刚果（金）维和部队90例恶性疟临床特征分析

目的 探讨非洲刚果（金）维和部队恶性疟疾的临床特点、诊断和治疗方法,为提高治疗疟疾的疗效提供依据。方法 对2018年9月—2019年5月治疗的90例恶性疟患者的临床表现、实验室检查及治疗进行回顾性分析。结果 门诊患者给予服用双氢青蒿素哌喹片,住院治疗患者随机分为两组,一组给予青蒿琥酯静脉推注加口服双氢青蒿素哌喹片,二组给予蒿甲醚针剂肌肉注射加口服双氢青蒿素哌喹片;90例患者治疗效果均较满意,治愈率为100%,死亡率为0;门诊治疗患者中有1例复燃,住院患者2组不同治疗药物无1例复燃;平均退热时间,一组为（26.5±8.7） h,二组为（30.9±9.7） h;平均原虫转阴时间,一组为（37.4±12.2） h,二组为（41.2±11.1） h。结论 恶性疟患者临床表现多样化,部分病例缺乏典型症状、体征。门诊给予口服双氢青蒿素哌喹片,住院患者给予青蒿琥酯+双氢青蒿素哌喹片或蒿甲醚+双氢青蒿素哌喹片,可作为我刚果（金）维和部队二级医院治疗疟疾的常规方案。脑型疟等凶险发作恶性疟及症状较重者可首选青蒿琥酯作为基础治疗药物。

Clinical characteristics analysis of 90 cases of falciparum malaria in peacekeeping contingent in Congo

Objective To investigate the clinical characteristics of falciparum malaria in peacekeeping contingent in Congo and the therapeutic effect of anti-malaria to provide the reference for the clinical diagnosis of malaria. Methods A retrospective analysis on the clinical manifestations, laboratory examination and therapeutic regimens of 90 cases of falciparum malaria in peacekeeping contingent in Congo from September 2018 to May 2019. Results Outpatient patients were given Dihydroartemisinin and Piperaquine Phosphate tablets, and hospitalized patients were randomly divided into two groups. One group was given Artesunate for injection in combination with Dihydroartemisinin and Piperaquine Phosphate tablets, the other group was given Artemether Injection in combination with Dihydroartemisinin and Piperaquine Phosphate tablets. Satisfactory results were achieved in the treatment of 90 patients. The cure rate was 100% and the mortality rate was 0. There was one recurrence of malaria in outpatient patients and no recurrence of malaria in hospitalized patients. The average antipyretic time of hospitalized patients was (26.5±8.7) h in the first group and (30.9±9.7) h in the second group. The average time for malaria to become negative was (37.4±12.2) h in the first group and (41.2±11.1) h in the second group. Conclusion Clinical manifestations of falciparum malaria patients are diverse, some cases lack of typical symptoms and signs, we should pay attention to our ordinary work. The Artesunate for Injection and Artemether Injection in combination with Dihydroartemisinin and Piperaquine Phosphate tablets can be the conventional treatment for the falciparum malaria in Peacekeeping contingent in Congo, Artesunate may be the first choice for the treatment of complex malaria and severe falciparum malaria.