최근 5년간 경북지역에서 발생한 한국형 출혈열의 임상적 고찰

Abstract

The epidermiology, clinical course, treatment and factors of related prognosis in 157 cases of Korean Hemorrhagic Fever(KHF) were analyzed. The patients studied were admitted to Keimyung University Hospital in Kyungpook Province from January 1982 through December 1986. The results were as follow : 1. By age distribution, the group in the ages 40 to 60 was 55.4%. By sex, there were more male than female(2.4:1). 78.6% of the KHF studied, occurred from October to December in every year which revealed a single large peak prevalence pattern. 2. The geographic distribution in the Kyungpook Province showed the occurrence of KHF concentrated in the northern and middle part of the province near the So Bak Mountains. 3. The oliguric phase was the most frequent phase of the disease on admission. The common clinical symptoms were fever, chill, general aches, and abdominal pain and nausea. Conjunctival congestion, CVA tenderness, and abdominal tenderness were frequently found on physical examination. Soft palate petechiae was the most common finding of the bleeding tendency. 4. Leukocytosis, thrombocytopenia, hematuria, proteinuria and elevation of BUN ＆ serum creatinine levels were the common laboratory findings. Usually the SGOT level was higher than SGPT level. SGOT elevated cases were 73% in all of the KHF patients. 5. 47.1% of the patients received hemodialysis , 11% were treated with peritoneal dialysis, and the remaining patients received conservative therapy. The frequency of hemodialysis was less than 3 times in most of the cases and the average duration of peritoneal dialysis was 7.4 days. 6. The overall mortality rate of KHF was 11.5% in this study. The fatalities in the hypotensive phase were 61.6% and oliguric phase was 38.9%, but there were no deaths during the diuretic phase. The main cause of death was irreversible shock(61.1%). Other causes of death were pulmonary edema(16.7%), gastrointestinal bleeding, cerebral hemorrhage, and encephalopathy (5.6% respectively). 7. The factors more commonly seem in the patients who died were the older age group with elevated hemoglobin, hematocrit, urine specific gravity, and serum transaminase levels.