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目的分析和总结恙虫病并多脏器损害的临床特点及误诊情况,以提高其早期诊断和治愈率。方法对1998年5月-2009年5月收治的恙虫病并发多脏器损害46例患者的临床资料,实验室检查、治疗等资料进行回顾性分析。结果患者最常受损的器官有肝、肺、心脏、肾脏、血液系统,损害率为69.57%、56.32%、47.83%、43.48%、15.22%。全部病例均用氯霉素治疗,治疗后体温降至正常的时间为3-10天,脏器损害可于3-6周恢复。治疗效果显著,治愈43例,治愈率为93.48%,死亡2例,病死率为4.35%。5例无焦痂及溃疡。10例外-斐氏反应为阴性。本组误诊33例,误诊率为71.74%。结论恙虫病并发多脏器损害常见、易误诊。如能早期诊断和及时治疗,疗效显著。
Objective To analyze and summarize the clinical features and misdiagnosis status of scrub typhus and multiple organ damage in order to improve its early diagnosis and cure rate. Methods The clinical data, laboratory tests and treatment of 46 cases of scrub typhus complicated with multiple organ diseases admitted from May 1998 to May 2009 were analyzed retrospectively. Results The most damaged organs of patients were liver, lung, heart, kidney and blood system. The damage rates were 69.57%, 56.32%, 47.83%, 43.48% and 15.22% respectively. All cases were treated with chloramphenicol, body temperature dropped to normal after treatment for 3-10 days, organ damage can be recovered in 3-6 weeks. The curative effect was remarkable, 43 cases were cured, the cure rate was 93.48%, 2 died and the case fatality rate was 4.35%. 5 cases without eschar and ulcer. 10 exceptions - Fijian reaction was negative. The group misdiagnosed 33 cases, misdiagnosis rate was 71.74%. Conclusion scrub typhus complicated by multiple organ damage common, easily misdiagnosed. If early diagnosis and timely treatment, the effect is significant.