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目的初步探讨成人恶性脑型疟疾的临床特征、诊断及治疗。方法回顾性分析2例确诊成人恶性脑型疟疾患者的流行病学特征、临床表现、实验室检查、治疗经过及其预后,并复习相关文献。结果 2例成人恶性脑型疟疾患者均有非洲工作或生活史,同时均为急性起病,表现为高热、头昏头痛,意识障碍,同时伴有肝功能异常,累及两系以上血象异常,C-反应蛋白明显升高,外周血涂片均找到恶性疟原虫;予以青蒿琥酯等治疗患者痊愈,其中1例出院后因未服用伯安喹而引起复燃,再次治疗有效。结论成人恶性脑型疟疾在我国多为输入性感染,临床易误诊,有必要反复血涂片找疟原虫以便于确诊;该病起病迅速,病情进展快,及时有效抗疟疾治疗病情恢复快,治疗效果好。
Objective To investigate the clinical features, diagnosis and treatment of adult malignant cerebral malaria. Methods The epidemiological characteristics, clinical manifestations, laboratory tests, treatment and prognosis of 2 patients with malignant cerebral malaria diagnosed in adults were retrospectively reviewed. Relevant literatures were reviewed. Results Both of the 2 adult patients with malignant cerebral malaria had working or living history in Africa. All of them were acute onset with high fever, dizziness, headache and disturbance of consciousness, accompanied by abnormal liver function. --Reactive protein was significantly increased, peripheral blood smear were found in Plasmodium falciparum; artesunate and other treatment to patients recovered, 1 of them discharged after discharge because of not taking benequin caused a resurgence, re-treatment effective. Conclusion Malignant cerebral malaria in adults is mostly imported infections in our country. It is easy to be misdiagnosed in clinic. It is necessary to find out the blood smear to find the malaria parasite in order to confirm the diagnosis. The onset of the disease is rapid, the disease progresses rapidly, Good therapeutic effect.