腹水型晚期血吸虫病合并结核性胸膜炎15例临床分析  

Clinical analysis of 15 patients suffered from advanced ascetic schistosomiasis with tuberculous pleurisy

作　　者：廖红保 陈芳 

机构地区：[1]湖北省洪湖市血吸虫病专科医院,洪湖433200

出　　处：《中国血吸虫病防治杂志》2016年第3期343-344,共2页Chinese Journal of Schistosomiasis Control

摘　　要：目的探讨晚期血吸虫病(晚血)合并结核性胸膜炎的临床特点,减少误诊和误治,提高诊治水平。方法回顾性分析15例晚血合并结核性胸膜炎患者的临床资料,并进行描述性统计分析。结果 15例患者病程中均有不同程度的胃肠道症状,表现为腹胀、乏力、纳差,14例有不同程度的水肿,9例有胸闷,4例有咳嗽咳痰,2例有低热盗汗。有3例入院后2 d内确诊,9例入院后1周内确诊,3例超过1周后确诊。15例患者均在常规护肝、利尿、对症、支持基础上予以抗痨治疗,有1例合并严重肝肾功能损害死亡,1例合并消化道大出血死亡,其余13例均临床好转出院。结论晚血合并结核性胸膜炎患者的结核中毒症状不典型,容易误诊、漏诊。对胸腹水消退不理想、症状不易改善的晚血患者应积极完善规范的辅助诊断,及早明确诊断,以免延误治疗。Objective To discuss the clinical characteristics of advanced schistosomiasis combined with tuberculous pleurisy,so as to reduce misdiagnosis and mistreatment. Methods The clinical data of 15 patients suffered from advanced schistosomiasis combined with tuberculous pleurisy were collected and analyzed retrospectively. Results The 15 patients all showed various degrees of gastrointestinal symptoms with the performance of abdominal distension,digestive function and fatigue,14 patients showed various degrees of edematous,9 patients showed stuffiness,4 patients had cough and expectoration,and 2 patients had low fever and night sweats. Three cases were diagnosed within 2 days after admission,9 cases were diagnosed within one week after admission,and 3 cases were diagnosed after one week. Fifteen patients all received anti-tuberculosis treatment based on routine liver protection,diuresis,and symptomatic and supportive treatment. One patient with severe liver and kidney dysfunction died and one with gastrointestinal bleeding died. The remaining 13 patients were clinically cured. Conclusions The patients suffered from advanced schistosomiasis combined with tuberculous pleurisy do not show obvious tuberculosis poisoning symptoms,and are easily misdiagnosed and missed-diagnosed. Therefore,physicians should pay much attention to the patients whose pleural effusion cannot subside effectively or whose symptom cannot improve.

关 键 词：晚期血吸虫病 结核性胸膜炎 腹水 

分 类 号：R532.21[医药卫生—内科学]