35例输入性疟疾流行病学及临床特征分析

目的:分析南充地区输入性疟疾的流行病学及临床特征,为提高早期诊断和改善预后提供理论依据。方法:对我院2010年1月至2013年8月收治的35例输入性疟疾患者的流行病学、临床表现、实验室检查、临床转归进行回顾性分析。结果:输入性疟疾患者主要为外出务工男性,临床表现各异,大多患者除畏寒、发热、热退后出汗外,伴随有乏力、纳差、寒战、头痛、肌肉酸痛,部分患者伴随咳嗽、咳痰、腹痛、腹泻、身黄、尿黄。实验室检测主要为白细胞、中性粒细胞百分比升高、血红蛋白、血小板下降,肝肾功、电解质异常。蒿甲醚治疗效果佳,蒿甲醚联合伯氨喹治疗复发病例有效。脑型疟疾预后差。结论:输入性疟疾临床表现复杂多样,详细询问流行病学史能提高早期诊断率,及时抗疟原虫治疗、有效的综合治疗能有效提高治愈率,改善预后。

Analysis on epidemiology and clinical characteristics of 35 cases of impor-ted malaria

Objective:To analyze the epidemiology and clinical characteristics of imported malaria in Nanchong area and to pro-vide a theoretical basis for early diagnosis and prognosis improvement. Methods:35 cases of imported malaria were enrolled from Janu-ary 2010 to August 2013 in our hospital. Retrospective method was used to analyze epidemiology,clinical manifestations,laboratory in-dexes,clinical outcome. Results:Imported malaria patients were mainly migrant male workers. Clinical manifestations varied,most pa-tients with chilly, fever, heat back sweating, accompanied by fatigue, anorexia, shiver, headache, muscle aches, part of patients with cough,expectoration,abdominal pain,diarrhea,yellow,yellow urine. Laboratory testing showed that leukocyte count and the percentage of neutrophile granulocyte were increased,while hemoglobin and platelet count were decreased,with liver and kidney dysfunction,and e-lectrolyte abnormality. Therapeutic effect of artemether was good. Artemether combined with primaquine were used to treat recurrent ca-ses. The treatment was effective. The prognosis of cerebral malaria was poor. Conclusion:The clinical manifestations of imported malaria were complex. Asking the epidemiological history in detail can improve the rate of early diagnosis. Treatment of malaria timely and effec-tive comprehensive therapy can improve the cure rate and the prognosis.