并殖吸虫病临床表现及误诊分析  

Clinical Manifestations of Paragonimiasis and Analysis of the Reasons for Misdiagnosis

作　　者：丁红芳[1] 田德英[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院,武汉430030

出　　处：《内科急危重症杂志》2006年第1期16-17,45,共3页Journal of Critical Care In Internal Medicine

摘　　要：目的:探讨并殖吸虫病的临床表现、治疗及误诊情况,提高对本病的认识,减少误诊率。方法:分析80例并殖吸虫病的临床类型、实验室检查结果、诊治方法及误诊情况。结果:临床分型依次为胸肺型55例(68.8%);皮肤型18例(22.5%);腹型4例(5%);其他3例(3.7%)。临床误诊49例,占61.3%,多被误诊为肺结核、结核性胸膜炎、慢性支气管炎,其次为肺肿瘤、嗜酸性粒细胞增多症、结核性心包炎及颅脑肿瘤等。所有患者肺吸虫抗体检测均为阳性,90%患者白细胞及嗜酸性粒细胞升高,白细胞数为(10.91±4.99)×109/L,嗜酸性粒细胞计数为(1.65±2.07)×109/L,嗜酸性粒细胞百分比为(39.40±19.17)%,经吡喹酮驱虫治疗后嗜酸性粒细胞百分比下降至(9.20±10.17)%,且全部患者治愈。结论:并殖吸虫病临床表现复杂多变,临床误诊率高,提高对本病的认识,保持高度的警惕性,是减少误诊的关键。如能及时诊断和治疗,预后良好。Objective： To study the clinical characteristics of different types of paragonimiasis and analyze the reasons of misdiagnosis. Methods： The clinical types, laboratory data and the mode of misdiagnosis of 80 patients with paragonimiasis were analyzed retrospectively. Results： According to the incidence of the clinical types, the chest-lung type accounted for 68. 8% ; the skin type 22. 5% ; the abdomen type 5% and the other types 3. 7%. 49 of 80 cases were misdiagnosed, the misdiagnosis rate was 61.3%. The implicated diseases of misdiagnosis included pulmonary tuberculosis, tuberculous pleuritis, chronic bronchitis, lung tumor, eosinophilia, tuberculous pericarditis, intracranial tumour and so on. The positive rate of the lung fluke antibody was 100% in all of the patients, Both white blood cells and eosinophile granulocytes elevated in 90% of cases. Conclusion： The Clinical manifestations of paragonimiasis are complex, the rate of the misdiagnosis is higher. To improve the recognition and to keep higher alert are the key points to minimize the misdiagnosis rate, and if we diagnose and treat the disease in time, the patients could obtain a good prognosis.

关 键 词：并殖吸虫病 临床表现 误诊 

分 类 号：R532.22[医药卫生—内科学]