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目的通过分析中国大陆近30年血吸虫病对人体泌尿生殖系统损害的病例资料,为诊断、治疗和防控非主要寄生部位的血吸虫病提供较系统的数据支持。方法收集、整理大陆1980-01/2009-12多种寄生虫学科技期刊、专著、临床医学杂志、医学书籍等有关我国不同地区的人体血吸病资料,分析发病原因与危害状况。结果大陆近30年报道的血吸虫病对人体泌尿生殖系统损害的病例为169例,分布于四川、云南、湖南、湖北、福建、江西、安徽、江苏、浙江、陕西10省。除福建21例与陕西1例系援外工程人员在国外感染埃及血吸虫回国后发病外,其余147例均来自国内南方日本血吸虫病流行区。患者最小年龄为6岁,最大68岁,男性122人,女性47人,男性患者为女性的2.6倍。患者职业为农民、工人、儿童、学生、教师。3-12月均有发病,患者潜伏期3d2年不等。169例患者中有149例表现为肾脏损害,2例膀胱损害,2例精索、鞘膜、睾丸、副睾的损害,11例卵巢损害,3例子宫损害,2例输卵管损害。吡喹酮治愈率为98.73%,福阿亭治愈率为66.67%,显效率为33.33%,硝硫氰胺治愈率为100%。结论重视人群健康教育,加强粪便无害化管理,提高基层医务人员对该病的诊治水平,注意对来自于疫区患者的病史问诊与实验室检查,不仅是控制血吸虫病流行与传播的有效措施之一,也是防止该病在非常见部位危害人体健康的主要手段。
Objective To provide more systematic data for diagnosis, treatment and prevention and control of schistosomiasis in non-major parasitic sites by analyzing the case data of human genitourinary system damage caused by schistosomiasis in mainland China in recent 30 years. Methods The data of human bloodstream diseases in different areas of China from January 1980 to January 2009 were collected and sorted out, and the etiology and the causes of the disease were analyzed. Results There were 169 cases of human genitourinary system damage reported by schistosomiasis in mainland China in recent 30 years, which were distributed in 10 provinces of Sichuan, Yunnan, Hunan, Hubei, Fujian, Jiangxi, Anhui, Jiangsu, Zhejiang and Shaanxi provinces. Except for 21 cases from Fujian and 1 case from Shaanxi Province, foreign aid workers came abroad after returning from abroad. The remaining 147 cases were all from endemic areas of southern Japan with schistosomiasis japonica. The minimum age of patients was 6 years, the maximum age of 68, 122 males and 47 females, male patients were 2.6 times the women. Patient occupations for farmers, workers, children, students, teachers. 3-12 months have morbidity, the patient’s incubation period 3d2 years without. Of the 169 patients, 149 showed renal damage, 2 bladder lesions, 2 spermatic cord, sheath, testis and epididymis lesions, 11 ovarian lesions, 3 uterine lesions, and 2 tubal lesions. The cure rate of praziquantel was 98.73%, the cure rate of Fu-an Ting was 66.67%, the effective rate was 33.33%, and the cure rate of nitrofurazone was 100%. Conclusions Emphasis is placed on health education of the population to strengthen harmless management of excrement and to improve the diagnosis and treatment of the disease among grassroots medical personnel. Attention should be paid to the medical history examination and laboratory examination of patients from the endemic areas, not only to control the epidemic and spread of schistosomiasis One of the measures is also the main means of preventing the disease from endangering human health in uncommon areas.