CAJ | 학술논문

目的：掌握恙虫病的流行和临床特征，为提出有效的预防控制和诊治措施提供依据。方法收集2009～2011年临床诊断治疗的恙虫病病例，Excel软件建立相关数据库并进行整理分析。结果共收集3年间临床诊治恙虫病病例66例，63例（95.5％）发生于夏秋季7～10月，呈现明显的季节相关性；各年龄段人群普遍易感，农民为高发人群（占57.6％）。临床症状突出表现为高热或超高热（86.4％），多位于身体隐蔽部位的特征性焦痂或溃疡（74.2％），可同时存在多器官功能损害，肝功能损害44例（66.7％），心肌酶谱异常15例（22.7％），肺部感染24例（36.4％）。早期检测外斐氏试验阳性率较低（26.8％）。氯霉素、四环素类、大环内酯类和喹诺酮类抗生素单用或联合使用对恙虫病有效。结论恙虫病发病有明显的季节性，预防重点应是夏秋季的农村地区，争取早期诊断并使用敏感抗生素治疗可有效控制恙虫病病情。
목적：장악양충병적류행화림상특정，위제출유효적예방공제화진치조시제공의거。방법수집2009～2011년림상진단치료적양충병병례，Excel연건건립상관수거고병진행정리분석。결과공수집3년간림상진치양충병병례66례，63례（95.5％）발생우하추계7～10월，정현명현적계절상관성；각년령단인군보편역감，농민위고발인군（점57.6％）。림상증상돌출표현위고열혹초고열（86.4％），다위우신체은폐부위적특정성초가혹궤양（74.2％），가동시존재다기관공능손해，간공능손해44례（66.7％），심기매보이상15례（22.7％），폐부감염24례（36.4％）。조기검측외비씨시험양성솔교저（26.8％）。록매소、사배소류、대배내지류화규낙동류항생소단용혹연합사용대양충병유효。결론양충병발병유명현적계절성，예방중점응시하추계적농촌지구，쟁취조기진단병사용민감항생소치료가유효공제양충병병정。
Objective To clarify the characteristic of prevalence and clinical features of scrub typhus in Xiangyun , Yunnan Province , and propose effective measures for prevention , diagnosis and treatment.Methods Scrub typhus cases from 2009 to 2011 in Xiangyun people′s Hospital were collected , relevant databases were established and analyzed by Excel software.Results 66 scrub typhus cases were collected in three years , 63 cases( 95.5%) occurred in the sum-mer and autumn from July to October , showing a clear correlation with the season;all age groups was generally suscepti-ble to scrub typhus , the farmers was high -risk population ( accounting for 57.6%). Prominent clinical symptoms of high fever (86.4%), characteristic eschar or ulcer almost in hidden parts of the body (74.2%), and multiple organ dysfunction including liver dysfunction in 44 cases (66.7%), myocardial enzymes abnormalities in 15 cases (22.7%), pulmonary infection in 24 patients (36.4%) were found.The positive rate of Weil -Felix test was low at the onset of this disease (26.8%).Chloramphenicol , tetracyclines, macrolides and quinolones used alone or in combination with were effective on scrub typhus.Conclusions Obvious seasonal characteristics of scrub typhus were found in Xiangyun , prevention should focus on rural areas in summer and autumn , strive for early diagnosis and sensitive antibiotic treatment can effectively control this disease.