38例恙虫病的诊治分析

Diagnosis and treatment of 38 cases of tsutsugamushi disease

目的加深对恙虫病临床特点的认识,以提高诊治水平。方法选取嵊州市人民医院2015年6月～2016年10月收治的38例恙虫病患者的临床资料进行回顾性分析。结果全部患者均有持续发热,均发现焦痂;血白细胞升高5例、下降10例、正常23例,C反应蛋白升高32例,血小板下降19例,谷丙转氨酶升高29例,低血钠22例,低血钾19例,血白蛋白下降38例;并发皮疹26例,肺炎23例,腹股沟淋巴结肿大22例,并发感染性休克、呼吸衰竭3例。结论恙虫病临床症状多样,缺乏特异性,夏秋季遇上持续发热患者,均需警惕恙虫病,及时发现焦痂,及早诊断治疗,减少误诊率。

Objective To deepen the understanding of the clinical features of tsutsugamushi disease,in order to improve the diagnosis and treatment level.Methods The clinical data of 38 patients with tsutsugamushi disease were analyzed retrospectively in Shengzhou People＇s Hospital from June 2015 to October 2016.Results All patients had persistent fever,were found eschar;5 cases of elevated white blood cells,decreased in 10 cases,23 cases of normal,C-reactive protein increased in 32 cases,19 cases of thrombocytopenia,alanine aminotransferase increased in 29 cases,22 cases of serum sodium,19 cases of hypokalemia,38 cases of serum albumin decreased;26 cases of rash,23 cases of pneumonia,inguinal lymph nodes in 22 cases,complicated by septic shock,respiratory failure in 3 cases.Conclusion The clinical symptoms of tsutsugamushi disease are diverse and lack of specificity.In patients with persistent fever in summer and autumn,it is necessary to guard against tsutsugamushi,and the eschar is found in time.The diagnosis and treatment is reduced and the misdiagnosis rate is reduced.