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目的探讨武汉市东西湖区收治的输入性疟疾流行病学和临床特征。方法对2015年2月至2016年12月武汉市医疗救治中心收治的输入性疟疾患者流行病学资料、临床表现、诊治情况等进行描述性分析。结果共收集37例输入性疟疾,恶性疟35例(94.59%),卵形疟2例(5.41%);除发热外,畏寒占54.05%、寒战48.65%、出汗29.73%、头痛37.84%、恶心呕吐62.16%、腹泻18.92%、肌肉酸痛13.51%;此组患者误诊率54.05%;经青蒿琥酯、双氢青蒿素哌喹及伯喹联合治疗,第4d内体温恢复正常者占90.91%,第6d外周血涂片疟原虫检查转阴者占84.38%,至23d累计32例(86.49%)患者治愈出院,复燃1例(2.70%)。结论输入性疟疾以恶性疟为主,患者临床表现复杂多样,并发症多;必须加强疟疾诊断防治知识教育和镜检技能培训和考核,保持对输入疟疾的发现与诊治能力。青蒿素类药物联合治疗输入性疟疾疗效可靠应予坚持。
Objective To investigate the epidemiology and clinical features of imported malaria in Dongxihu district of Wuhan. Methods Descriptive analysis of the epidemiological data, clinical manifestations, diagnosis and treatment of imported malaria patients admitted to Wuhan Medical Treatment Center from February 2015 to December 2016 was conducted. Results A total of 37 cases of imported malaria and falciparum malaria were collected in 35 cases (94.59%) and 2 cases (5.41%) of oval malaria. In addition to fever, chills accounted for 54.05%, chills 48.65%, sweating 29.73% and headache 37.84% , Nausea and vomiting 62.16%, diarrhea 18.92%, muscle ache 13.51%; misdiagnosis rate of 54.05% in this group of patients; artesunate, dihydroartemisinin and piperaquine combined treatment, 4d body temperature returned to normal accounted for 90.91%. On the 6th day, 84.38% of the patients with negative plasmodium negative examination turned negative, 32 patients (86.49%) were cured and discharged to the 23rd day. One case (2.70%) was rekindled. Conclusions The imported malaria is predominantly falciparum malaria and its clinical manifestations are complex and diverse with many complications. Training and assessment on malaria diagnosis and prevention knowledge education and microscopic examination skills should be strengthened to maintain the ability to find and diagnose imported malaria. Artemisinin-based combination therapy of imported malaria should be adhered to.