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目的分析肾综合征出血热(HFRS)患者自发性肾破裂的临床特点,探讨其有效的治疗措施及预防。方法对感染科2003年至2012年收治的7例HFRS并自发性肾破裂患者的临床资料进行回顾性分析。结果 7例HFRS自发性肾破裂均有诱因,发生在移行阶段4例,少尿期2例,发热期1例;表现以腹痛突然加剧多见,右肾破裂5例,左肾破裂2例;血小板减少3例,血小板正常4例;内科保守治疗痊愈6例,家属放弃治疗死亡1例。结论 HFRS自发性肾破裂多发生在少尿期、移行阶段,移行阶段虽然尿量增多,但易自发性肾破裂。肾破裂多有诱因,如频繁恶心呕吐、腹泻、血透等。内科保守治疗仍为首选的有效治疗措施。
Objective To analyze the clinical features of spontaneous renal rupture in patients with hemorrhagic fever with renal syndrome (HFRS) and to discuss its effective treatment and prevention. Methods The clinical data of 7 HFRS patients with spontaneous renal rupture treated in our department from 2003 to 2012 were analyzed retrospectively. Results 7 cases of spontaneous renal rupture of HFRS have incentives, occurred in the migration stage in 4 cases, 2 cases of oliguria, fever in 1 case; performance of abdominal pain suddenly worsened more common in 5 cases of right renal rupture, left renal rupture in 2 cases; Thrombocytopenia in 3 cases, platelet normal in 4 cases; conservative treatment of internal medicine in 6 cases cured, family members give up treatment of death in 1 case. Conclusions Spontaneous renal rupture of HFRS occurred mostly in the oliguria and transitional stages. Although the urine output increased during the transitional period, spontaneous renal rupture occurred. Kidney rupture and more incentives, such as frequent nausea and vomiting, diarrhea, hemodialysis and so on. Conservative medical treatment is still the preferred effective treatment.