国内文献报道森林脑炎1153例分析

Analysis of 1153 Cases of Forest Encephalitis Reported by Domestic Documents

目的对森林脑炎临床特点、诊断及治疗等资料归纳总结,为修订相关诊断标准提供依据。方法于2020年1月至12月,回顾性分析2009年至2020年中国知网、万方中文期刊数据中森林脑炎病例临床特点、诊断和治疗,计量资料用±s表示,性别、地区、职业等计数资料用数及构成比(%)表示,对相关资料进行描述性分析。结果国内文献报道的森林脑炎确诊病例1153例,男910例,女243例;年龄16~78岁;病例主要分布在吉林省、内蒙古自治区和黑龙江省;病例中森林管护员(112/518)、自由职业者(104/518)、伐木工(88/518);588例有明确发病时间,常见症状和体征依次为发热(81.2%,936/1153)、头痛(70.3%,811/1153)、脑膜刺激征(29.0%,334/1153)、呕吐(25.3%,292/1153)、恶心(21.8%,251/1153)等;有48.1%(555/1153)患者从血和(或)脑脊液标本中获得阳性病原学检测结果;有42.1%(485/1153)的患者有明确诊断分级,其中轻度354例,中度58例,重度73例;有完整治疗过程的730例森林脑炎患者中,痊愈511例,好转148例,未愈48例,死亡23例。结论森林脑炎流行有严格的地区性、季节性和职业性,早期诊断早期治疗可以减少病死率和致残率。

Objective To summarize the clinical characteristics,diagnosis and treatment of forest encephalitis,and provide basis for revising relevant diagnostic criteria.Methods From January to December 2020,the clinical characteristics,diagnosis and treatment of forest encephalitis cases in the data of China National Knowledge Infrastructure(CNKI)and Wanfang Chinese journals from 2009 to 2020 were retrospectively analyzed.The measurement data are expressed in Mean±SD,numbers,and the counting data of gender,region and occupation are expressed in numbers and composition ratio.Descriptive analysis of relevant data is carried out.Results There were 1153 confirmed cases of forest encephalitis reported in domestic literature,including 910 males and 243 females.Age:16-78 years old;Cases were mainly distributed in Jilin Province,Inner Mongolia Autonomous Region and Heilongjiang Province.The cases included forest rangers(112/518),freelancers(104/518)and loggers(88/518).The common symptoms and signs were fever 81.2%(936/1153),headache 70.3%(811/1153),meninges irritation 29.0%(334/1153),vomiting 25.3%(292/1153),nausea 21.8%(251/1153),etc.Only 48.1%(555/1153)of the patients obtained positive pathogenic test results from blood and/or cerebrospinal fluid specimens.42.1%(485/1153)had definite diagnosis grade,354 cases were mild,58 cases were moderate,and 73 cases were severe.Among 730 patients with forest encephalitis who received complete treatment,511 cases were cured,148 cases were improved,48 cases were not cured,and 23 cases died.Conclusion The epidemic of forest encephalitis has strict regional,seasonal and occupational characteristics.Early diagnosis and treatment can reduce the mortality and disability rate.