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目的探讨老年人带状疱疹的临床特点、诊断及误诊原因。方法复习1999-02-2009-02南京军区福州总医院收治的60岁以上老年人带状疱疹72例的临床资料。结果 72例中67例以疼痛为首发,误诊31例,误诊率43.1%。疼痛后1~3 d出现皮疹10例,4~6 d 22例,>1周32例。被误诊的疼痛有冠心病、头部肿瘤、三叉神经痛、肋间神经痛等13种疼痛。以抗病毒、止痛、营养神经等治疗后一般于2周治愈,遗留神经痛8例。结论老年人带状疱疹的临床表现早期复杂、多样,正确的诊断,有赖于提高认识,详细询问病史,认真体检,对于发生在单侧沿神经放射痛又缺乏阳性体征者,应想到带状疱疹的可能。
Objective To investigate the clinical features, diagnosis and misdiagnosis of herpes zoster in the elderly. Methods The clinical data of 72 cases of herpes zoster in the elderly over the age of 60 admitted to Fuzhou General Hospital of Nanjing Military Command from February 1999 to February 2009 were retrospectively reviewed. Results Of the 72 cases, 67 cases were diagnosed as painful and 31 cases were misdiagnosed with a misdiagnosis rate of 43.1%. There were 10 rash cases 1-3 days after pain, 22 cases 4 ~ 6 days and 32 cases> 1 week. Pain was misdiagnosed as coronary heart disease, head cancer, trigeminal neuralgia, intercostal neuralgia and other 13 kinds of pain. To antiviral, analgesic, nourishing nerves and other treatment is generally cured in 2 weeks, 8 cases of neuralgia. Conclusion The clinical manifestations of the elderly with herpes zoster early complex, diverse and correct diagnosis, depends on awareness, detailed medical history, careful examination, occurred in unilateral radiofrequency pain and lack of positive signs, should think of shingles Possible.