新型布尼亚病毒感染致发热伴血小板减少综合征医疗纠纷相关性研究

Study on medical disputes of fever and thrombocytopenia syndrome caused by SFTSV

目的探讨新型布尼亚病毒感染致发热伴血小板减少综合征的临床、病原学、流行病学特征,对临床诊断、治疗、结局及医疗纠纷相关性进行分析。方法本研究选取山东、辽宁、安徽、江苏、浙江、湖北6省2009年1月~2018年3月国内文献报导新型布尼亚病毒感染致发热伴血小板减少综合征疑似案例(共1279例)。对新型布尼亚病毒检测阳性案例的性别、省份、临床表现、抗病毒药物应用、治疗结局分别进行分组及组间差异的统计分析。结果病毒检测阳性率、死亡率在性别、省份分组间差异无统计学意义(P>0.05);山东省、辽宁省、安徽省、江苏省、浙江省、湖北省新型布尼亚病毒感染致发热伴血小板减少综合征抗病毒药物应用比率分别为84.84%、94.74%、88.99%、81.82%、79.55%、81.58%,辽宁省与其他省份抗病毒药物应用比率间差异有统计学意义(P<0.05),其余五省份组间抗病毒药物应用比率差异无统计学意义(P>0.05)。结论新型布尼亚病毒感染致发热伴血小板减少综合征疑似案例病毒检测阳性率与性别、地理位置等因素无关;辽宁省抗病毒药物应用率与其他省份之间差异有统计学意义,但未对死亡率产生明显影响。

Objective To investigate the clinical,pathogenic,epidemiological characteristics of fever and thrombocytopenia syndrome caused by SFTSV,and to analyze the clinical diagnosis,treatment,outcome,the correlation of medical disputes.Methods In this study,1279 fever and thrombocytopenia syndrome suspected cases caused by SFTSV of Shandong,Liaoning,Anhui,Jiangsu,Zhejiang and Hubei provinces were selected,reported from January 2009 to March 2018 in domestic literature.The difference between groups of the gender,province,clinical manifestation,antiviral treatment,treatment outcome were analyzed.Results There was no significant difference in the positive rate of virus detection and mortality rate in sexes and in provinces(P>0.05).The rate of antiviral treatment for fever and thrombocytopenia syndrome suspected cases caused by SFTSV in Shandong,Liaoning,Anhui,Jiangsu,Zhejiang and Hubei provinces were 84.84%,94.74%,88.99%,81.82%,79.55%,81.58%.There were significant differences in the rate of antiviral treatment between Liaoning and other provinces(P<0.05),and there was no significant difference in the rate of antiviral treatment among the other five provinces(P>0.05).Conclusion The positive rate of virus detection in suspected cases of fever and thrombocytopenia syndrome caused by SFTSV is not related to sex and geographical location,and there is a significant difference of the antiviral treatment rate between Liaoning Province and other provinces,but no significant impact on mortality.