三峡库区儿童肺吸虫病的发病现状及诊治情况

目的 分析三峡库区儿童肺吸虫病的发病现状及临床特征,比较该疾病患者的用药情况和康复效果,以提高临床诊治水平,减少误诊误治。方法 统计 2000—2015 年在重庆市万州区第一人民医院确诊的 91 例不同类型的儿童肺吸虫病患者临床资料,对其临床特点进行分类,观察两种临床常用药硫双二硫酚和吡喹酮应用于儿童肺吸虫病后,患者的恢复效果,并分析其治疗和预后情况。结果 肺吸虫病临床表现复杂,无特征性临床表现,在我们本次研究中的91例儿童肺吸虫病例中,临床表现多种多样,主要表现为一般症状（主要包括发热、乏力等,7.69%）、肺部病变（29.67%）、肝脏病变（32.97%）、中枢神经系统病变（23.08%）、皮下结节（56.04%）、心脏病变（9.89%）、胸腔病变（4.40%）、眼部病变（1.10%）等。多由于食用生的以及未煮熟的溪蟹或饮用生水而感染。本病使用硫双二硫酚或吡喹酮治疗效果良好,且后者疗效优于前者,在本院接受治疗的91例患者中,总共治愈 80 例(治疗后半年至 5 年, 临床症状体征全部消失),情况好转8 例,3例无效果（均为硫双二氯酚治疗）,无1例死亡,总有效率 96.7% ,且预后良好。结论 儿童肺吸虫病临床表现复杂多样,临床医师要积极拓宽诊断思路,积累临床经验,注意流行病学史的询问,结合血嗜酸性粒细胞计数、影像学及免疫学检查做到早诊断早治疗。

The morbidity and theranostics of pulmonary paragonimiasis in children from the Three Gorges Reservoir Areas

Objective To analyze the morbidity and clinical characteristics of pulmonary paragonimiasis in children from the Three Gorges Reservoir Areas, compare their pharmaceutic strategy and recovery effect, so as to improve the diagnosis and treatment levels clinically, as well as reduce the rate of misdiagnosis. Methods The clinical data of 91 cases of different types of pulmonary paragonimiasis in children of The First People's Hospital of Chongqing Wanzhou District from 2000 to 2015 were collected, their clinical characteristics were classified, moreover their recovery effect and prognosis were observed after administrated with two kinds of clinical drug, thiophenol and praziquantel. Results The clinical manifestations of paragonimiasis were complex, and there was no specific clinical manifestation with the disease. Among the 91 cases of paragonimiasis we reported in this study, the patients exhibited diverse clinical manifestations. It’s mainly characterized by the general symptoms (including fever, fatigue, etc., 7.69%), pulmonary disorders (29.67%), hepatic disorders (32.97%), central nervous system disorders (23.08%), subcutaneous nodules (56.04%), cardiac disorders (9.89%), chest disorders (4.40%), ocular disorders (1.10%), etc. The infection was mainly caused by eating raw and undercooked brook crabs or drinking raw water. The treatment effects of bithionol or praziquantel were favorable either, and the latter was better than the former. Among the 91 cases in our hospital, a total of 80 cases were cured (clinical symptoms and signs disappeared after treatment for 6 months to 5 years), 8 cases got better, no effect was observed in 3 cases (all administrated with bithionol), no body died, the total effective rate reached 96.7%, furthermore the prognosis was good as well. Conclusion The clinical manifestations of pulmonary paragonimiasis in children were complex. Therefore, clinicians should widen their thinking way of diagnosis actively, accumulate clinical experience, as well as pay more attention to the inquiries of epidemiology history of patients. Moreover, the combination of blood eosinophilic granulocyte counts, imaging and immunological examination was necessary to access the early diagnosis and treatment.