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目的探讨输入性疟疾的流行病学和临床特征,为该病的诊断和治疗提供指导。方法对2014-2015年的43例输入性疟疾患者的流行病学和临床资料进行回顾性分析。结果 43例输入性疟疾病例均为男性,年龄(40.04±11.90)岁。间日疟19例,恶性疟24例。有12例(27.91%)在疟疾流行区曾经感染疟疾。所有病例均发热,37.21%病例热退后有大汗,30.23%有寒战。此外还伴有肌肉酸痛65.12%(28/43)、恶心呕吐55.81%(24/43)、咳嗽30.23%(13/43)、腹痛腹泻18.60%(8/43)、贫血27.91%(12/43)、黄疸4.65%(2/43)和肝脾肿大37.21%(16/43)。43例病例中,中性粒细胞比值升高58.14%(25/43),嗜酸性粒细胞降低60.47%(26/43),PLT降低76.74%(33/43)、HGB降低27.91%(12/43);肝脏酶学升高60.47%(26/43)、总胆红素升高4.65%(2/43)、白蛋白降低4.65%(2/43);尿素氮和肌酐升高2.33%(1/43)。B超查见肝脏长大者占4.65%(2/43),脾脏长大者占32.56%(14/43)。经病原学治疗和对症治疗后,除1例死亡外,其余病例均在1~2周内治愈。结论输入性疟疾临床表现复杂,遇有疟疾流行区返回人员,临床医师要高度警惕输入性疟疾的发生,结合流行病学史和临床表现,及时诊断并进行抗疟治疗及处理并发症。
Objective To investigate the epidemiological and clinical features of imported malaria and provide guidance for the diagnosis and treatment of the disease. Methods The epidemiological and clinical data of 43 imported malaria patients from 2014 to 2015 were analyzed retrospectively. Results All 43 cases of imported malaria were male, with a mean age of (40.04 ± 11.90) years. 19 cases of vivax malaria and 24 cases of falciparum malaria. Twelve cases (27.91%) had been infected with malaria in malaria-endemic areas. All cases were fever, 37.21% of patients had fever back sweat, 30.23% chills. In addition, there were 65.12% (28/43) cases of muscle soreness, 55.81% (24/43) cases of nausea and vomiting, 30.23% (13/43) of cough, 18.60% (8/43) of abdominal pain and diarrhea, 27.91% of anemia ), Jaundice 4.65% (2/43) and hepatosplenomegaly 37.21% (16/43). In 43 cases, the neutrophil ratio increased by 58.14% (25/43), eosinophils decreased by 60.47% (26/43), PLT decreased by 76.74% (33/43), HGB decreased by 27.91% (12 / 43), liver enzymes increased by 60.47% (26/43), total bilirubin increased by 4.65% (2/43), albumin decreased by 4.65% (2/43), urea nitrogen and creatinine increased by 2.33% 1/43). B ultrasound showed that the liver grew up accounted for 4.65% (2/43), spleen grew up accounted for 32.56% (14/43). After the etiological treatment and symptomatic treatment, in addition to 1 case of death, the remaining cases were cured within 1 to 2 weeks. Conclusions The clinical manifestations of imported malaria are complicated. In the case of malaria endemic areas, clinicians should be highly alert to the incidence of imported malaria. Combined with the epidemiological history and clinical manifestations, timely diagnosis and anti-malarial treatment should be conducted and the complications should be treated.