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目的分析肺吸虫病住院病人的临床特征,提高对肺吸虫病的临床诊治水平。方法回顾分析2012-2016年在某院住院确诊的肺吸虫病病人的临床资料,总结其临床表现、诊疗情况及随访病情转归。结果住院肺吸虫病病人共67例,其中未成年病人56例,成年病人11例,男性47例、女性20例,年龄3~60岁(平均12岁);其中64例病前有疫源接触史;起病症状:45%(30/67)为咳嗽、气促,27%(18/67)为发现体表包块,19%(13/67)为头痛、呕吐,6%(4/67)体检发现胸腔积液,6%(4/67)为肝脏病变,1%(1/67)反复皮疹,1%(1/67)发现眼睑肿胀。辅助检查:88%(59/67)外周血嗜酸性粒细胞增高,42%(28/67)肺吸虫血清抗体检查阳性,15例病灶活检:11例皮下包块、2例颅内病及2例肝脏病变活检符合肺吸虫病病理改变。36例合并浆膜腔积液,17例行胸腔穿刺,其中13例胸水乳酸脱氢酶(Lactate dehydrogenase,LDH)>1 000 U/L,8例腺苷脱氨酶(Adenosine deaminase,ADA)大于45 U/L。治疗:67例病人均诊断为肺吸虫病,予吡喹酮治疗,均取得较好疗效。结论肺吸虫病发病呈逐年上升趋势,且临床可多系统受累,易误诊,应详细询问病史尤其生活饮食习惯,结合病人血嗜酸粒细胞增多、影像学及肺吸虫特异免疫学等检查,早诊断、早治疗,改善病人预后。
Objective To analyze the clinical characteristics of paragonimiasis inpatients and improve the clinical diagnosis and treatment of paragonimiasis. Methods The clinical data of patients with paragonimiasis diagnosed in hospital from 2012 to 2016 were retrospectively analyzed. The clinical manifestation, diagnosis and treatment and prognosis of the patients were summarized. Results There were 67 patients with paragonimiasis in hospital, of which 56 were juvenile patients, 11 were adult patients, 47 males and 20 females, aged from 3 to 60 years old (average 12 years old) History of symptoms: onset symptoms: 45% (30/67) of cough, shortness of breath, 27% (18/67) of the body surface mass was found, 19% (13/67) were headache, vomiting, 6% 67) Pleural effusion was found on physical examination. Liver lesions were found in 6% (4/67) of the patients, with 1% (1/67) recurrent skin rashes and 1% (1/67) swollen eyelids. Assisted examination: Peripheral blood eosinophilia increased in 88% (59/67), positive in 42% (28/67) paragonimiasis, and biopsy in 15 cases: 11 cases of subcutaneous mass, 2 cases of intracranial disease and 2 Cases of liver biopsy in line with the pathological changes of paragonimiasis. Of the 36 patients with pleural effusion, thirteen had thoracentesis, of which thirteen had thymocytic lactate dehydrogenase (LDH)> 1000 U / L and eight had adenosine deaminase (ADA) greater than 45 U / L. Treatment: 67 patients were diagnosed as paragonimiasis, to praziquantel treatment, have achieved good results. Conclusion The incidence of paragonimiasis is increasing year by year, and the clinical system may be involved and misdiagnosed, it should be asked in detail about the history of life and eating habits, combined with the patient’s blood eosinophilia, imaging and paragonimiasis immunology and other tests as early as Diagnosis, early treatment, improve patient prognosis.