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1990～1994年我们收治流行性出血热(EHF)病人200例,现结合资料对其早期诊断体会介绍如下。 一般资料:本组年龄8～60岁,病程平均4.2天。临床分型为轻型19例,中型124例,重及危重型57例。死亡4例,病死率为2％。主要临床表现为发热195例,五痛(头、眼、腹、腰、全身)191例,醉酒貌126例;胸前、腋下、背部呈条索状抓痕或大片淤斑样出血点,轻者为数个散在,中度者呈簇状,重度者融合成片状破溃或血疱。面部浮肿、球结膜水肿178例,尿少或尿闭173例,低血压110例,意识朦胧、烦躁不安、抽搐、精神症状52例。本组28例呈典型五期经过,越期型(缺少低血压期)112例,重叠期型(发热、低血压、少尿三期重叠)60例。血清学检查190例,EHF-IgM均阳性,其中急性期164例,急性期阴性而恢复期阳性26例。血常规示白细胞4～40×10~0/L,血小板20～90×10~0;尿常规示蛋白+～++++,BUN5.4～43.65mmol/L。
From 1990 to 1994, we treated 200 cases of epidemic hemorrhagic fever (EHF) patients, now combined with the information on its early diagnosis experience described below. General information: The group aged 8 to 60 years old, average duration of 4.2 days. Clinical classification of mild in 19 cases, 124 cases of medium, heavy and critically ill in 57 cases. 4 died, the case fatality rate was 2%. The main clinical manifestations of fever in 195 cases, five pain (head, eyes, abdomen, waist, body) 191 cases, 126 cases of drunken appearance; chest, underarm, back was a cord-like scratches or large ecchymosis-like bleeding points, The light for a few scattered, moderate were clustered, severe fusion into flaky ulcer or blood blisters. Facial edema, conjunctival edema in 178 cases, oliguria or urinary tract obstruction in 173 cases, 110 cases of hypotension, hypnosis, irritability, convulsions, psychiatric symptoms in 52 cases. The group of 28 cases were typical of the past five, 112 cases of overdose type (lack of hypotension), overlap type (fever, hypotension, oliguria three overlapping) 60 cases. Serological tests of 190 cases, EHF-IgM were positive, of which 164 cases of acute phase, acute negative and convalescent 26 cases. Blood shows white blood cells 4 ~ 40 × 10 ~ 0 / L, platelets 20 ~ 90 × 10 ~ 0; urinary routine protein + ~ ++++, BUN5.4 ~ 43.65mmol / L.