摘要
目的调查2014~2018年我院不完全川崎病确诊情况,进一步分析患者的临床资料、实验室检查结果及误诊情况。方法回顾性分析2014年1月~2018年12月甘肃省妇幼保健院不完全川崎病诊断情况(10天内确诊),评估误诊率,收集确诊患者的临床表现及实验室检查结果。结果 2014~2016年我院不完全川崎病诊断例数较少,最高仅为23.07%,且误诊率较高;2017~2018年该院确诊率最高达85.71%;不完全川崎病主要临床表现有发热、结膜非渗出性充血、口唇潮红、卡介苗接种处红斑、多形性皮疹、甲床移行处膜状脱皮及淋巴结肿大;次要临床表现以易激惹、烦躁及消化系统症状为主;实验室指标以C-反应蛋白升高最为常见,其次还包括血沉、白细胞计数升高。结论 2014~2016年该院不完全川崎病误诊率较高,2017年后有较大改善。另外,该病主要表现以发热为主,应充分认识其临床特征,尽早行相关实验室检查,做到早诊断、早治疗。
Objective To investigate the incomplete diagnosis of Kawasaki disease in our hospital from 2014 to 2018,and to further analyze the clinical data,laboratory test results and misdiagnosis of patients.Methods A retrospective analysis of the incomplete diagnosis of Kawasaki disease in Gansu Maternity and Child Health Hospital from January 2014 to December 2018(diagnosed within 10 days)was performed to assess the misdiagnosis rate,and collect the clinical manifestations and laboratory test results of confirmed patients.Results The number of diagnosed cases of incomplete Kawasaki disease in this hospital from 2014 to 2016 was small,the highest was only 23.07%,and the misdiagnosis rate was high;from 2017 to 2018,the highest diagnosis rate in this hospital was 85.71%;The main clinical manifestations of incomplete Kawasaki disease include fever,non-exudative conjunctival hyperemia,lip flushing,erythema at the BCG vaccination site,polymorphic skin rash,membranous peeling at the transition of the nail bed,and lymphadenopathy;secondary clinical manifestations are irritable,Irritability and digestive system symptoms;the most common laboratory indicators are elevated C-reactive protein,followed by elevated erythrocyte sedimentation rate and white blood cell count.Conclusion The misdiagnosis rate of incomplete Kawasaki disease was high in this hospital from 2014 to 2016,and it has improved significantly after 2017.In addition,the main manifestation of the disease is fever,and its clinical features should be fully understood,and relevant laboratory tests should be performed as soon as possible to achieve early diagnosis and early treatment.
作者
张伟
王莉
朱生东
张贵斌
ZHANG Wei;WANG Li;ZHU Sheng-dong;ZHANG Gui-bin(Department of Pediatric Comprehensive Internal Medicine,Gansu Provincial Maternal and Child Health Hospital,Lanzhou 730050,Gansu,China)
出处
《医学信息》
2021年第2期149-151,共3页
Journal of Medical Information
基金
甘肃省卫生行业项目(编号:GSWSKY-2019-11)。
关键词
不完全川崎病
临床特点
发热
Incomplete Kawasaki disease
Clinical features
Fever
