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目的分析四川省南充市13例输入性疟疾的流行病学特征、临床特点和治疗情况,以期提高临床诊治率。方法对南充市某院2010-02/2013-07收治的13例(均为住院病例)输入性疟疾患者的流行病学特征、临床表现、辅助检查、临床治疗情况进行回顾性分析。结果 13例患者均为男性,平均年龄为40.80岁,且有非洲、东南亚务工史。所有病例均从血涂片和或骨髓涂片中检查到疟原虫。临床表现各异,涉及消化、血液、呼吸、神经等多个系统。其主要症状有:寒战、发热、热后出汗。实验室检查主要有血小板减少、肝肾功能异常、肝脾肿大等。所有患者均给与蒿甲醚或联合磷酸氯喹和磷酸伯氨喹治疗,11例治愈,2例死亡,治愈率84.62%。结论输入性疟疾临床表现具有复杂化、多样化的特点,极易导致误诊和漏诊。
Objective To analyze the epidemiological characteristics, clinical characteristics and treatment of imported malaria in 13 cases in Nanchong, Sichuan Province in order to improve the clinical diagnosis and treatment rate. Methods Retrospective analysis was made on the epidemiological characteristics, clinical manifestations, auxiliary examinations and clinical treatment of 13 imported malaria patients (all inpatients) admitted from 2010-02 to 2013-07 in a hospital in Nanchong City. Results All the 13 patients were male, with an average age of 40.80 years and a history of working in Africa and Southeast Asia. Plasmodium was detected in all cases from blood smear and / or bone marrow smear. Different clinical manifestations, involving digestion, blood, respiration, nerves and other systems. The main symptoms are: chills, fever, sweating after fever. Laboratory tests are thrombocytopenia, liver and kidney dysfunction, hepatosplenomegaly and so on. All patients were given artemether or combined with chloroquine phosphate and primaquine phosphate treatment, 11 cases were cured, 2 died, the cure rate was 84.62%. Conclusion The clinical manifestations of imported malaria are complicated and diversified, which can easily lead to misdiagnosis and missed diagnosis.