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目的:分析钩端螺旋体病的临床特点,进一步提高对该病的临床认知和处理能力。方法:选取2000年1月至2013年12月我院收治住院的钩端螺旋体病356例患者,对其临床表现及诊断治疗情况综合分析。结果:所有患者的症状与体征有发热、全身酸痛、乏力、食欲差、头痛等表现。临床分型包括流感伤寒型303例(85.1%),黄疸出血型35例(9.8%),肺出血型8例(2.2%),脑膜脑炎型8例(2.2%),肾功能衰竭型2例(0.6%);356例病例均明确诊断,治疗仍以青霉素G钠为主,治疗好转出院354例(99.4%),死亡2例(0.6%),发生赫氏反应18例(5.6%);结论:我县钩端螺旋体仍以流感伤寒型为主,其他型亦可见,抗病原治疗仍以青霉素G钠为主,但应注意防范赫氏反应,减少医患纠纷。
OBJECTIVE: To analyze the clinical features of leptospirosis and further improve the clinical cognition and handling ability of the disease. Methods: From January 2000 to December 2013, 356 cases of leptospirosis hospitalized in our hospital were selected for comprehensive analysis of their clinical manifestations and diagnosis and treatment. Results: All patients had symptoms and signs of fever, body aches, fatigue, poor appetite, headache and other performance. Clinical typing included 303 cases of influenza typhoid (85.1%), 35 cases (9.8%) of hemorrhagic jaundice, 8 cases of pulmonary hemorrhage (2.2%), 8 cases of meningoencephalitis (2.2%) and 2 cases of renal failure 354 cases (99.4%) were discharged, 2 died (0.6%) and 18 cases (5.6%) had Hemorrhagic reaction. Among them, 356 cases were diagnosed with penicillin G sodium, Conclusion: Mycobacterium tuberculosis is still predominant in the epidemic of typhoid fever in our county. Other types are also seen. The anti-pathogenic treatment is still dominated by penicillin G sodium, but care should be taken to prevent Heath reaction and reduce disputes between doctors and patients.