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布氏桿菌病146例臨床分析

發(fā)布時間:2018-03-22 19:57

  本文選題:布氏桿菌病 切入點:體征和癥狀 出處:《新疆醫(yī)科大學》2013年碩士論文 論文類型:學位論文


【摘要】:目的:布氏桿菌病是一種由布氏桿菌引起的人畜共患傳染病。世界各地均有分布,但以發(fā)展中國家高發(fā)[1]。探討新疆地區(qū)布氏桿菌病的流行情況、臨床癥狀、體征、相關(guān)檢查及治療結(jié)果。方法:對新疆醫(yī)科大學第一附屬醫(yī)院2005年1月—2012年7月146例布病住院患者進行回顧性分析。結(jié)果:收集的146例布病患者平均年齡為41.6±14.2歲,其中80.1%為男性(男:女=4.03:1)。本地區(qū)布病4-8月高發(fā);發(fā)病地區(qū)主要為塔城、阿勒泰等農(nóng)牧區(qū)為主。在此患者中73例有明確的接觸牛羊史(50%)。臨床表現(xiàn)以發(fā)熱為主(97.3%),同時伴有大汗(39.7%),肌肉骨關(guān)節(jié)疼痛(34.2%),部分患者查體可有脾腫大(28.8%)、肝腫大(14.4%),淋巴結(jié)腫大(11.6%)。實驗室檢查缺乏特異性。部分出現(xiàn)血沉(80.9%)、C-反應蛋白(83.7%)、類風濕因子(62.5%)等升高。在出現(xiàn)并發(fā)癥患者中,降鈣素原有不同程度的升高。治療主要用福平+多西環(huán)素,利福平+喹酮類聯(lián)合治療為主,,1個療程(6周)治愈率97.6%。治療效果在不同年齡組及不同民族患者中無明顯差別。結(jié)論:布氏桿菌病發(fā)病率逐年升高,新疆為高發(fā)地區(qū),在診治“不明原因發(fā)熱”患者時應考慮該疾病的可能,并詳細詢問流行病學史,可提高診斷率,合理規(guī)范抗菌治療。
[Abstract]:Objective: brucellosis is a zoonotic infectious disease caused by brucellosis. Methods: 146 inpatients with brucellosis were retrospectively analyzed from January 2005 to July 2012 in the first affiliated Hospital of Xinjiang Medical University. Results: the average age of 146 patients with brucellosis was 41.6 鹵14.2 years old. Of these, 80.1% were male (male: female 4.03: 1). The incidence of brucellosis in this area was high from April to August, and the main area of the disease was Tacheng. Altay and other farming and pastoral areas are the main. 73 cases of this patient have clear contact with cattle and sheep history. The clinical manifestation is fever as the main part, accompanied by 39. 7%, muscle and bone pain, muscle and bone pain, muscle bone and joint pain, some patients can have splenomegaly 28. 8 points, hepatomegaly 14.4m, lymphoid swelling 14. 4%, lymphoid. No specificity was found in laboratory tests. Some of the patients with ESR 80.9 or 83.7A, rheumatoid factor 62.5 were found to have increased ESR in the patients with complications, and in the patients with complications, some of them were found to have increased erythrocyte sedimentation rate (ESR) 83.7g, rheumatoid factor (rheumatoid factor 62.5g) and so on. Increased calcitonin in different degrees. Treatment with Fupin doxycycline, The cure rate was 97.60.There was no significant difference in the curative effect among patients of different ages and nationalities. Conclusion: the incidence of brucellosis is increasing year by year and Xinjiang is a high incidence area. The possibility of this disease should be considered in the diagnosis and treatment of "fever of unknown origin", and the epidemiological history should be inquired in detail, which can improve the diagnostic rate and reasonably standardize the antibacterial treatment.
【學位授予單位】:新疆醫(yī)科大學
【學位級別】:碩士
【學位授予年份】:2013
【分類號】:R516.7

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