.