晚期血吸虫病新临床分型方法探讨

目的探讨一种更实用、更科学的晚期血吸虫病新标准化临床分型方法,以便更准确地应用于晚期血吸虫病的普查、诊断、治疗和疗效评估。方法收集湖南省血吸虫病防治所附属湘岳医院1990 01-2010 01住院病人及2004 01-2010 01湖南省晚期血吸虫病医疗救助项目的晚期血吸虫病人共计11 092例,采用现行分型和新分型法2种分型方法分别统计并进行分析比较。结果 11 092例按现行分型法分型:巨脾型5 710例,腹水型2 993例,结肠增殖型834例,侏儒型54例;但有1 501例未列出类型。新分型法为8型:巨脾型、腹水型、结肠增殖型、侏儒型、普通型、出血型、脑病型、混合型。分别为2 870、1 885、425、38、1 281、1 857、553、1 759例;但有424例归于慢性血吸虫病。根据临床特征以及专业角度,提出晚期血吸虫病新的分型。结论新的分型方法能更全面准确地反映血吸虫病临床特征、严重并发症和预后,为诊断与治疗提供更大的帮助。

Recommendation of a new clinical classification of advanced schistosomiasis

Objective To recommend a new clinical classification of advanced schistosomiasis for improving the diagnosis and evaluation of therapeutic effect of advanced schistosomiasis.Methods The medical records of 11 092 cases of advanced schistosomiasis from the Xiang-Yue Hospital from January 1990 to January 2010 and the medical aid centre for advance schistosomiasis in Hunan Province from January 2004 to January 2010 were collected and classified with the current and new clinical classification methods and the results were statistically analyzed and compared.Results Based on the current classification method,there were huge splenomegaly(5 710 cases),ascites(2 993 cases),colon proliferative(834 cases),and dwarf(54 cases).However,1 501 cases were excluded from the current classification.Based on the new classification method,there were 8 types: huge splenomegaly(2 870 cases),ascites(1 885 cases),colon proliferative(425 cases),dwarf(38 cases),universal(1 281 cases),bleeding(1 857 cases),hepatic coma(553 cases),and miscellaneous(1 759 cases).Totally 424 cases were classified into chronic schistosomiasis.Conclusion The new classification method can present a more comprehensive picture for clinical features,severe complications and prognosis of advanced schistosomiasis,and is useful for the diagnosis and treatment of advanced schistosomiasis.