湖州地区布鲁菌病临床分析

摘要

Objective To analyze the incidence characteristics,clinical diagnosis and treatment of brucellosis in Zhejiang Huzhou. Methods 17 cases of patients were reviewed of brucellosis epidemiological data,clinical manifestations,laboratory examination,treatment and outcome of the situation at all levels of hospital in Huzhou area of Zhejiang province from April 2005 to December 2014.ResultsAll the 17 cases were living in the local area,5 cases were slaughtered sheep,4 cases were selling sheep,1 cases were slaughter sheep and dogs and diet; the other 7 cases were surrounded by sheep,but no direct contact with sheep. 8 cases had fever,in high fever,after the detection of Brucella positive blood culture were given rifampin,doxycycline,levofloxacin,streptomycin combined treatment,15 cases were cured,2 cases were finally also found associated with lumbar tuberculosis and remained normal for 3 months of follow-up.Conclusion The symptoms of brucellosis in Huzhou city is not typical,easy to be misdiagnosed or missed rash of unexplained fever,and the sheep contact history of patients,medical personnel need to guard against the disease, the diagnosis of blood culture is a simple and effective method,choose effective antibiotics,the general prognosis is good.%目的：分析浙江湖州地区布鲁菌病的发病特点、规律、临床诊断及治疗特点。方法回顾性分析2005年4月至2014年12月浙江省湖州地区各级医院17例布鲁菌病患者的流行病学资料、临床表现、实验室检查、治疗和转归等情况。结果17例患者均为居住本地区，5例为屠宰羊；4例均为卖羊；1例为屠宰羊狗并饮食；其余7例周围有羊，但无明确与羊直接接触。8例有发热，以中、高热为主，后经血培养检出布鲁菌阳性确诊，给予利福平、多西环素、左氧氟沙星、链霉素等联合治疗，15例治愈，2例最后还查出合并腰椎结核，随访3个月正常。结论湖州市布鲁菌病症状不一定典型，易被误诊或漏疹，对发热原因不明者，及有羊接触史的患者，医务人员需警惕本病，血培养是简单、有效的诊断方法，选择敏感抗生素治疗有效，一般预后良好。