CAJ | 학술논문

目的:分析泸州市输入性疟疾的流行病学和临床特征,探讨治疗方法.方法:对2012年7月至2014年6月收治住院的18例输入性疟疾患者的临床资料进行回顾性分析. 结果:18例患者均为非洲劳务回国人员,男性居多,年龄为(41.1 ± 6.5)岁,8例在国外曾感染疟疾. 其中,恶性疟11例、间日疟1例、疟原虫未分型6例,77.8%为重症疟疾. 所有病例均发热,9例有寒战、发热、出汗的典型发作,多伴头痛、肌肉酸痛、乏力及恶心,意识障碍3例,贫血7例,脾大5例,双下肢水肿1例,胸腔积液2例. 实验室检查以中性粒细胞比值升高,血红蛋白及血小板数下降,肝肾功能异常多见. 大部分病例采用蒿甲醚联合氯/伯喹八日疗法,经抗疟及对症治疗后所有病例短期内均临床治愈出院,无死亡病例.结论:输入性疟疾患者临床表现复杂,重症比例高,对发热患者,结合流行病学史和临床表现,及时诊断,早期规范抗疟治疗效果好.
목적:분석로주시수입성학질적류행병학화림상특정,탐토치료방법.방법:대2012년7월지2014년6월수치주원적18례수입성학질환자적림상자료진행회고성분석. 결과:18례환자균위비주노무회국인원,남성거다,년령위(41.1 ± 6.5)세,8례재국외증감염학질. 기중,악성학11례、간일학1례、학원충미분형6례,77.8%위중증학질. 소유병례균발열,9례유한전、발열、출한적전형발작,다반두통、기육산통、핍력급악심,의식장애3례,빈혈7례,비대5례,쌍하지수종1례,흉강적액2례. 실험실검사이중성립세포비치승고,혈홍단백급혈소판수하강,간신공능이상다견. 대부분병례채용호갑미연합록/백규팔일요법,경항학급대증치료후소유병례단기내균림상치유출원,무사망병례.결론:수입성학질환자림상표현복잡,중증비례고,대발열환자,결합류행병학사화림상표현,급시진단,조기규범항학치료효과호.
To analyse the epidemiological characteristics and clinical manifestations of the imported malaria in Luzhou, and to explore the best treatment strategy. Methods: Clinical data of 18 imported malaria cases from July 2012 to June 2014 were collected and analyzed retrospectively. Results: All patients were migrant workers returned from Africa, most were male whose average age was (41.1 ± 6.5) years old, 8 patients had past history of malaria in endemic areas.11 patients were infected with plasmodium falciparum and 1 patient was with plasmodium vivax, other patients were with undifferentiated type, 77.8% were considered severe malaria. All the patients had fever,50%of the patients had a typical attack containing shiver,fever, and sweating after fever subsided. In addition to fever, headache, muscle soreness, fatigue, and nausea were found in the majority of patients. 3 patients had disturbance of consciousness, 7 patients had anemia, 5 cases had enlarged spleen, 1 case had lower extremity edema, and 2 cases had pleural effusion. Laboratory testing showed that neutrophil ratio were increased,while hemoglobin and platelet count were decreased,and liver and kidney were dysfunctional in most cases. The most patients were cured by artemether combined with chloride/primaquine. After antimalarial and symptomatic treatment,all the cases were cured clinically in a short term and nobody died. Conclusion: The patients with imported malaria have complicated clinical manifestations, with a high proportion of severe cases. Patients coming with fever, epidemiological history, and clinical manifestations should be diagnosed malaria. Early specific antimalarial treatments are recommmended.