本土登革热287例临床特征分析

Clinical characteristics of 287 indigenous dengue fever patients

目的探讨本土登革热病例的临床特征,为登革热的防治提供依据。方法回顾性分析2017年至2019年云南省耿马傣族佤族自治县第二人民医院收治的287例本土登革热患者的临床特征、诊断、治疗及预后情况。结果287例本土登革热患者主要分布地区为云南省(225例),主要症状为全身疼痛(99.7%)、发热(92.7%)、疲劳(88.9%)、厌食(77.7%)、头痛(73.5%)、皮疹(32.4%)等。所有患者均接受防蚊隔离、解热、生命体征监测、物理降温、利巴韦林抗病毒、升高白细胞和血小板、营养支持、保护肝肾功能、预防和治疗并发症、补液支持等处理,最终285例患者康复,其中3例为重症登革热患者;余2例重症登革热患者转上级医院进一步治疗。随访1个月,所有患者均未复发。结论本土登革热的主要临床症状是发热、皮疹、肌肉和关节疼痛以及头痛,尽早诊断、及时治疗后预后较好。

Objective To investigate the epidemic situation of indigenous dengue fever,so as to provide experience for formulating effective diagnosis and treatment plan of dengue fever.Method The clinical characteristics,diagnosis,treatment and prognosis of 287 indigenous dengue fever patients in the Second People’s Hospital of Gengma Dai and Wa Autonomous County,Yunnan Province from 2017 to 2019 were analyzed retrospectively.Result The 287 indigenous dengue fever patients,were mainly from Yunnan Province(225 cases).The main symptoms of patients were generalized pain(99.7%),fever(92.7%),fatigue(88.9%),anorexia(77.7%),headache(73.5%),rash(32.4%),etc.All patients were treated with mosquito prevention and isolation,antipyretic,vital signs monitoring,physical cooling,ribavirin antiviral,elevated white blood cells and platelets,nutritional support,protection of liver and kidney functions,prevention and treatment of complications,and fluid replacement support,etc.Finally,285 patients were cured and recovered,among them,3 cases were severe dengue fever patients,and the remaining 2 cases were transferred to a superior hospital for further treatment.Follow-up for 1 month,no recurrence were found in all patients.Conclusion The main clinical symptoms of indigenous dengue fever are fever,rash,muscle and joint pain,and headache.Early diagnosis and timely treatment will lead to better prognosis.