青蒿琥酯联合血液净化治疗凶险型恶性疟二例并文献复习

目的探讨凶险型恶性疟的临床特征及青蒿琥酯联合血液净化治疗凶险型恶性疟的疗效。 方法对本院收治的2例凶险型恶性疟患者的临床资料、治疗经过及预后进行回顾性分析。 结果2例凶险型恶性疟患者均为境外输入，均有明确的疫区生活居住史，均为中年男性，主要临床症状为发热，病情进展迅速，快速出现神志改变，并伴随急性肝、肾功能衰竭及休克等。经给予青蒿琥酯联合血液净化并积极对症治疗，2例患者均治愈，其中1例间断使用血液净化治疗患者遗留肾功能不全，另1例患者出院时各指标均在正常范围；长期随访2例患者均未见再燃现象。 结论尽早诊断凶险型恶性疟，及时予以青蒿琥酯抗疟治疗的同时，早期、持续行血液净化治疗，并及时予以对症治疗，有利于凶险型恶性疟的预后。

Artesunate combined with blood purification therapy for two cases of severe falciparum malaria

ObjectiveTo investigate the characteristics of severe falciparum malaria and the effect of artesunate combined with blood purification for severe falciparum malaria. MethodsThe clinical data, treatment and prognosis of 2 cases with severe falciparum malaria were analyzed, retrospectively. ResultsBoth cases with severe falciparum malaria cases were overseas input, and both had a clear life history of endemic falciparum malaria area. Both cases were middle-aged men, the main clinical symptom was fever. The conditions of both patients developed rapidly. They occurred consciousness soon, and accompanied by acute liver function, renal function failure and shock. Both cases with severe falciparum malaria were cured by artesunate combined with blood purification. Long-term follow-up indicated that neither of them recrudesced with malaria. ConclusionsEarly diagnosis of severe falciparum malaria, timely artesunate antimalarial treatment, early and continuous blood purification, and timely symptomatic treatment, may improve the prognosis for severe falciparum malaria.