宜昌市一例输入性恶性疟疫情处置与分析

目的分析处置输入性恶性疟疫情指施,避免患者病情加重及二代病例的出现。方法对患者积极进行双氢青蒿素哌喹、磷酸伯氨喹、蒿甲醚（80mg,首量加倍,连续使用7d）的抗疟治疗,辅以脱水、抗感染、护肝、改善微循环等支持治疗;保护易感人群、对疫点消杀灭蚊及监测。结果治疗10d后患者痊愈出院,出院后定期复查未检出疟原虫,肾功能由尿素12.3mmol/L,血肌酐217μmol/L转至正常,肝功能由丙氨酸氨基转移酶73.5U/L,总胆红素58.4μmol/L,清蛋白21.34g/L转至正常;疫点无二代病例出现。结论快速正确诊断并积极控制及治疗传染源、有效切断传播途径、切实保护易感人群、加强监测管理是有效控制疫情、防止二代病例传播的关键。

Management of an imported malignant malaria case in Yichang city

Objective To deal with an imported malignant malaria case from abroad in Yichang city,prevent the exacerbations of patient and occurrence of second cases.Methods Use dihydroartemisinin piperaquine,primaquine,artemether（at dose 80mg,the first dose doubles）were used for treatment of case for seven days.Besides dehydration,anti-infection,protecting liver,improving microcirculation and other supportive therapies,protection of the susceptible population,vector control and insecticide spraying of infectious foci were also conducted.Results the patients was discharged after cured 10 days later,no the plasmodium was not detected from the patient after reexamination,The levels of urea,blood Scr,ALT,stb,and albumin were 12.3mmol/L,217μmol/L,73.5U/L and 58.4μmol/L in the patients before treatment returned to normal after treatment.No secondary cases occurred in the area.Conclusions Rapid and correct diagnosis,active control and treatment of infectious source,interrupting of the route of transmission,protect the susceptible population and strengthening monitoring are the key measures for control prevalence and prevention the occurrence of second cases.