反射式共聚焦显微镜在儿童疥疮诊疗中的应用  

Application of reflectance confocal microscopy in the diagnosis and treatment of childhood scabies

作　　者：毕田田[1] 管志伟[1] 刘欣欣[1] 李钦峰[1] Bi Tiantian;Guan Zhiwei;Liu Xinxin;Li Qinfeng(Department of Dermatology,Tianjin Children′s Hospital,Tianjin 300074,China)

机构地区：[1]天津市儿童医院皮肤科,300074

出　　处：《中华皮肤科杂志》2021年第5期433-435,共3页Chinese Journal of Dermatology

摘　　要：目的分析儿童疥疮反射式共聚焦显微镜(RCM)图像特征,探讨其在儿童疥疮诊疗中的临床意义。方法回顾性分析2018年4月至2019年10月于天津市儿童医院皮肤科门诊确诊的疥疮患儿77例,分成无治疗史组61例,有治疗史组16例。对所有病例进行刮片镜检和RCM检查。结果77例疥疮患儿中33例(42.86%)刮片镜检阳性,其中无治疗史组28例,有治疗史组5例。56例(72.73%)在RCM下可见隧道以及疥螨虫体或虫卵、粪便,其中无治疗史组49例(80.33%),有治疗史组7例。RCM检查总体阳性率显著高于刮片镜检,差异有统计学意义(χ^(2)=14.08,P<0.05);无治疗史组RCM阳性率明显高于刮片镜检,差异亦有统计学意义(χ^(2)=15.53,P<0.05)。结论RCM在儿童疥疮诊疗中具有较高的临床应用价值。Objective To investigate reflectance confocal microscopic features of childhood scabies,and to analyze clinical significance of reflectance confocal microscopy(RCM)in the diagnosis and treatment of childhood scabies.Methods A retrospective analysis was performed in 77 children with confirmed scabies at Department of Dermatology,Tianjin Children′s Hospital from April 2018 to October 2019.These patients were divided into negative treatment history group(61 cases)and positive treatment history group(16 cases).All the patients underwent RCM and microscopic examination of skin scrapings.Results Among the 77 children with scabies,positive microscopic examination results were found in 33(42.86%),including 28 in the negative treatment history group and 5 in the positive treatment history group.Burrows,sarcoptid mites or their eggs and fecal pellets were observed in 56 cases(72.73%)by RCM,including 49(80.33%)in the negative treatment history group and 7 in the positive treatment history group.RCM showed a significantly increased overall positive rate compared with microscopy of skin scrapings(χ^(2)=14.08,P<0.05).In the negative treatment history group,RCM also showed a significantly increased positive rate compared with microscopy of skin scrapings(χ^(2)=15.53,P<0.05).Conclusion RCM is of high clinical value to the diagnosis and treatment of childhood scabies.

关 键 词：疥疮 显微镜检查 共焦 儿童 疥螨 诊断 

分 类 号：R757.1[医药卫生—皮肤病学与性病学]