CAJ | 학술논문

目的：分析登革热近年流行特点及误漏诊原因,以提高不典型病例的早期诊断率。方法回顾性分析我院2014年9—11月收治登革热67例的临床资料。结果67例中20例(29.9%)合并有基础疾病,18例(26.9%)有既往病史,入院时病程(3.9±1.6) d,大多病例在发热同时伴肌痛、头痛、疲乏及肝功能异常等典型表现,46例(68．7%)出现明显的消化道症状,17例(25.4%)以呼吸道症状为首发症状。本组首诊误诊14例(20.9%),分别误诊为上呼吸道感染、胃肠炎、胆道感染、肝炎,漏诊1例。本组均符合登革热诊断标准( WS216-2008),给予综合治疗后均痊愈,无死亡病例。结论登革热流行季节,对于发热伴有非特异性消化道、上呼吸道症状等患者,应考虑到登革热可能,并需注意合并感染的可能,避免误漏诊。
목적：분석등혁열근년류행특점급오루진원인,이제고불전형병례적조기진단솔。방법회고성분석아원2014년9—11월수치등혁열67례적림상자료。결과67례중20례(29.9%)합병유기출질병,18례(26.9%)유기왕병사,입원시병정(3.9±1.6) d,대다병례재발열동시반기통、두통、피핍급간공능이상등전형표현,46례(68．7%)출현명현적소화도증상,17례(25.4%)이호흡도증상위수발증상。본조수진오진14례(20.9%),분별오진위상호흡도감염、위장염、담도감염、간염,루진1례。본조균부합등혁열진단표준( WS216-2008),급여종합치료후균전유,무사망병례。결론등혁열류행계절,대우발열반유비특이성소화도、상호흡도증상등환자,응고필도등혁열가능,병수주의합병감염적가능,피면오루진。
Objective To analyze clinical characteristics and the causes of diagnostic errors of Dengue Fever in re-cent years. It is of great significance to improve the initial diagnostic rate of Dengue Fever with atypical symptoms. Methods The clinical data of the patients of Dengue Fever treated in Chancheng District Hospital of Foshan during September and December 2014 were collected and analyzed. Results 20 out of 67 cases (29. 9%)were complicated with existing physical illnesses and 18 cases (26. 9%) with past medical history. The patients visited doctors within (3. 9 ±1. 6)d after symptoms occurred. Muscle pain, headache, extreme fatigue and abnormal liver function were typical symptoms in most of the cases, 68. 7% of all the patients came with obvious gastrointestinal symptoms, and 25. 4% of them complained about respiratory symptoms. There were 14 cases (20. 9%) initially misdiagnosed as upper respiratory tract infection, gastroenteritis, cholangitis and hepatitis. One case missed diagnosis. All the patients complained of WS216-2008 diagnostic standard of Dengue Fever and completely recovered after comprehensive treatment with no mortality. Conclusion In the epidemic season of Dengue Fever, we should pay more attention to the pyretic patients with non-specific symptoms of digestive tract or respiratory tract for possible Dengue Fever and to avoid co-infection and prevent misdiagnosis and missed diagnosis.