天津市2010-2015年百日咳病例临床症状与误诊的特征分析

发布时间：2018-03-02 10:02

本文关键词： 百日咳临床特征病程误诊　出处：《疾病监测》2016年09期 　论文类型：期刊论文

【摘要】：目的对天津市近年来百日咳确诊病例的临床特征及诊断情况进行分析,提高医务人员对百日咳的认知。方法采用描述流行病学方法对在2010-2015年医院被动监测和2010-2012年社区症状主动监测中确诊的百日咳病例的临床症状进行分析。结果百日咳病例咳嗽时间中位数为14 d,咳嗽时间在14 d以下的占46.45%。25.63%的病例只表现为单纯的持续咳嗽,无其他特异的临床症状。具有阵发性痉挛性咳嗽(痉咳)症状的比例最多,占74.37%,其次为咳嗽后呕吐(呕吐)占32.95%,鸡鸣音、青紫、窒息的发生率均低于30.00%。医院监测的发生率均显著高于社区诊所(P0.05)。1岁以下病例组出现痉咳、鸡鸣音、呕吐、青紫和窒息的发生率均为最高,15岁及以上病例组上述症状的发生率均为最低。未接种疫苗人群中痉咳、鸡鸣音、呕吐及青紫的发生率均高于已接种疫苗的人群(P0.05)。社区诊所确诊病例在初次就诊时其误诊率高达95.16%,误诊为肺炎的比例最高,占50.00%。结论百日咳临床症状不典型,误诊率高,建议修订现行百日咳监测病例定义,提高百日咳的监测水平。
[Abstract]:Objective to analyze the clinical characteristics and diagnosis of confirmed cases of whooping cough in Tianjin in recent years. Methods the clinical symptoms of pertussis cases confirmed in hospital passive surveillance from 2010 to 2015 and community symptom active monitoring from 2010 to 2012 were analyzed by descriptive epidemiology. The median cough time of cough cases was 14 days, and 46.45.25.63% of the cases with cough duration less than 14 days showed only persistent cough. No other specific clinical symptoms. The proportion with paroxysmal spasmodic cough (spasmodic cough) was the highest (74.37), followed by vomiting (vomiting) after cough (32.95%), rooster, blue and purple, The incidence of asphyxia was lower than that of 30.00.The incidence of hospital surveillance was significantly higher than that of the patients under the age of P0.05 in the community clinic. The incidence of cyanotic and asphyxia was the highest in the patients aged 15 years and above, and the incidence of the above symptoms was the lowest in the unvaccinated population, and the incidence of spasmodic cough and roaring of chicken in the unvaccinated population was the lowest. The incidence of vomiting and cyanotic was higher than that of vaccinated population. The misdiagnosis rate of confirmed cases in community clinics was 95.16 at the first visit, and the rate of misdiagnosis as pneumonia was the highest (50.005%). Conclusion the clinical symptoms of whooping cough are atypical and the misdiagnosis rate is high. It is suggested that the current definition of pertussis surveillance cases should be revised to improve the surveillance level of pertussis.
【作者单位】：天津市疾病预防控制中心免疫规划科;
【基金】：天津市卫生和计划生育委员会科技基金(No.2015KY18)~~
【分类号】：R516.6

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