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目的总结恙虫病的新特点和诊断、治疗经验。方法随机抽取恙虫病111例,包括普通型97例,重型14例,对流行病学及临床资料进行回顾性分析。结果 5~9月间发病者占78.4%(87/111),有明显的季节性;>60岁占39.6%(44/111),22.5%(25/111)出现3个以上器官损害,其中有48%(12/25)年龄>60岁;住院时间与退热时间、白蛋白之间差异有统计学意义(P<0.05);重型组白蛋白、血小板、退热时间、丙氨酸氨基转移酶、白细胞水平较普通型组差异有统计学意义(P<0.05);不同抗感染药物组的退热时间、住院时间有显著差异,治愈率无差异;氯霉素组35.7%(25/70)出现粒细胞减少,其它组无明显不良反应。结论恙虫病发病呈高龄化,临床表现趋向多样化、复杂化;白蛋白、血小板、退热时间、丙氨酸氨基转移酶、白细胞水平与病情的严重程度有关;氯霉素、多西环素序贯治疗效果好且副作用少。
Objective To summarize the new features of scrub typhus and its diagnosis and treatment experience. Methods 111 cases of tsutsugamushi were randomly selected, including 97 cases of common type and 14 cases of heavy type. The epidemiological and clinical data were retrospectively analyzed. Results The incidence rate was 78.4% (87/111) between May and September, with a clear seasonal distribution. The prevalence was 39.6% (44/111) in> 60 years and more than 3 organs were found in 22.5% (25/111) 48% (12/25) of patients were older than 60 years old. There was a significant difference in albumin between hospital stay and antipyretic time (P <0.05). Serum albumin, platelets, antipyretic time, (P <0.05). The antipyretic time and hospitalization time of different anti-infective drugs groups were significantly different, and there was no difference in the cure rate. Among the chloramphenicol groups, 35.7% (25 / 70) showed neutropenia, no significant adverse reactions in other groups. Conclusion The incidence of tsutsugamushi disease is aging, the clinical manifestations tend to be diversified and complicated. The albumin, platelets, antipyretic time, alanine aminotransferase and leukocyte levels are related to the severity of the disease. Chloramphenicol, doxycycline Sequential treatment effect and less side effects.