小兒登革熱之臨床觀察

Clinical Observations of Dengue Fever among Children

黃高彬(Kao-Pin Hwang) ； 蘇淑娟(Shu-Chuan Su) ； 江季勛(Chi-Hsiun Chiang)

《The Kaohsiung Journal of Medical Sciences》 5卷1期 (1989/01) Pp. 50-57

https://doi.org/10.6452/KJMS.198901.0050

摘要

從1987年11月開始台灣南部登革熱流行，至1988年10月底止，因罹患小兒登革熱而至高雄醫學院小兒科就診的病例共77位，這77位均是經過病毒培養或血清學檢查証實；年齡在10歲至14歲的罹患率最高，佔64.9%，男與女之間沒有差異；病例數在1987年11月和1988年10月達到兩個高峯，病兒的臨床表徵主要為發燒，頭痛，皮疹和咳嗽，將近一半的病兒有噁心，嘔吐，肌肉痛和皮膚劇癢的現象，37.7%的病兒合併出血症候，出血的部位以皮膚和粘膜的出血點最多見，其次是鼻出血和便血。有兩位病例是出血性登革熱，其中一位是登革休克症候群。大部分(92.5%)的病兒體溫(腋溫)均超過38.5℃，平均發燒天數是5.9天；77位病兒經過治療後均痊癒出院，沒有死亡的病例，亦沒有發現後遺症。此外，本研究尚可得到兩個結論：第一，罹患率最高的年齡層在10至14歲之間，顯示學校與學童活動環境的病煤蚊撲滅工作應是登革熱防治的重點之一。第二，出血性登革熱的出現是臨床醫師和公共衛生行政上要特別注意和面對的問題。

並列摘要

From November 1987 to October 1988, seventy-seven cases diagnosed as dengue fever and confirmed by viral culture or serological examination in the Pediatric Department of Kaohsiung Medical College Hospital were studied. In nearly two thirds (64.9%) of the total cases, the ages were between 10 and 14 years old. No significant sexual difference could be found in this study. Two peaks of cases distribution occurred at November 1987and October 1988. The major clinical manifestations of Dengue Fever were fever, headache, skin rash and cough. Nearly half of the total cases had nausea, vomiting, myalgia and skin itching. 29 cases (37.7%) had hemorrhagic complications during the course of disease. The most common features of hemorrhage was petechiae followed by epistaxis. Two cases were confirmed as hemorrhagic dengue fever and one was also dengue shock syndrome. Most (92.5%) of the cases had body temperatures over 38.5℃ at the onset of the disease. The mean duration of fever was 5.9 days. No fatality was found. It is concluded that eradication of vectors in the school environment might be one of the major points of disease control according to the age distribution of this study. The appearance of hemorrhagic dengue fever is a major problem and should be closely followed by clinicans and workers of public health in Taiwan.

並列關鍵字

dengue fever ； children