意识障碍患者发生鼻蝇蛆病1例及文献复习  

Nasal myiasis in patients with disturbance of consciousness:A case report and literature review

作　　者：寇华炜[1] 孟秀娟[2] 黄勋[2] 吴安华[2] 龙莉莉[3] KUO Huawei;MENG Xiujuan;HUANG Xun;WUAnhua;LONG Lili(Department of Nosocomial Infection Control,General Hospital of Ningxia Medical University,Yinchuan 750004;Nosocomial Infection Control Center,Xiangya Hospital,Central South University,Changsha 410008;Department of Neurology,Xiangya Hospital,Central South University,Changsha 410008,China)

机构地区：[1]宁夏医科大学总医院院内感染科,银川750004 [2]中南大学湘雅医院医院感染控制中心,长沙410008 [3]中南大学湘雅医院神经内科,长沙410008

出　　处：《中南大学学报（医学版）》2021年第12期1442-1446,共5页Journal of Central South University ：Medical Science

基　　金：国家重点研发计划项目(2020YFC2005403)。

摘　　要：鼻蝇蛆病是一种较为罕见的寄生虫病,蝇蛆在鼻腔内生长对鼻腔、鼻窦造成损伤,一旦移行,会导致眼、颅腔等周围结构受损,妥善治疗和积极防控才能减少和避免严重并发症的出现。2020年5月14日中南大学湘雅医院收治的1例脑梗死昏迷患者发生了鼻蝇蛆病。该患者在治疗原发病的过程中,发现感染了蝇蛆。给予脱水降颅压、护脑、控制血糖和血压、抗感染等,积极治疗原发疾病,对鼻腔进行了鼻内镜检查/取虫、鼻腔冲洗等以治疗鼻蝇蛆病,然后对患者进行了妥善安置和隔离防控,以防止蝇蛆病在病区内播散。入院第16天后,患者神志恢复,鼻腔内未再发现虫体,病情好转出院。随访6个月,患者鼻腔未再发现蝇蛆,未诉鼻腔不适,收治病区无患者及医务人员感染蝇蛆。蝇蛆病重在预防,应当积极采取措施以降低社区及医院感染的风险。Nasal myiasis is a rare parasitic disease.The growth of myiasis in the nasal cavity causes damage to the nasal cavity and paranasal sinuses.Once the dipeterous larvae are migrated,it causes damage to the surrounding structures such as eyes and skull cavity.Proper treatment and active prevention and control can reduce and avoid the occurrence of serious complications.On May 14,2020,a patient with cerebral infarction and coma was admitted to Xiangya Hospital of Central South University and developed nasal myiasis.During the treatment of the primary disease,the patient was found to be infected with rhinomyiasis.The patient was treated with dehydration,cranial pressure reduction,brain protection,blood glucose control,blood pressure control,and anti-infection.Nasal endoscopy and nasal irrigation were carried out to treat nasal myiasis.The patient was properly placed and isolated for prevention and control so as to prevent the spread of myiasis in the ward.After16 days,the patient regained consciousness,no worm was found in the nasal cavity,and was discharged from the hospital.The patient was followed-up for 6 months,no maggots were found in the nasal cavity of the patients,no complaints of nasal discomfort was occurred,and no other patients and medical staff were infected with myiasis.The prevention of myiasis is very important,and proper measures should be taken to reduce the risk of community and hospital infection.

关 键 词：鼻蝇蛆病 意识障碍 感染防控 

分 类 号：R53[医药卫生—内科学]