摘要
目的对江苏省11例输入性重症疟疾病例进行分析,总结重症疟疾的成因、评价诊治效果,为制定切实可行的重症疟疾救治措施提供科学依据。方法收集2019年江苏省11例重症疟疾病例传染病报告信息管理系统和寄生虫病防治信息管理系统的个案信息、流行病学调查报告以及住院病历,对重症疟疾病例的发病时间、临床表现、诊断过程、治疗情况进行汇总分析。结果11例重症疟疾病例中恶性疟10例、卵形疟1例,均为境外输入性病例,在境外生活时间最短22 d,最长1070 d,在国外期间有4例曾患过疟疾。10例恶性疟重症病例均在回国后一个月内发病,其中有3例在回国当天就发病。1例卵形疟重症病例在回国后134 d才开始发病。11例重症疟疾病例发病至就诊平均时间为2.5 d,就诊至确诊平均时间为1.81 d。重症表现为昏迷或休克3例、重度贫血3例、急性肾功能衰竭4例、急性呼吸窘迫综合征1例。1例卵形疟由于出现自发性脾破裂引起重度贫血。除1例卵形疟病例给予双氢青蒿素哌喹片加服伯氨喹片治疗外,其余10例恶性疟重症病例均采用青蒿琥酯注射抗疟治疗,接受抗疟治疗后均痊愈出院。11例重症病例,住院天数最短9 d,最长40 d,平均22.64 d;住院费用最少9270元,最多177174元,平均81520.76元。结论应加强多部门合作,提高患者及时就诊意识;加强医务人员疟疾专业知识和业务的培训,尽早发现输入性疟疾病例并及时治疗,防止因延误诊断造成的重症疟疾。
Objective This paper analyzed 11 cases of severe malaria in Jiangsu Province,summarized the causes of severe malaria,evaluated the effect of diagnosis and treatment,and provided scientific basis for formulating feasible treatment measures of severe malaria.Methods The case information,epidemiological investigation reports and inpatient medical records of 11 severe malaria cases in Jiangsu Province in 2019 were collected from the Infectious Disease Report Information Management System and Parasitic Disease Prevention and Control Information Management System.The onset time,clinical manifestations,diagnosis process and treatment of severe malaria cases were summarized and analyzed.Results Totally 11 cases of severe malaria,including 10 cases of falciparum malaria,and 1 case of ovale malaria,were all imported cases from abroad.The shortest time of living abroad was 22 days,and the longest was 1070 days.Four cases had malaria while abroad.All of the 10 severe cases of falciparum malaria developed within one month after they returned to China,and three of them became ill on the day they returned home.One severe case of Plasmodium ovale began onset 134 days after returning home.The average time from onset to treatment was 2.5 days,and the average interval time from visit to diagnosis was 1.81 days.There were 3 cases of coma or shock,3 cases of severe anemia,4 cases of acute renal failure,and 1 case of acute respiratory distress syndrome.1 case of Plasmodium ovale had severe anemia due to spontaneous rupture of spleen.Except one case of ovale malaria was treated with dihydroartemisinin piperaquine tablets plus primaquine tablets,the other 10 severe falciparum malaria cases were treated with artesunate injection for antimalarial treatment,and all of them were cured and discharged from hospital after receiving antimalarial treatment.11 cases of severe cases,the shortest length of stay was 9 days,the longest was 40 days,with an average of 22.64 days;the minimum hospitalization cost was 9270 yuan,the maximum was 177174 yuan,with an average of 81520.76 yuan.Conclusion It is necessary to strengthen multi department cooperation to improve patients′awareness of timely treatment,strengthen the professional knowledge and professional training of medical staff,find and treat imported malaria cases as soon as possible,so as to prevent severe malaria caused by delayed diagnosis.
作者
王伟明
曹园园
杨蒙蒙
顾亚萍
徐岁
周华云
朱国鼎
曹俊
WANG Wei-ming;CAO Yuan-yuan;YANG Meng-meng;GU Ya-ping;XU Sui;ZHOU Hua-yun;ZHU Guo-ding;CAO Jun(Jiangsu Institute of Schistosomiasis/Parasitic Diseases/WHO Collaborating Center for Research and Training on Malaria Elimination/Key Laboratory of National Health Commission on Parasitic Disease Control and Prevention/Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology,Wuxi,Jiangsu 214064,China)
出处
《中国热带医学》
CAS
2021年第1期29-32,41,共5页
China Tropical Medicine
基金
江苏省公益类科研院所自主科研项目(No.BM2018020)
江苏省“科教强卫工程”项目
江苏省卫生计生委医学科研课题(No.H2017029,No.H2018102)
江苏省卫生计生委科研项目(No.X201828)。
关键词
恶性疟
卵形疟
重症疟疾
输入性
Falciparum malaria
Ovale malaria
severe malaria
imported case
作者简介
王伟明(1965-),男,大专,主任医师,研究方向:疟疾疫情管理;通信作者:周华云,E-mail:hyzhou88@163.com。
