恙虫病致肺损害46例临床分析

目的：总结本地恙虫病的发病规律及其肺部损害的特点。方法：统计1998年1月至2000年12月住本院的恙虫病致肺损害病人46例资料，寻找其临床特点。结果：5－9月为发病高峰期。所有病例均有高热。咳嗽者30例（65．2％），伴咳痰者12例（26％），重症者有气促、紫绀。有 肺部罗音的26例（56．5％）。X线胸片表现为两肺纹理增粗、模糊的22例（47．8％），支气管肺炎样改变的18例（39％）。伴多器官损害的8例，7例治愈，死亡1例，死于ARDS。入本院前误诊率100％，到本院2d内未确诊者32．6％。结论：近3年本院恙虫病收住率是前3年的4．2倍，重症病例多，伴肺部损害多。延误治疗可引起死亡，应认清其特点，引起重视。

Clinical feature of 46 cases of pulmonary damage caused by scrub typhus

Objective To sumerize clinical nature and features of pulmonary damage caused by scrub typhus in Zhaoqing areas.Methods 48 cases of pulmonary damage caused by scrub typhus from Jan.1998 to Dec.2000 were reviewed in order to find the clinical features.Results The incidence of scrub typhus was the highest between May to September.All cases showed high fever,in which 30 cases(65.2%) had cough,12 cases(26%) had sputum,in severe cases accompanied hyspnea and cyanosis.26 cases(56.5%) had rales.Chest X-rays:22 cases showed blur and increase of lung markings,18 cases showed bronchopneumonia lesion.8 cases accompanied multi-organ damage,7 cases of which were cured,1 case died of ARDS.Misdiagnosis rate was 100% before hospitalization,and 32.6% could not be diagnosed correctly within two days after hospitalization.Conclusion The hospitalized scrub typhus cases in recent three years were 4.2 times higher than those in past three years.Severe cases and patients pulmonary damage increase.Delay treatment may cause death,which should be emphesized.