数理医药学杂志
數理醫藥學雜誌
수리의약학잡지
JOURNAL OF MATHEMATICAL MEDICINE
2013年
4期
417-419
,共3页
恙虫病%血小板减少%误诊%阿奇霉素
恙蟲病%血小闆減少%誤診%阿奇黴素
양충병%혈소판감소%오진%아기매소
tsutsugamushi disease%thrombocytopenia%misdiagnosis%azithromycin
目的：分析我院7年来儿童恙虫病病例的临床特征，探讨血液系统改变在儿童恙虫病诊断中的意义。方法：回顾性分析我院收住的28例恙虫患儿的临床资料，尤其是血液系统损害的临床表现及实验室检查异常结果等。结果：血液系统改变主要表现为25例出现不同程度的肝肿大，11例出现脾大，12例浅表淋巴结肿大。实验室结果异常主要表现为18例血小板下降，其中10～20×109/L1例，20～50×109/L5例，80～100×109/L12例，正常10例；18例行凝血功能检查，其中11例凝血酶原时间、部分凝血酶原时间延长，伴纤维蛋白原下降；外周血白细胞上升8例，下降8例，正常12例；血红蛋白下降10例，90～110g/L 8例，80～90g/L2例。20例行骨髓穿刺检查，骨髓常规10例示正常骨髓象，10例示感染性骨髓象或增生性骨髓象。结论：恙虫病在儿童中发病率不高，临床表现差异较大，并发症多，血液系统损害突出，给临床医师造成困扰，常致误诊或漏诊，延误病情，可因多脏器功能衰竭而死亡。
目的：分析我院7年來兒童恙蟲病病例的臨床特徵，探討血液繫統改變在兒童恙蟲病診斷中的意義。方法：迴顧性分析我院收住的28例恙蟲患兒的臨床資料，尤其是血液繫統損害的臨床錶現及實驗室檢查異常結果等。結果：血液繫統改變主要錶現為25例齣現不同程度的肝腫大，11例齣現脾大，12例淺錶淋巴結腫大。實驗室結果異常主要錶現為18例血小闆下降，其中10～20×109/L1例，20～50×109/L5例，80～100×109/L12例，正常10例；18例行凝血功能檢查，其中11例凝血酶原時間、部分凝血酶原時間延長，伴纖維蛋白原下降；外週血白細胞上升8例，下降8例，正常12例；血紅蛋白下降10例，90～110g/L 8例，80～90g/L2例。20例行骨髓穿刺檢查，骨髓常規10例示正常骨髓象，10例示感染性骨髓象或增生性骨髓象。結論：恙蟲病在兒童中髮病率不高，臨床錶現差異較大，併髮癥多，血液繫統損害突齣，給臨床醫師造成睏擾，常緻誤診或漏診，延誤病情，可因多髒器功能衰竭而死亡。
목적：분석아원7년래인동양충병병례적림상특정，탐토혈액계통개변재인동양충병진단중적의의。방법：회고성분석아원수주적28례양충환인적림상자료，우기시혈액계통손해적림상표현급실험실검사이상결과등。결과：혈액계통개변주요표현위25례출현불동정도적간종대，11례출현비대，12례천표림파결종대。실험실결과이상주요표현위18례혈소판하강，기중10～20×109/L1례，20～50×109/L5례，80～100×109/L12례，정상10례；18례행응혈공능검사，기중11례응혈매원시간、부분응혈매원시간연장，반섬유단백원하강；외주혈백세포상승8례，하강8례，정상12례；혈홍단백하강10례，90～110g/L 8례，80～90g/L2례。20례행골수천자검사，골수상규10례시정상골수상，10례시감염성골수상혹증생성골수상。결론：양충병재인동중발병솔불고，림상표현차이교대，병발증다，혈액계통손해돌출，급림상의사조성곤우，상치오진혹루진，연오병정，가인다장기공능쇠갈이사망。
Objective:To explore the clinical characteristics of children with tsutsugamushi disease in our hospital for 7 years and the significance of the hematological changes in the diagnosis of tsutsugamushi dis-ease in children .Methods :The clinical data of 28 children with Tsutsugamushi disease in our hospital were retrospectively analyzed ,especially the clinical manifestation and laboratory data of hematological system . Results:The main manifestations of hematological changes were that hepatomegaly occurred in 25 cases in different degree ,splenomegaly in 11 cases and superficial lymph node enlargement in 12 cases .T he main ab-normal laboratory results showed 18 cases with platelet decline ,including 1 case declining by 10~20 × 109/L ,5 cases by 20~50 × 109/L ,12 cases by 80~100 × 109/L ,and 10 normal cases ;coagulation were tested in 18 cases ,and the prothrombin time and activated partial thromboplastin time extended in 11 cases with fi-brinogen declining ;peripheral blood leukocytes increased in 8 cases and declined in 8 cases ,while 12 cases were normal ;Hemoglobin declined in 10 cases ,of which 8 cases declined by 90~110g/L ,and 2 cases de-clined by 80~90g/L .The bone marrow examinations were performed in 20 cases .The results showed that 10 cases were normal and infective myelogramm or proliferative myelogramm were found other 10 cases .Con-clusion:The incidence of tsutsugamushi disease in children is not high .It has varied clinical manifestations , more complications ,and obvious hematological damage ,which often disturbs the clinician ,causes misdiag-nosis or missed diagnosis ,and delays in the treatment .Therefore patients will die due to multiple organ function failure .
