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南水北调中线水源区儿童肺吸虫病临床特征分析 被引量:1

Clinical characteristics of children with paragonimiasis in the water source area of the middle route project of South-to-North Water Diversion Project
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摘要 目的分析南水北调中线水源区工程启用后对某三甲医院肺吸虫病住院病人的发病率、临床诊治情况的影响。方法回顾性分析2010-2017年某院感染性疾病科和儿科住院确诊的肺吸虫病病人的流行病学资料、临床特征,并与本院南水北调中线水源区启动前肺吸虫病临床诊疗情况作对照,分析南水北调中线水源区启动对该地区肺吸虫病的影响。结果住院肺吸虫病病人共19例,男性16例、女性3例,年龄6~12岁(平均8. 9±1. 1岁);病前1~6月有疫源接触史(18例生食溪蟹,1例饮用溪水);病人以水源区上游安康市居多;呼吸系统症状为主诉6例,神经系统症状为主诉5例,皮下包块为主诉4例,全身水肿为主诉1例,消瘦、消化不良为主诉1例,腹痛为主诉1例,发热为主诉1例。体检:肺部啰音、胸腔积液10例次;肝脏肿大4例次;皮下包块3例次;颈强、皮疹、全身水肿、腹腔积液、扁桃腺肿大各1例次。外周血嗜酸性粒细胞(Eosinophils,EOS)显著增高100. 00%;肺吸虫抗原皮试阳性100. 00%;CT和MRI(增强MRI)发现颅内肺吸虫病病灶1例、胸肺部病灶22例次、心包积液1例、肝脏肿大4例、腹腔积液1例。出现症状到确诊的时间1周~1年。全部病例予吡喹酮治疗(2~4个疗程)均治愈。结论南水北调中线水源区启用后水源区肺吸虫病住院病人显著减少,误诊率上升。详细病史询问、仔细体检、科学分析EOS、影像学检查,配合肺吸虫抗原皮试,是早发现、早诊断、早治疗的关键。 Objective To analyze the impact of the Middle Route Project of South-to-North Water Diversion Project on the incidence,clinical diagnosis and treatment of inpatients with paragonimiasis in a first class hospital. Methods The epidemiological data and clinical features of hospitalized patients with paragonimiasis in infectious diseases department and pediatrics in a hospital from 2010 to 2017 were retrospectively analyzed. Compare them with the clinical diagnosis and treatment of paragonimiasis before the launch of the Middle Route Project of South-to-North Water Diversion Project,so as to analyze the influence of the Middle Route Project of South-to-North Water Diversion Project on paragonimiasis. Results There were 19 patients with paragonimiasis in the hospital,16 males and 3 females,aged 6 ~ 12 years( mean 8. 9 ± 1. 1 years old). There was a history of exposure to the disease from 1 to 6 months before the disease( 18 cases of eating raw crabs,1 case of drinking stream). The patient were mainly from Ankang City,the upper reaches of the water source area. Among 19 patients,6 cases consulted their physician with chief complaint of symptoms of respiratory system first,5 cases consulted their physician with chief complaint of symptoms of neurological system,4 cases consulted their physician with chief complaint of subcutaneous masses,1 case consulted their physician with chief complaint of symptoms of hyposarca anasarca,1 cases consulted their physician with chief complaint of slim down and dyspepsia,1 cases consulted their physician with chief complaint of abdominal pain,1 cases consulted their physician with chief complaint of fever. CT and dynamically enhanced. Blood acidophilic granulocyte count/EOS of all cases were increased and the positive rate to intradermal test of paragonimiasis were 100. 00%. MRI found intracranial paragonimiasis lesions( 1 lesions),chest paragonimiasis lesions( 22 lesions),hydropericardium( 1 lesions),liver enlargement( 4 lesions)and seroperitoneum( 1 lesions). The period from symptom
作者 卢晓琴 胡波 李芳 李金科 杨靖 李健 谭华炳 LU Xiaoqin;HU Bo;LI Fang;LI Jinke;YANG Jing;LI Jian;TAN Huabing(Shiyan People's Hospital ( People's Hospital Affiliatod to Hubei Medical College) ,Hubei442000 ,China)
出处 《医学动物防制》 2019年第5期426-429,共4页 Chinese Journal of Pest Control
基金 2014年十堰市人民医院/湖北医药学院附属人民医院创新团队项目(201404).
关键词 南水北调中线水源区 肺吸虫病 回顾性分析 临床确诊 Middle Route Project of South-to-North Water Diversion Project Pulmonary paragonimiasis Retrospective study Clinical diagnosis
作者简介 卢晓琴(1974-),女,主治医师,从事儿科临床工作;通讯作者:谭华炳,E-mail:renmthb@163.com.
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