斯氏狸殖吸虫病53例临床分析  

Clinical analysis of 53 cases with pagumogonimiasis skrjabini

作　　者：郭鄂平[1] 朱洁[2] 张光玉[1] 方孝梅[2] 宋明华[1] 

机构地区：[1]郧阳医学院寄生虫学教研室,十堰442000 [2]郧阳医学院附属太和医院信息统计科

出　　处：《陕西医学杂志》2008年第3期298-299,共2页Shaanxi Medical Journal

基　　金：湖北省教育厅科研项目(2004D015)

摘　　要：目的:探讨食源性斯氏狸殖吸虫病的流行病学特征、临床表现及误诊原因。方法:分析53例斯氏狸殖吸虫病的临床资料。结果:53例患者中,城镇居民占54.7%,儿童占83%,主要因生食或半生食溪蟹和饮生溪水而感染。临床表现复杂多样,以胸肺型和脑型为主,嗜酸性粒细胞增多者占62.3%,痰、粪检查均未发现虫卵,皮下包块活检后病理检查主要表现为嗜酸性肉芽肿和隧道样改变,误诊率达41.5%。吡喹酮治疗取得较好疗效。结论:斯氏狸殖吸虫病流行呈"城镇"化态势,临床医生应提高对斯氏狸殖吸虫病的认识,加强流行病学资料的收集,以降低斯氏狸殖吸虫病的误诊率。吡喹酮疗效较好,可作为斯氏狸殖吸虫病治疗首选药物,而预防本病的关键措施是加强健康教育工作,不生食或半生食溪蟹。Objective： To study the epidemioiogical characteristics, clinical manifestation and misdiagnosis of pagumogonimiasis skrjabini by food borne. Methods： The analysis was performed with 53 cases of pagumogonimiasis. Results： Among 53 cases, 54.7% of cases was residents in cities or towns and 83% of cases was children. The patients were mainly infected by ingesting raw or undercooked freshwater crabs and drinking raw stream water. The clinical manifestations of patients were complex and diverse. A majority of patients had chest pulmonary and cerebral involvement. 62. 3% of cases showed eosinophilia. Eggs weren＇t found in sputum or feces. The pathological examination of subcutaneous nodule biopsy specimen mainly manifested eosinophilic granuloma and tunnellike lesions. 41.5% of cases were misdiagnosed. Chemotherapy with praziquantel was effective to patients. Conclusion： There were more and more patients in cities or towns. Clinician should enhance their cognition to pagumogonimiasis and collect more information of epidemiology;in order to lower the rate of misdiagnosis. Praziguantel is the first choice for chemotherapy of pagumogonimiasis. The key measures to prevent pagumogonimiasis are health education and the inhabitants should be advised to avoid eating raw or undercooked freshwater crabs.

关 键 词：血吸虫病/流行病学 血吸虫病/诊断 血吸虫病/药物疗法 误诊 

分 类 号：R532.2[医药卫生—内科学] R557.3[医药卫生—临床医学]