CAJ | 학술논문

恙虫病是一种自然疫源性疾病，流行有明显的季节性和地区性，多为散发病例，临床特征表现为溃疡和焦痂，但部位隐蔽，因可发生多脏器功能衰竭，临床表现多样化，故临床易误漏诊。对2005—2012年中国误诊疾病数据库收录的117篇恙虫病误诊文献进行分析，总误诊病例数2888例，共误诊81种疾病，居前5位的是上呼吸道感染、肺炎、伤寒、支气管炎和肾综合征出血热；误诊原因以“经验不足，缺乏对恙虫病的认识”和“问诊及体格检查不细致”并列位居首位。通过加强流行地区人口的卫生宣教工作、提高医师对该病的认识、重视病史询问和仔细体格检查、注意鉴别诊断等可减少发病和防止误漏诊的发生。
양충병시일충자연역원성질병，류행유명현적계절성화지구성，다위산발병례，림상특정표현위궤양화초가，단부위은폐，인가발생다장기공능쇠갈，림상표현다양화，고림상역오루진。대2005—2012년중국오진질병수거고수록적117편양충병오진문헌진행분석，총오진병례수2888례，공오진81충질병，거전5위적시상호흡도감염、폐염、상한、지기관염화신종합정출혈열；오진원인이“경험불족，결핍대양충병적인식”화“문진급체격검사불세치”병렬위거수위。통과가강류행지구인구적위생선교공작、제고의사대해병적인식、중시병사순문화자세체격검사、주의감별진단등가감소발병화방지오루진적발생。
Objective Tsutsugamushi disease or Scrub typhus is a natural focus disease. The prevalence of Tsutsuga-mushi disease is obviously seasonal and local, and sporadic. Although the eschars or ulcers or ulcers are characteristic, they are often hidden in the shelter areas of the body, and the clinical manifestations of Tsutsugamushi disease are complex and di-verse. Thus it easily results in misdiagnosis and missing diagnosis, leading to multiple organ dysfunction syndrome ( MODS) . We analyzed 117 misdiagnosis literatures of tsutsugamushi disease in the misdiagnosed disease database of China from 2005 to 2012. In result, the total number of the misdiagnosis of tsutsugamushi disease was 2888, which included 81 kinds of disease, among the top five of the misdiagnosis were the upper respiratory tract infection, pneumonia, typhoid, bronchitis and hemor-rhagic fever with renal syndrome. The first causes of misdiagnosis were inexperience, lack of awareness of tsutsugamushi dis-ease and interrogation, carelessness in physical examination. Strengthening the health education in population in endemic are-as, increasing the awareness of tsutsugamushi disease in physician, being careful to history and physical examination, and paying attention to differential diagnosis are the necessary to reduce the incidence of tsutsugamushi disease and prevent the misdiagnosis and missing diagnosis.