目的 探讨猫抓病的临床特征及诊断方法 .方法回顾性分析8例猫抓病患者的流行病学资料、临床表现、辅助检查结果 和诊断等.结果8例中,1例成年患者长期喂养流浪猫并有明确被猫抓伤史,2例患儿有明确长期与猫、狗密切接触史.8例患者均表现为淋巴结肿大或局部肿块,质地中等或硬.8例患者中,4例患者单核细胞百分比升高,2例患者血小板升高,2例患者乳酸脱氢酶升高,3例患者血沉加快,1例患者进行了淋巴细胞亚群检测:CD3+CD8+细胞和CD3+CD56+细胞偏高,CD3+CD4+细胞和CD3-CD19+细胞偏低.入院疑诊淋巴瘤或淋巴结炎4例,腮腺或颌下腺肿瘤3例,发热待查1例.3例患者局部麻醉下行淋巴结活检手术,另外5例患者全身麻醉下接受肿块切除术或腮腺切除术.结论 对于淋巴结肿大的患者,除了要鉴别肿瘤性疾病、结核感染和反应性淋巴结炎等,还应多关注猫、狗等宠物的接触史,警惕猫抓病的发生.%Objective To investigate the clinical features and diagnostic methods of cat-scratch disease .Methods The epidemiology ,clinical features ,auxiliary inspection results and diagnosis of 8 patients with cat-scratch disease were retrospectively analysed .Results Of 8 cases ,1 adult patient had long term feeding of stray cats and a history of being scratched by cat ,and 2 children patients had a history of closely contacting with cat and dog .All patients had lymphadenectasis or local mass ,which were medium or hard in texture .The mononuclear cell percentage was higher in 4 cases ,platelet count and lactic dehydrogenase were higher in 2 cases ,and erythrocyte sedimentation rate was risen in 3 cases .The lymphocyte subsets were detected in 1 case ,which showed higher CD3+ CD8+ cell and CD3+CD56+ cell and lower CD3+ CD4+ cell and CD3- CD19+ cell .The lymphoma or lymphnoditis was suspected in 4 cases ,parotid gland tumor and submandibular gland tumor in 3 cases ,and fever of unkown origin in 1 case .Three patients were treated with lymph node biopsy under local anaesthesia and 5 patients accepted oncotomy or parotidectomy under general anesthesia .Conclusion In the patients with lymphadenectasis ,we should pay more attention to the history of contacting with cat and dog in addition to considering neoplastic disease ,tuberculosis infection and reactive lymphadenitis ,and be aw are of the occurance of cat-scratch disease .
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