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我院曾收治肾综合征出血热142例,由于部分患者发病早期症状体征不典型,三红征、三痛症,皮肤及粘膜出血点,球结膜充血水肿,肾区叩痛等症状体征不明显,以致首诊误诊12例,误诊率8.5％。12例中误诊为呼吸道感染5例,急性肾炎及急性胆囊炎各2例,急性黄疸型肝炎、急性细菌性痢疾、急性心肌炎各1例。肾综合征出血热临床表现复杂多样,发病早期由于临床症状不典型或仅表现某系统症状酷似其他疾病,或询问病史不够详细,体检不细致,对辅诊检查结果缺乏全面分析而造成误诊。尤其对软腭粘膜出血点,尿蛋白及血小板计数追综观察不够而误诊。因此,临床医师必须熟练掌握肾综合征出血热的早期临床特征。对于非典型病例,应动态观察,反复检查血、尿常规,血小板计
Our hospital had received 142 cases of hemorrhagic fever with renal syndrome, as some patients with early onset of symptoms and signs of atypical, three red sign, three pains, skin and mucosal bleeding, conjunctival hyperemia and edema, peritoneal nephropathy and other symptoms and signs were not obvious , Resulting in the first diagnosis of misdiagnosis in 12 cases, misdiagnosis rate of 8.5%. 12 cases were misdiagnosed as respiratory tract infection in 5 cases, acute nephritis and acute cholecystitis in 2 cases, acute jaundice hepatitis, acute bacillary dysentery, acute myocarditis in 1 case. Clinical manifestations of hemorrhagic fever with renal syndrome complicated and diverse, early onset due to clinical symptoms or atypical symptoms of only a system resembles other diseases, or ask the history is not detailed enough, physical examination is not detailed, a lack of comprehensive analysis of the results of the diagnosis of misdiagnosis. Especially for soft palate mucosal bleeding, urinary protein and platelet count chase comprehensive observation is not enough and misdiagnosed. Therefore, clinicians must be familiar with the early clinical features of hemorrhagic fever with renal syndrome. For atypical cases, should be dynamic observation, repeated examination of blood, urine, platelet