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目的探讨输入性疟疾的临床特点,为早期识别及更好地救治疟疾提供依据。方法对我院2005至2015年收治的449例疟疾住院患者的临床和实验室资料进行回顾性分析。结果 449例患者均为输入性疟疾病例,其中重症疟疾患者48例(10.7%)。血涂片检测可见恶性疟351例,间日疟85例,卵形疟1例,恶性疟合并间日疟12例,未发现三日疟的病例。患者以男性为主(88.2%);平均年龄(37.00±10.22)岁。临床表现以不规则热(74.4%)、疲乏(84.2%)、头痛(71.9%)、脾大(33.4%)为主要症状及体征,常见并发症为中毒性肝炎、急性肾功能不全、休克、严重出血等。实验室特征为血小板减少,红细胞压积下降,胆红素升高及低蛋白血症等。98.2%患者治愈出院,26例出现疟疾再燃,4例出现疟疾复发。结论输入性疟疾以恶性疟为主,重症比例较高,临床症状常不典型。
Objective To investigate the clinical features of imported malaria and provide a basis for early identification and better treatment of malaria. Methods The clinical and laboratory data of 449 malaria inpatients admitted from 2005 to 2015 in our hospital were analyzed retrospectively. Results All the 449 patients were imported malaria cases, including 48 severe malaria patients (10.7%). Blood smear test showed 351 cases of falciparum malaria, vivax malaria in 85 cases, 1 case of oval-shaped malaria, 12 cases of falciparum malaria in combination with vivax malaria and 3 cases of malaria were not found. Patients were predominantly male (88.2%); mean age (37.00 ± 10.22) years. The clinical manifestations were irregular fever (74.4%), fatigue (84.2%), headache (71.9%) and splenomegaly (33.4%) as the main symptoms and signs. Common complications were toxic hepatitis, acute renal insufficiency, shock, Serious bleeding and so on. Laboratory characteristics of thrombocytopenia, hematocrit decreased, elevated bilirubin and hypoproteinemia. 98.2% of patients were cured and discharged, 26 cases of malaria re-ignited, and 4 cases of recurrent malaria. Conclusion The imported malaria is predominantly falciparum malaria, with a high proportion of severe cases and clinical symptoms are not typical.