中国实用医刊
中國實用醫刊
중국실용의간
CENTRAL PLAINS MEDICAL JOURNAL
2013年
16期
21-22
,共2页
恙虫病%脑炎%多器官损伤%焦痂%治疗
恙蟲病%腦炎%多器官損傷%焦痂%治療
양충병%뇌염%다기관손상%초가%치료
Tsutsugamushi disease%Encephalitis%Multiple organ damage%Eschar%Treatment
目的 总结恙虫病并脑炎及多器官损伤患者的临床诊治经验.方法 选择昆明市儿童医院2009年1月至2012年11月收治住院的46例恙虫病并脑炎及多器官损伤患者为研究对象.46例患儿均给予多西环素片抗感染、脱水降颅压、短期应用激素治疗,血小板过低者加用静脉丙种球蛋白、白蛋白过低者补充白蛋白等对症支持治疗,2例呼吸衰竭者应用机械通气辅助治疗.结果 经积极有效治疗,除1例就诊晚入院不足4h死亡外,其余45例均临床治愈出院.结论 恙虫病是严重威胁儿童健康的急性传染病,易引起多器官损伤及并发脑炎.由于基层医院对该病的认识不足,易出现误诊.焦痂对诊断最具意义.多西环素是治疗该病的特效用药,早期诊断、治疗是减轻恙虫病并发多器官损伤及病死率的关键.
目的 總結恙蟲病併腦炎及多器官損傷患者的臨床診治經驗.方法 選擇昆明市兒童醫院2009年1月至2012年11月收治住院的46例恙蟲病併腦炎及多器官損傷患者為研究對象.46例患兒均給予多西環素片抗感染、脫水降顱壓、短期應用激素治療,血小闆過低者加用靜脈丙種毬蛋白、白蛋白過低者補充白蛋白等對癥支持治療,2例呼吸衰竭者應用機械通氣輔助治療.結果 經積極有效治療,除1例就診晚入院不足4h死亡外,其餘45例均臨床治愈齣院.結論 恙蟲病是嚴重威脅兒童健康的急性傳染病,易引起多器官損傷及併髮腦炎.由于基層醫院對該病的認識不足,易齣現誤診.焦痂對診斷最具意義.多西環素是治療該病的特效用藥,早期診斷、治療是減輕恙蟲病併髮多器官損傷及病死率的關鍵.
목적 총결양충병병뇌염급다기관손상환자적림상진치경험.방법 선택곤명시인동의원2009년1월지2012년11월수치주원적46례양충병병뇌염급다기관손상환자위연구대상.46례환인균급여다서배소편항감염、탈수강로압、단기응용격소치료,혈소판과저자가용정맥병충구단백、백단백과저자보충백단백등대증지지치료,2례호흡쇠갈자응용궤계통기보조치료.결과 경적겁유효치료,제1례취진만입원불족4h사망외,기여45례균림상치유출원.결론 양충병시엄중위협인동건강적급성전염병,역인기다기관손상급병발뇌염.유우기층의원대해병적인식불족,역출현오진.초가대진단최구의의.다서배소시치료해병적특효용약,조기진단、치료시감경양충병병발다기관손상급병사솔적관건.
Objective To summarize the clinical diagnosis and treatment experience of tsutsugamushi disease complicated with encephalitis and multiple organ damage.Methods Forty-six hospitalized patients were choosed as the research object with tsutsugamushi disease complicated with encephalitis and multiple organ damage from January 2009 to November 2012.All cases were given Doxycycline hydrochloride tablets to anti-infection,dehydrator to lower cranial pressure and hormone of short-term application.Intravenous gamma globulin and human serum albumin was applied to support treatment if blood platelet and albumin were low.Two cases of respiratory failure had applied mechanical ventilation therapy.Results By the positive and effective treatment,45 cases were crued and discharged from hospital,except 1 case death,when admitted to hospital less than 4 hours.Conclusions Tsutsugamushi disease is acute infectious diseases and a serious threat to children' s health,and it is easy to cause multiple organ damage and concurrent encephalitis.Basic-level hospitals easily misdiagnosis because of lack of awareness of the disease.Eschar is the most significant for diagnosis of tsutsugarmushi disease.Doxycycline tablets is effective drug to treat tsutsugamushi disease,it is the key to early diagnosis and treatment to reduce tsutsugamushi disease complicated with multiple organ damage and mortality.
