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目的对黑热病病例复发和死亡进行临床分折,探讨复发与死亡的主要原因。方法收集和整理全省历年黑热病疫情报告、各级卫生医疗机构诊治复发与死亡病例的病历记录资料,进行核对、整理和统计。结果全省1985-1991年采用传统锑剂用法,诊治423例,平均复发率和死亡率分别为14.66%、5.67%;1992-2009年增加锑剂用量,诊治638例,平均复发率和死亡率分别降为6.58%、1.88%。结论黑热病复发与发病地区、职业、年龄、病程长短、并发症和锑剂用量及用法等有关;对病例加大锑剂用量,改传统用药为按不同公斤体重增大锑剂总剂量给药可降低复发率。复发病例加大锑剂剂量治疗仍有效,对复发1次的治愈率可达79.81%。死亡与复发次数、并发症多少和误诊以及患者经济困难有关。
Objective To analyze the clinical recurrence and death of kala-azar patients and discuss the main causes of recurrence and death. Methods Collecting and arranging the records of epidemic situation of kala-azar in the whole province in past years, records of medical records of the recurrence and death of cases diagnosed by medical institutions at all levels, and checking, sorting and statistics. Results The province from 1985 to 1991 using traditional antimony agent usage, diagnosis and treatment of 423 cases, the average recurrence rate and mortality were 14.66%, 5.67%; 1992-2009 to increase the amount of antimony agent, diagnosis and treatment of 638 cases, the average recurrence rate and mortality Down to 6.58% and 1.88% respectively. Conclusions The recurrence of kala azar is related to the area, occupation, age, duration of disease, complications and dosage of antimony agent, usage and so on. The dosage of antimony agent is added to the cases and the traditional medicine is used to increase the total antimony dose by different kilogram body weight Reduce the recurrence rate. Recurrence cases to increase antimony dose treatment is still valid, the recurrence of a cure rate up to 79.81%. The number of deaths and relapses, the number of complications and misdiagnosis and the patient’s financial difficulties.