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目的报告1例输入性埃及血吸虫病病例的诊治经过,并观察其病理特征及吡喹酮治疗效果。方法收集患者病例资料,经膀胱镜取膀胱组织,切片镜检观察其病理特征。此外,对患者采用吡喹酮进行治疗,治疗前后收集尿液,沉淀后镜检虫卵,孵化毛蚴。结果患者在安哥拉务工3个月,回国后出现间歇性无痛性终末血尿症状,经多家医院抗炎治疗无效。膀胱镜下未见沙样斑,病理切片镜下可见大量嗜酸性粒细胞浸润膀胱黏膜的寄生虫性炎性反应,并可见具有个性特征的虫卵结构。治疗前尿液检出虫卵并孵出毛蚴,吡喹酮治疗后血尿症状消失。治后7 d尿液仍能查到虫卵,但不能孵出毛蚴。治疗后1个月和6个月尿液检查均未查及虫卵。结论输入性埃及血吸虫病病例常被误诊,需对境外务工人员加强健康教育并提高诊断能力。本例病理切片具有典型的虫卵结构和虫卵性肉芽肿特征,患者吡喹酮治疗效果满意。
Objective To report the diagnosis and treatment of one case of imported schistosomiasis japonica and observe its pathological features and the effect of praziquantel treatment. Methods The data of patients were collected, the bladder tissue was taken by cystoscopy and the pathological features were observed by section microscopy. In addition, patients treated with praziquantel, urine collected before and after treatment, microscopic examination of eggs after precipitation, incubation of miracidia. Results The patients were employed in Angola for 3 months. After returning home, they experienced intermittent painless hematuria symptoms and were ineffective after antihypertensive treatment in many hospitals. Cystoscopy no sand spot, a large number of histopathological microscope eosinophils infiltrating the bladder mucosa parasite inflammatory response, and can be seen with the personality characteristics of the egg structure. Urine detected before treatment and eggs hatch miracidia, praziquantel treatment of hematuria symptoms disappear. 7 d after treatment of urine can still find the eggs, but can not hatch miracidia. One month and 6 months after treatment urinalysis did not check the eggs. Conclusions The imported cases of schistosomiasis are often misdiagnosed, which require strengthening the health education and improving the diagnostic ability of overseas workers. The pathological section of this case has the typical features of the egg structure and egg granuloma, praziquantel treatment of patients with satisfactory results.