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1.
李莉  傅瑜  贺伟  王丽萍 《临床肺科杂志》2011,16(9):1401-1403
目的通过对老年结核性胸膜炎的临床症状、合并症、实验室检查、影像检查、延误诊情况进行分析,探讨老年结核性胸膜炎临床发病特点。方法对62例年龄在60岁及以上的结核性胸膜炎患者的临床资料进行分析。结果①临床症状不典型,以纳差、咳嗽咳痰及痰中带血较常见,与对照组比较P〈0.05。②合并症多,占87.7%,以心脑血管病最多见。③实验室检查无特异性。④胸部CT提示:胸膜粘连、肥厚明显,占58.1%。⑤就诊延误率达87.1%,就诊时间超过30天者明显高于对照组。结论掌握老年结核性胸膜炎临床发病特点,早期诊断,减少误诊,提高防治效果。  相似文献   

2.
目的 为了解廊坊市2010~2012 年手足口病疫情特点,分析流行因素及流行病学规律,为防控措施提供依据.方法 用描述流行病学方法对廊坊市2010~-2012 年手足口病疫情资料进行分析.结果 2010~2012 年累计报告手足口病16 306 例,其中临床诊断病例15 445 例,实验室诊断病例861 例,重症445 例,死亡8 例.年均发病率为129.22/10 万,2010~2012 年发病率分别为188.74/10 万、81.79/10万、117.14/10 万.发病数性别比为1.56 颐1,发病年龄以5 岁以下儿童为主,占病例总数的88.90%.散居儿童和托幼机构内儿童分别占75.07%和20.22%.发病时间以4~8 月为高峰,占病例总数的85.73%.实验室诊断病例中,病原为EV71 型占48.66%,Cox A16 型占32.29%.结论 2010~2012 年廊坊市手足口病分布有明显的地区、季节、人群集中特征,同时存在EV71 和Cox A16 感染,在监测和防控工作中应根据其流行特点,制订科学规范的防控预案.  相似文献   

3.
作者为探讨某些临床症状的诊断价值和查明肺结核、慢性肺炎和肺癌的误诊原因,对477例患者进行了分析。经临床、X线、实验室、器械检查和部分患者结合病理组织形态学检查,诊断为肺结核220例(占46.2%),慢性肺炎202例(占42.3%)和肺癌55例(占11.5%)。上述三种疾病均以男性患者较多,特别是胚细胞瘤忠者,男性达81.1%。肺结核和慢性肺炎  相似文献   

4.
目的分析2004~2013年7月全国疟疾发病趋势和规律,为消除疟疾工作的开展提供依据。方法利用中国疾病预防控制中心疾病监测信息报告管理系统(网络直报系统)以及全国疾病控制调查制度《疟疾防治工作调查表》(年报系统),收集2004~2013年7月全国疟疾疫情数据资料,用Excel 2010软件进行统计分析。结果 2004~2013年7月,网络直报系统共报告疟疾病例241 430例,其中间日疟、恶性疟和未分型病例分别占76.54%、8.33%和15.13%;患者以男性青壮年为主;主要分布在安徽(占45.16%)、云南(占22.26%)、海南(占9.68%)、河南(占8.16%)和湖北(占4.28%)五省;临床诊断病例和实验室确诊病例分别占33.02%和66.98%;死亡病例235例,其中恶性疟占87.66%;2004~2012年,全国年报系统共报告本地感染病例204 613例和输入性病例47 439例,分别占81.18%和18.82%;2013年1~7月,全国网络直报系统共报告疟疾病例2 987例,其中临床诊断病例占0.87%,恶性疟病例占74.89%,本地感染病例仅34例。结论全国疟疾疫情已得到有效控制,但输入性疟疾尤其是输入性恶性疟所占比例呈大幅度上升趋势。  相似文献   

5.
目的通过分析2004-2015年新疆输入性疟疾疫情,掌握其流行病学特征。方法收集2004-2015年新疆报告的疟疾病例个案调查表信息和各类疫情报告资料,分析疟疾疫情和病例特征。结果 2004-2015年,新疆共报告疟疾病例77例,均为输入性病例。2004-2009年42例,占54.5%(42/77),其中实验室确诊24例,临床诊断18例。2010-2015年35例,占45.5%(35/77),其中实验室确诊27例,临床诊断8例。77例中,51例为实验室确诊,26例为临床诊断病例。在实验室确诊的51例中,恶性疟18例,间日疟31例,未分型2例。病例中男女比例为6.7∶1,男性高于女性(P0.05)。患者年龄为14~75岁,平均(39.7±13.3)岁。31~40岁年龄组占26.0%(20/77),41~50岁年龄组占24.7%(19/77),各年龄组间差异无统计学意义(P0.05)。从输入来源地分析,非洲输入28例,占总病例数的36.4%(28/77);亚洲(含中国其他省份)输入49例,占63.6%(49/77)。患者自发病到确诊的时间为1~320 d,其中,发病24 h内确诊的仅3例(3.9%),1周以上的59例(76.6%)。自治区级医疗机构报告28例(36.4%),地(州、市)级医疗机构报告例15例(19.5%),疾控机构报告5例(6.5%),其余29例(37.7%)由县级及以下医疗机构报告。所有输入病例均未引起继发二代病例。结论 2004-2015年间新疆输入性疟疾病例多为实验室确诊病例,且主要由医疗机构报告,主要输入源为非洲和亚洲。  相似文献   

6.
林芳  王维  王浩彦 《国际呼吸杂志》2016,(22):1714-1717
目的:分析结节病的不同影像分期与临床特征,提高结节病临床诊断准确率。方法选择2010年2月至2015年12月在我院经病理证实的结节病患者45例,回顾性分析这些患者不同影像分期与临床特征。结果结节病呼吸系统主要症状为咳嗽、咳痰,其次是胸闷,分别占55.6%、48.9%和44.4%。全身症状无特异性,肺外表现常见为外周淋巴结肿大和皮下结节,分别占31.1%和24.4%。实验室检查常见血沉增快而 C 反应蛋白多正常,84.2%患者 BALF 中 CD4/CD8升高(>3.5)。肺CT表现最常见为双肺门对称性淋巴结肿大(55.6%),确诊依赖组织病理学检查。结论提高对肺结节病多系统受累表现的认识,完善并提高辅助检查手段能协助临床诊断,尽可能行组织病理学检查明确诊断,口服激素治疗对多数患者有效。  相似文献   

7.
目的探究分析肺吸虫病合并慢性阻塞性肺病的临床特点。方法选择2013年1月至2019年1月在本院因肺吸虫合并COPD而住院或门诊治疗的患者50例,详细记录患者临床资料,临床表现,相关实验室、影像学及病理学检查,对于血清学中寄生虫抗体谱的检查主要由本市疾病预防控制中心协助完成。结果 50例研究对象中主要以咳嗽、咳痰为主要临床表现,占34.0%,其次分别为气促和发热,均占28.0%;包块占16%;50例研究对象,PaO2低于60 mmHg的患者27例,占54.0%,肺动脉压>35 mmHg的患者19例,占38.0%。肺功能II级以上者26例,占52.0%。血常规检查,白细胞数在(10~20)×10^9/L的患者29例,占58.0%,嗜酸性细胞绝对值在(0.53~17.4)×10^9/L的患者44例,占88.0%。其中血清中肺吸虫抗体阳性者21例,占42%,血沉升高者28例,占56.0%,大便中发现虫卵者1例,占2.0%。结论结合患者饮食习惯、吸烟史及相关特征性临床特点及实验室检查,可以对肺吸虫病合并COPD患者尽可能做到及时诊断,及时治疗,对于提高临床治愈率,改善患者预后及提高生活质量有着重要意义。  相似文献   

8.
目的探讨CT检查在心源性肺水肿诊断中的应用价值。方法回顾性分析2012年3月~2016年2月我院收治的34例心源性肺水肿患者的临床资料,均行肺部CT检查,并对检查结果进行分析。结果本组共纳入34例患者,间质性肺水肿25例(占73.53%),肺泡性肺水肿9例(占26.47%);33例出现胸腔积液(占97.06%),1例无胸腔积液(占2.94%);全部患者均出现心脏外形改变,以左室及左房扩大、左心室明显扩张最为常见。结论心源性肺水肿的CT检查征象明显,且具有特征性表现,提示CT检查在心源性肺水肿的诊断中具有重要的价值,故值得推广。  相似文献   

9.
目的探讨缺血性肠病的临床特点。方法回顾性分析襄阳市中心医院1998—2012年收治的30例缺血性肠病患者的临床特点。结果 30例中,内科保守治疗27例,手术治疗3例,全部治愈无死亡。从临床特点分析,夜间发病者占40%(12例),进食高脂肪食物者20%(6例),口服避孕药者10%(3例),有心脑血管病史者60%(18例),过度劳累者占13.3%(2例),所有患者均有腹痛及血便症状,实验室检查无特异性阳性结果,影像学检查仍为诊断缺血性肠病的主要手段,53.3%(16例)患者结肠镜下表现较为典型。结论具有典型腹痛,血便症状,特别是合并心脑血管病史,夜间发病及进食高脂肪食物者要高度怀疑缺血性肠病的诊断。  相似文献   

10.
老年急性胰腺炎患者临床特征分析   总被引:14,自引:1,他引:13  
目的:探讨老年急性胰腺炎患者的临床特点。方法:回顾性分析我院1993-1999年间住院的老年急性胰腺炎患者病历资料,分别统计发病诱因、临床症状、检查和治疗结果。结果:83例患者共发病107次,其中轻型急性胰腺炎80例次,重症Ⅰ级23例次,重症Ⅱ级4例次;以腹痛为首发症状的占94.4%(101/107),以其他症状为首发表现的上5.6%(6/107);有胆系结石患者占53.0%(44例),仅有胆囊炎而无明确胆系结石患者占7.2%(6例),发病前有进食高脂饮食史者占26.5%(22例),13例急性胰腺炎反复发作的患者中11例有胆系结石;腹部B超和CT检查的阳性诊断率分别为60.5%和72.6%,两者有良好的一致性。结论:老年急性胰腺炎患者症状表现不典型;胆系疾患包括不易被发现的胆系泥沙样结石是其常见的致病原因,尤其是急性复发性胰腺炎的重要原因,高脂饮食或进食过饱是常见的诱因;B超和CT检查是诊断急性胰腺炎的良好辅助手段。  相似文献   

11.
澳门老年登革热患者156例临床分析   总被引:1,自引:0,他引:1  
目的 分析澳门地区老年登革热病患者的临床特点。方法 回顾性分析澳门镜湖医院2001年8~12月间156例老年登革热住院患者的临床资料。结果 老年登革热以发热、疼痛、皮疹为主要临床症状。实验室检查提示白细胞减少,血小板减少、丙氨酸转氨酶升高发生率分别为83.3%和64.7%,较非老年患者的54.9%和27.6%为高。老年组并发症27例(17.4%),较非老年组6例(2.2%)多,差异有显著性(P<0.01) 结论 老年登革热的临床病情较严重,并发症较多。  相似文献   

12.
Dengue fever (DF) and Dengue hemorrhagic fever (DHF) are widespread in Southeast Asia. An outbreak of DF/DHF in Delhi in 2003 started during September, reached its peak in October-November, and lasted until early December. This study describes the clinical and laboratory data of the 185 cases of DF/DHF admitted to Lok Nayak Hospital, New Delhi. The mean age of the patients was 26 +/- 10 years. Fever was present in all the cases with an average duration of fever being 4.5 +/- 1.2 days with headache (61.6%), backache, (57.8%), vomiting (50.8%) and abdominal pain (21%) being the other presenting complaints. Hemorrhagic manifestations in the form of a positive tourniquet test (21%), gum bleeding and epistaxis (40%), hematemesis (22%), skin rashes (20%) and melena (14%) were also observed. Hepatomegaly and splenomegaly were observed in 10% and 5% of cases, respectively. Laboratory investigations revealed thrombocytopenia (with a platelet count of < 100,000/microl) in about 61.39% of cases, Leukopenia (WBC <3,000/mm2) and hemoconcentration (Hct >20% of expected for age and sex) were found in 68% and 52% of the cases, respectively. The mortality rate was 2.7%. Despite widespread measures taken to control outbreaks of DF, it caused major outbreaks. More stringent measures in the form of vector control, improved sanitation and health education are needed to decrease morbidity, mortality and health care costs caused by a preventable disease.  相似文献   

13.
目的 总结登革热(DF)并发肝损伤的临床特点。方法 2019年1~12月广东省第二人民医院收治的70例DF患者,给予DF患者对症处理,给予肝损伤患者甘草酸类护肝、降酶和对症处理。总结分析临床资料,包括血液和血生化指标。结果 在70例DF患者中,主要症状有发热、关节痛、皮疹、腹痛、腹泻、呼吸道和泌尿道感染,外周血白细胞降低者34例,血小板计数降低者35例,血生化异常33例;33例肝功能损伤患者住院时间为(7.1±2.2)天,显著长于37例无肝损伤患者【(5.8±2.0),P<0.05】,70例DF患者经治疗后均治愈出院,无死亡病例;肝损伤与无肝损伤患者外周血白细胞计数无显著性差异(P>0.05),但肝损伤患者血小板计数为(105.0±48.6)×109/L,显著低于无肝损伤组【(156.2±88.7)×109/L,P<0.05】;肝损伤组血生化指标主要表现为血清ALT、AST、GGT、CRP和CK-MB水平轻度升高,但均恢复良好。结论 DF患者可能并发肝损伤,但总体肝损伤程度轻,护肝降酶效果好,恢复快。  相似文献   

14.
Epidemics of Dengue fever (DF) and Dengue hemorrhagic fever (DHF) are common in Southeast Asia. DF is defined & classified according to WHO criteria. Variable clinical manifestations of DF & DHF have been described in earlier studies. But some patients present with unusual clinical features and clinical profile not classifiable according to the present WHO criteria. Some of these complications if not recognized early and treated properly can even prove fatal. So this study was done to describe various clinical features in Dengue fever with special emphasis on unusual manifestations. This study was conducted at University College of Medical Sciences and associated Guru Teg Bahadur hospital; a tertiary care hospital, located in East Delhi in India. It was a retrospective study of 76 patients of probable DF; including 4 cases of DHF (according to WHO classification); 60 males & 16 females above 12 years of age admitted in medical wards of Guru Teg Bahadur hospital in an outbreak of DF which occurred during September-December 2009. The data obtained was analyzed to see clinical and laboratory profile of DF/DHF with special emphasis on unusual manifestations. The mean age of the patients was 28 +/- 9.6 years. Fever was present in all the cases with an average duration of fever being 5.47 +/- 2.2 days with body ache, (84.2%), vomiting (61.8%), abdominal pain (51.3%) and headache (19.7%) being the other presenting complaints. Hemorrhagic manifestations in the form of gum bleeding and epistaxis (35.5%), positive tourniquet test (27.6%); skin rashes (15.8%), melena (15.8%) and hematemesis (5.26%) were also present. In our study a fair no of patients presented with unusual symptoms like pain in abdomen 39 (51.3%), nausea 32 (42.1%), & vomiting 47 (61.8%), which is higher than that reported previous outbreak. Of the 39 patients who presented with abdominal pain; ultrasonography of abdomen was done in 25 patients. Fifteen (38%) of these were found to have acalculous cholecystitis. Amongst the known manifestations of DF, abdominal pain has been well described, but acalculous cholecystitis as a cause of abdominal pain is scantly reported. Another unusual manifestation was the presentation of patients (7.89%) in circulatory failure without the evidence of plasma leakage and not fulfilling all the criterion proposed by WHO for DHF/DSS. All of the above patients had very low platelet counts & tourniquet test was positive in all these six patients. Hepatomegaly and splenomegaly were observed in 34.2% and 7.89% of cases, respectively. Renal dysfunction was observed in 13.1% of cases. Laboratory investigations revealed thrombocytopenia (with a platelet count of < 100,000/microl) in all cases. Leucopenia (WBC < 4,000/mm2) and Hemoconcentration (Hct > 20% of expected for age and sex) were found in 38% and 5.26% of the cases, respectively. Results of our study indicate that apart from usual manifestations, sometimes unusual but clinically extremely important manifestations can occur which if not detected early can prove fatal. So a vigilant and timely approach is warranted.  相似文献   

15.
Objective: To review the management experience of a consecutive series of patients presenting as acute surgical abdomen whom were ultimately diagnosed to have DF(Dengue fever)/ DHF(Dengue heamorrhagic fever),Methods: Clinical data of all cases of apparent acute abdomen(AA) which were later confirmed as having DF/DHF reviewed by two surgical units from December 2012 to December 2013 were analyzed,Initially confirmed patients with DF/DHF who developed abdominal symptoms were not considered,Results: Out of the seventeen cases(7 males,age range 10-71 years) presented with fever and AA; appendicitis,cholecystitis,pancreatitis and non-specific peritonitis were suspected initially in 8,5,1 and 3 cases,respectively,Neutropenia or thrombocytopenia signifying DF/DHF occurred only in 11 patients at first evaluation thus six remained as surgical candidates beyond 24 h,One patient underwent appendicectomy with a prolonged hospital stay,DF was confirmed by serology in all patients,latest by fourth day of admission,One required blood product transfusion,4 needed critical care treatment and there was 1 death,Conclusions: DF/DHF misleads the clinicians when it presents as AA,Initial heamatological and ultrasonographic findings may be equivocal creating a diagnostic and management dilemma,Vigilant clinical suspicion and early dengue serological assessment is advisable in equivocal cases of AAs with fever in dengue endemic areas,to confirm/exclude the infection in order to avoid unnecessary surgical morbidity in the presence of DF.  相似文献   

16.
Dengue fever (DF) with acute acalculous cholecystitis is rarely reported. To investigate the incidence, treatment, and prognosis of acute acalculous cholecystitis in DF patients, we retrospectively studied 10 patients with DF and acute acalculous cholecystitis. From October 2001 to July 2002, 131 patients were diagnosed with DF. Ten of 131 DF patients (7.63%) had complications of acute acalculous cholecystitis. Two patients underwent cholecystectomy and one underwent percutaneous transhepatic gallbladder drainage due to poor resolution of acute acalculous cholecystitis. We found acute acalculous cholecystitis in a small proportion of patients with DF. In our experience, closely monitoring vital signs to avoid shock and correct thrombocytopenia to avoid bleeding could be adequate for most patients. In some cases, surgical treatment may be needed for DF fever patients with complications of diffuse peritonitis.  相似文献   

17.

Background

Thrombocytopenia is a frequent finding among ill returned travellers and may be caused by a large number of different conditions, including infectious diseases specific or typical for tropical and subtropical regions. In order to assess the diagnostic significance of thrombocytopenia we investigated a large cohort of returned travellers.

Methods

This was a comparative study in which data collected on 19,473 returned travellers who consulted the outpatient travel clinic of the the University of Munich Hospital between 1999 and 2009 were analysed. Of these, 732 (3.8%) travellers were diagnosed with thrombocytopenia, and their data were compared with those of the remaining 18,741 travellers with normal platelet counts.

Results

Thrombocytopenia was significantly more frequent among patients with malaria (63%), acute human immunodeficiency virus infection (48%), dengue fever/dengue haemorrhagic fever (DF/DHF; 47%), Epstein?CBarr virus infectious mononucleosis (23%), paratyphoid/typhoid fever (14%), and rickettsiosis (12%). Malaria and DF/DHF caused 25% of all cases of thrombocytopenia (platelet count <140,000/??l) and 75% of all cases of severe thrombocytopenia (platelet count <30,000/??l). Sex, age, country of origin, duration and type of travel were not significantly correlated with thrombocytopenia. The most frequent travel destinations were Asia (42%), Africa (33%), and Latin America (14%). Travellers to Sub-Saharan Africa (high risk for malaria) and to South/South-east Asia (high risk for DF/DHF) had the highest relative risk for thrombocytopenia.

Conclusion

Platelet count among returned travellers is an essential screening parameter, as thrombocytopenia is highly correlated with important infectious diseases, particularly with malaria and DF/DHF.  相似文献   

18.
ObjectivesIn Singapore, dengue primarily affects adults. This study aimed to determine if older dengue patients in Singapore have greater morbidity and mortality.MethodsAll laboratory diagnosed dengue patients admitted to Tan Tock Seng Hospital in 2004 were retrospectively reviewed. Cases were re-classified into dengue fever and dengue hemorrhagic fever based on World Health Organization criteria. Demographic, clinical, laboratory, and outcome data of patients aged ≥60 years and <60 years were collected.ResultsOf 1971 laboratory confirmed dengue cases, 66 were aged ≥60 years. Older patients were significantly less likely to be male (44% vs. 64%), and more likely to have diabetes (17% vs. 2%), hypertension (48% vs. 4%), ischemic heart disease (6% vs. 0.1%), hyperlipidemia (18% vs. 1%), and secondary dengue infections (64% vs. 34%). Clinical features were similar except older patients were significantly less likely to report fever (92% vs. 99%), or have leukopenia (32% vs. 51%) or hemoconcentration (0 vs. 5%) on admission. Older patients had similar dengue hemorrhagic fever, bleeding, hypotension, severe thrombocytopenia, and elevated transaminase rates. Length of hospital stay, risk of intensive care unit admission, and outcome of death were not statistically different.ConclusionsDespite greater co-morbidity and secondary dengue infection, older dengue patients in Singapore did not have greater morbidity or mortality.  相似文献   

19.
Dengue hemorrhagic fever is characterized by the presence of a capillary leak syndrome. Its pathogenesis is presumed to differ from that of classical dengue fever (DF) and to be associated with secondary dengue infection. Returning travelers given a diagnosis of DF were evaluated for capillary leakage with abdominal sonography. Data were compared between travelers with primary/secondary infection defined by epidemiologic and serologic parameters. A total of 12 (34.3%) of 35 patients had sonographic signs of capillary leakage. Most (85%) patients with capillary leakage had classical DF. Capillary leak was diagnosed in 32% of primary dengue cases and in 40% of secondary dengue cases (P = 0.69). The two patients given a diagnosis of dengue hemorrhagic fever had primary infections. The high prevalence of capillary leakage among travelers, most of them with primary exposure to dengue, calls into question the importance of secondary infection in causing capillary leakage in dengue infection.  相似文献   

20.
《Pancreatology》2020,20(8):1631-1636
BackgroundSevere fever with thrombocytopenia syndrome (SFTS), a novel tick-borne disease caused by SFTS virus (SFTSV), has been reported in China, Japan, South Korea, and Vietnam since 2009. SFTSV infection can cause multiple organ damage, including acute pancreatitis (AP). We summarize the clinical features, treatment and outcome of AP associated with SFTSV.MethodsWe retrospectively review the clinical manifestations, laboratory tests, treatment, and outcome of AP associated with SFTSV infection from January 2009 to December 2018 in Liaoning Province, China.ResultsA total of 418 SFTS patients were reviewed. Fifteen (3.6%) of 418 met the criteria for AP associated with SFTSV infection. The first reported symptom for all SFTS-AP patients was fever. All the SFTS-AP patients presented with thrombocytopenia, and 13 (86.7%) of them presented with leukopenia on admission. Thirteen (86.7%) of 15 SFTS-AP patients were severe SFTS patients, and 9 (60.0%) patients were diagnosed with multiple organ dysfunction syndrome. One SFTS-AP patient died of multiple organ failure. Six (40%) of 15 SFTS-AP patients were not confirmed with SFTSV infection when AP was diagnosed, and the median delay between SFTSV infection and AP diagnosis was 5 days (range, 2–7 days).ConclusionsAP is not a frequent complication of SFTS, and is more frequently seen in severe SFTS patients. Most patients with SFTS-AP have mild or moderate disease, and can recover with conservative management; however, severe SFTS-AP can be fatal. In SFTS endemic areas, clinicians should be alert to the possibility of SFTS when AP patients with tick exposure, thrombocytopenia, and leukopenia have a fever before abdominal pain.  相似文献   

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