CAJ | 학술논문

目的探讨胸膜曼氏裂头蚴病的临床特点,提高临床医生对本病的认识.方法报道温州医科大学附属第一医院收治的1例胸膜曼氏裂头蚴确诊病例的临床表现、诊断治疗经过和转归,并以“曼氏跌宫绦虫”、“裂头蚴”、“裂头蚴与胸腔”、“裂头蚴与胸膜”为检索词检索维普数据库、万方数据库和中国学术期刊网络出版总库;以“sparganosis”为检索词检索PubMed数据库.结果患者男,38岁,因“右胸腔积液”入院.依据血液和胸腔积液嗜酸粒细胞增高、血清抗曼氏裂头蚴抗体阳性、内科胸腔镜活检的胸膜组织见寄生虫虫体而确诊为胸膜曼裂头蚴病.吡喹酮75 mg· kg-1 ·d-1治疗3d后痊愈.PubMed、万方数据库、维普数据库、中国学术期刊网络出版总库共检索到5篇胸膜曼氏裂头蚴病相关文献,共6例患者.5例X线胸部平片或CT见胸腔积液,5例血清曼氏裂头蚴抗体阳性,3例胸膜组织病理检查到寄生虫虫体.2例行外科胸腔镜检查.6例均服用吡喹酮后痊愈.结论胸膜裂头蚴属于罕见病,临床表现无特异性.血液和胸腔积液中嗜酸粒细胞增高的患者应行血清曼氏裂头蚴抗体检查,以避免误诊.内科胸腔镜在胸膜裂头蚴病的诊断中具有重要价值.
목적 탐토흉막만씨렬두유병적림상특점,제고림상의생대본병적인식.방법 보도온주의과대학부속제일의원수치적1례흉막만씨렬두유학진병례적림상표현、진단치료경과화전귀,병이“만씨질궁조충”、“렬두유”、“렬두유여흉강”、“렬두유여흉막”위검색사검색유보수거고、만방수거고화중국학술기간망락출판총고;이“sparganosis”위검색사검색PubMed수거고.결과 환자남,38세,인“우흉강적액”입원.의거혈액화흉강적액기산립세포증고、혈청항만씨렬두유항체양성、내과흉강경활검적흉막조직견기생충충체이학진위흉막만렬두유병.필규동75 mg· kg-1 ·d-1치료3d후전유.PubMed、만방수거고、유보수거고、중국학술기간망락출판총고공검색도5편흉막만씨렬두유병상관문헌,공6례환자.5례X선흉부평편혹CT견흉강적액,5례혈청만씨렬두유항체양성,3례흉막조직병리검사도기생충충체.2례행외과흉강경검사.6례균복용필규동후전유.결론 흉막렬두유속우한견병,림상표현무특이성.혈액화흉강적액중기산립세포증고적환자응행혈청만씨렬두유항체검사,이피면오진.내과흉강경재흉막렬두유병적진단중구유중요개치.
Objective To improve the understanding of pleural sparganosis by analyzing a clinical case and literature review.Methods The clinical data of a patient with pleural sparganosis diagnosed by immunoserology and pathology was analyzed.The data of 6 cases from literature reports regarding pleural sparganosis were reviewed through database including PubMed,VIP,Wanfang and China Knowledge Resource Integrated Database.The clinical characteristics,diagnosis and treatment of the 7 cases were summarized and analyzed.Results A 38-year-old man was admitted to our hospital with right pleural effusion,and received the final diagnosis of pleural sparganosis according to increase of eosinophils in blood and plural effusion,positive sparganum-mansoni antibody in serum,and parasite bodies in pleural tissues biopsied with medical thoracoscopy.The patient was treated successfully with consecutive three-day doses of praziquantel(75 mg · kg-1 · d-1).The documents reported 6 cases of pleural sparganosis on the database of PubMed,Wafang,VIP and China Knowledge Resource Integrated Database.Pleural effusion was found in 5 cases by chest radiograph or CT.Serum sparganum-mansoni antibody assays were strongly positive in 5 cases,and sparganosis bodies were confirmed by pleural histological findings in 3 cases.Two patients received video-assisted thoracic surgery examinations.Six patients recovered with the treatment of praziquantel.Conclusions Pleural sparganosis is a rare disease.Patients with increase of eosinophils in blood and pleural effusion should receive serum sparganum-mansoni antibody test to avoid misdiagnosis of pleural sparganosis.Medical thoracoscopy plays an important role in the diagnosis of pleural sparganosis.