62例小儿恙虫病临床特点及治疗分析

目的探讨小儿恙虫病临床特点，提高对小儿恙虫病的诊断及救治水平。方法回顾性分析了昆明市儿童医院2008年1月至2011年6月的62例恙虫病住院患儿的临床资料、治疗及转归情况。结果全部患儿均有发热、焦痂或溃疡，35例并发脑炎，29例出现肺炎，5例肺水肿的改变，41例血小板减少，31例白细胞总数升高，60例C反应蛋白升高。全部病例给予盐酸多西环素片及保护重要器官治疗，3例行机械辅助通气治疗，2例因多器官功能衰竭死亡，其余病例全部治愈。结论小儿恙虫病的临床表现形式多样，以发热、焦痂或溃疡为特征，早期发现、早期诊断、早期治疗，避免发展为严重恙虫病，引起严重并发症或者死亡。盐酸多西环素是治疗恙虫病的有效药物。

Clinical characteristics and treatment analysis of 62 children with tsutsugamushi disease

Objective To explore the clinical characteristics of children with tsutsugamushi disease and improve the diagnosis and treatment of tsutsugamushi disease. Methods The clinical data, treatment and outcome of 62 hospitalized patients with tsutsugamushi disease from January 2008 to June 2011 in our hospital were analyzed retrospectively. Results All patients had fever, eschar or ulcer, 35 cases complicated with encephalitis, 29 cases with pneumonia, 5 cases with pulmonary edema, 41 cases with thrombocytopenia, 31 patients with elevated WBC, 60 cases with C-reactive protein elevation. All cases were given doxycycline hydrochloride tablets and protect vital organs treatment, 3 cases with mechanical ventilation therapy. Two cases with multiple organ functional failure were dead, and the others were cured. Conclusions The clinical manifestations of children with tsutsugamushi disease are diverse. The main feature are fever, eschar or ulcer. Early detection, early diagnosis and early treatment can avoid serious tsutsugamushi disease and result in severe complications or death. Doxycycline hydrochloride is the effective drug for treatment of tsutsugamnshi disease.